Primary Care Reform Proposal 2015

Primary care is the entry point to the health care system for most Ontarians. Primary care providers carry out assessment and treatment as well as referral to secondary and tertiary care and community supports. How primary care performs can often have a cascading impact on other parts of the health care system. In fact, evidence shows that jurisdictions that have a strong foundation of primary care also have better health equity and overall better health system performance.

In February 2015, Minister Dr. Eric Hoskins announced Patients First: Action Plan for Health Care as the blueprint Ontario is following to build a better health system that meets all of the critical and complex needs of its patients.

On December 17, 2015 the Ministry of Health and Long-Term Care (MOHLTC) took the next step in making that system a reality with the release of its Discussion Paper entitled Patients First: Proposal to Strengthen Patient-Centred Health Care in Ontario. The paper focuses on four interconnected and overarching themes that will inform policy and program decisions moving forward:

1  More effective integration of services and greater equity.

2  Timely access to primary care, and seamless links between primary care and other services.

3  More consistent and accessible home and community care.

4  Stronger links between population and public health and other health services.

Most importantly, this proposal will work to achieve the government’s goal of ensuring a primary care provider for every Ontarian that wants one. The proposal has many features, but its core is to provide LHINs with the mandate and tools to improve how Ontario’s primary care sector performs for patients and how it functions as part of the broader health care system.

Beyond this core element, the other components of the strategy include: (i) developing and implementing a common set of performance measures that are tracked and reported on regularly; (ii) identifying sub-LHIN regions to be the focal point for planning, performance improvement and integration activities; (iii) assigning ‘primary care leads’ to support LHINs in their performance improvement, planning and integration activities, and; (iv) reforming current contracts and provincial access programs, such as Telehealth Ontario and Health Care Connect (HCC).

The standardized elements of the approach include a common primary care performance measurement framework and an approach to performance improvement that focuses on sub-LHIN regions supported through a primary care lead. Local flexibility can be applied in several areas, including the implementation of specific initiatives that will improve performance against a common set of indicators, how sub-LHIN regions are identified, and approaches to defining primary care lead roles.

At the preliminary stage of implementation, LHINs were asked to provide the Ministry with an approach to implement this commitment and provide a range of details that will support further joint implementation planning, including:

(i) The identification of sub-LHIN regions that will be the focal point for primary care planning and performance improvement;

(ii) Description of planned approaches to improve performance against key performance measures, including attachment and timely access to primary care;

(iii) Approaches to clinical leadership to facilitate performance improvement, including the type of lead, their roles and how the LHIN would work with them to advance the goals of the strategy.

The Waterloo Wellington LHIN Primary Care Reform Proposal was submitted to the MOHLTC on October 9, 2015.