Building on five position papers developed by the Primary Health Care Planning Group, the Expert Advisory Committee on Strengthening Primary Health Care in Ontario provided the Ministry of Health and Long-Term Care with recommendations for redesigning the primary care sector in early 2015 (the Price Report). It is anticipated that the Ministry will respond to these recommendations and propose greater devolution of the primary and community-based healthcare sector to the local level.
While the details of such a transformation are as yet unknown, it is assumed that organizations responsible for planning and commissioning primary care services for a defined population of residents (“patient care groups” in the Committee’s report) will be formed at the sub–Local Health Integrated Network (LHIN) level.
To prepare itself to support its membership, the Ontario College of Family Physicians commissioned Preparing for a Devolved, Population-Based Approach to Primary Care to provide background and information that will help the College become more knowledgeable about this type of primary care model in other jurisdictions.
The brief will also help the College to prepare to contribute to and shape the coming change in Ontario. The document is based on published and grey documents and several key informant interviews. It is mainly based on the experiences of primary care commissioning groups (local organizations that plan, fund, oversee and sometimes deliver care for a defined population) in the United Kingdom (U.K.), Australia and New Zealand. Where applicable, it also includes insights and parallels from the implementation of Family Health Teams (FHTs) and Health Links in Ontario. These jurisdictions have had fund-holding/commissioning roles in primary and community care for some time and have subsequently implemented various changes to these models.
This brief reviews the structure and the successes and challenges related to local-level planning and commissioning models, as well as critical factors to consider at the initiation of change, the key levers of change, and the requirements for organizational development and management.