RTHL Board to Board Meeting Dr Andrew Everett SELHIN Primary Care Lead (Lanark, Leeds & Grenville)

Primary Care Reform in Ontario Review the why ●Cost ●Performance ●Equity Review the Baker Price Report Vision Principles Review how primary care is being measured

The Commonwealth Fund 2014

Primary Health Care Expert Advisory Committee Vision That care will be: timely, comprehensive and coordinated, person-centred and community-based, interprofessional team-based, safe, with a commitment to continuous quality improvement, and of good value both financially and in improved health outcomes.

Primary Health Care Expert Advisory Committee Principles Building on the principles articulated in the 1994 Special Report in Canadian Family Physician, the Committee identified the following principles to guide its work: The primary care system supports engaged, empowered citizens and their circle of care. The primary care system is equitable. Every citizen is provided access to a primary care provider, either family physician and/or nurse practitioner. The primary care provider works in conjunction with an inter-professional team to provide comprehensive and continuous care.

Primary Health Care Expert Advisory Committee Principles The system is built on joint accountability: Each primary care provider group is responsible for a given population and their primary health care needs. Both provider groups and citizens are expected to use the system responsibly. Each primary care provider group is responsible for the care of their patients within their community and in other parts of the system, acting as the centre or home for their care throughout the health sector. The primary care system accommodates variation due to geography and builds on existing infrastructure. Linkages and connections with the broader health and social system are strengthened and support horizontal and vertical integration while minimizing fragmentation of care.

Primary Health Care Expert Advisory Committee Principles The system recognizes and functions within current fiscal constraints. The focus is on the functions necessary for effective primary care delivery, not on who performs them. Current structures and organizations will be leveraged wherever possible, and when new structures are required they will replace an existing entity, not add a new one. The recommendations are implementable in the short to medium term and with a reasonable expectation of success. The recommendations support local governance and accountability, and ensure alignment with ministry provincial policy priorities.

Health Quality Ontario Quality Indicators Primary Care Provider RegisteredOntario 94%SELHIN 97.3% (LHIN rank 1/14) Timely AccessOntario 44.3%SELHIN 39.5% (LHIN rank 11/14) Same day phone responseOntario 77.9%SELHIN 85.3% (LHIN rank 1/14) Involved in care & treatment decisionsOntario 86.2%SELHIN 90.9% (LHIN rank 1/14) Medication review in last yearOntario 69.2%SELHIN 73.5% (LHIN rank 2/14) Diabetes ComplicationsOntario 4.1%SELHIN 4.7% (LHIN rank 10=/14) Hospital 7 day post hospital visitOntario 29.1%SELHIN 27.1% (LHIN rank 9/14) 30 day readmissionOntario 13.5%SELHIN 13.2% (LHIN rank 7/14) Overdue for Colorectal Cancer ScreeningOntario 41.5%SELHIN 43.9% (LHIN rank 9=/14)

Small Group Discussion 1. What would a successful integrated primary care system look like in Rideau Tay Health Link? 2. Development of an integrated primary care model will require close collaboration with partners such as CCAC, hospitals, community support services, Addictions and Mental Health, etc. We would like you to reflect on your experiences and speculate on how deliberate collaboration would ensure a successful reform of primary care?