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January 10, 2025
Toronto, ON – Primary care in Canada is at a breaking point, with 6.5 million Canadians—2.5 million in Ontario alone—lacking access to a primary care provider. As part of a new strategy to tackle this crisis, Ontario’s Primary Care Action Team, led by Dr. Jane Philpott, former federal cabinet minister and family physician, has set an ambitious goal: by 2029, every Ontarian will have access to a family doctor or nurse practitioner within a publicly funded, team-based care model.
Dr. Philpott envisions a “health home” system, as outlined in her book Health for All. This model promises integrated, team-based care, ensuring every individual has access to a primary care team near their residence. The plan also addresses the mobility of patients, ensuring continuity of care when individuals move within the province.
The Primary Care Action Team recently unveiled five guiding principles aimed at reshaping Ontario’s approach to primary health care. These principles were proposed following discussions at the 2024 Trillium Primary Care Research Day and are designed to drive meaningful change in the system.
1. Minimum Standard Team Composition
Primary care teams must include a core group of health professionals, including family physicians, nurse practitioners (NPs), dietitians, nurses, occupational therapists, pharmacists, physiotherapists, and social workers. Current models like Family Health Teams (FHTs) demonstrate the potential of these interprofessional groups, though evidence-based guidelines are needed to determine optimal team composition and patient-to-provider ratios.
2. Direct Patient Access to Team Members
Empowering patients to book appointments directly with team members—without referrals—will improve access and efficiency. For instance, the UK’s National Health Service allows patients to book directly with physiotherapists for musculoskeletal issues, reducing costs while maintaining health outcomes. Ontario’s system must adopt similar practices to unlock the full potential of primary care teams.
3. Infrastructure for Health Neighborhoods
A seamless “health neighborhood” requires robust communication systems among primary care teams and other care providers. Shared electronic health records (EHRs) are essential for coordinated care. Allowing patients access to their own EHRs would further strengthen engagement and bridge gaps between primary care and external services like pharmacies, mental health counselors, and community organizations.
4. Comprehensive Data Collection
Systematic data collection is critical to improving accountability and quality in primary care. While Family Health Teams have existed for nearly two decades, they lack consistent methods for tracking care and outcomes provided by non-physician team members. Models like Community Health Centers demonstrate how integrating EHR data with administrative systems can measure impact and drive quality improvement.
5. Shared Leadership Structures
Governance of primary care teams should reflect the communities they serve. Shared leadership among diverse health professionals, alongside patient and family representation, is vital for achieving patient-centered care. Only 24 Family Health Teams currently have community-led governance, compared to all Community Health Centers. A more inclusive leadership model is needed to align decision-making with community needs.
Transforming Ontario’s Primary Care
“Achieving universal access to primary care teams is within reach,” says Dr. Philpott. “But it requires new ways of thinking, working together, and being accountable to communities.”
Ontario’s Primary Care Action Team faces a challenging mandate but has a clear path forward with these five principles. By prioritizing interprofessional collaboration, patient empowerment, and community-led governance, Ontario has an opportunity to set a global standard for equitable, accessible, and comprehensive primary care.
As the province moves forward, the focus remains on ensuring that every Ontarian has a health home, fostering a healthier and more equitable future for all.
Article provided by The Conversation.
