Six practices win Family Health Team status

Six new Family Health Teams (FHT) in Northern Ontario will be starting up within the year.

In northeastern Ontario, Mindemoya, Hearst, Chapleau, and Cochrane were selected, along with Nipigon and Manitouwadge in northwestern Ontario.

These six were among the 19 FHTs throughout the province that received Ministry approval from the Wave 4 application process announced December 11, 2009.

The Family Health Teams are part of the government's Family Health Care for All Strategy, an initiative to reduce the number of unattached patients, improve access to primary health care, promote chronic disease prevention and management, and provide self-help tools to improve health.

FHTs work as multidisciplinary teams to meet the needs of their communities.

Teams include physicians, nurse practitioners, nurses and possibly other health care providers such as dietitians, pharmacists, social workers and mental health and addiction workers. Record keeping is performed electronically to facilitate access to patient information and test results.

Since 2004, 150 Family Health Teams (FHT) have been established in communities throughout Ontario.

This recent wave of applicants had approximately one month to submit proposals last summer. From the time of approval, the expectation is that FHTs will be up and running within a year. Of the six Northern Ontario teams, many have or are in the process of submitting a development grant application, which fine-tunes each centre's respective requests based on the needs and numbers of the people it serves.


Central Manitoulin

It took three submissions for the Manitoulin Central FHT in Mindemoya to receive the green light. The long drawn-out process forced them to look at what they were doing and why, said primary care provider Dr. Nick Jeeves.

"You have to have a good idea what services you can bring to the community, why it's important and how you can make it meaningful," he said.

Serving a catchment area of approximately 6,000, he and five physicians, one nurse practitioner and a registered practical nurse work out of the basement of the hospital. They have been working under the Rural and Northern Physician Group Agreement, a salary-based model whereby the practitioners work collaboratively to provide services to the emergency room, inpatient department and community through the clinic.

Jeeves said they serve an older population and many First Nation patients.

The district has the highest rate of diabetes in the province for both men and women. Consequently, chronic disease management and care is a big concern. He anticipates the FHT will enable greater sharing of resources and education with community agencies to give people the proper tools for improved self-care and prevention.


Nipigon

Nipigon submitted a joint application from the hospital and physicians.

"We have a picture of one-stop shopping for the whole continuum of health care - from primary care to prevention and chronic disease management," said Catherine Collinson, CEO and chief nursing officer, Nipigon District Memorial Hospital. "In small communities, hospitals and physicians have to work closely together. I think it is the best way to go."

The Nipigon District FHT serves approximately 6,000 people, of which 28 per cent are First Nation. Presently, there are five physicians and one nurse practitioner serving the community. The hospital has a diabetes education program, which Collinson said the team hopes to expand in partnership with the FHT. The clinic is located on hospital grounds in a separate building. Plans to build an extension are part of the vision, as is the recruitment of additional health care professionals, including another nurse practitioner, a diabetes educator, system navigator and/or a mental health and addictions counsellor.


Chapleau

In Chapleau, the hospital is administering the clinic because this small town of 2,500 currently has no doctors, only locums.

Gail Bignucolo, CEO of Chapleau Health Services, said three medical students have been recruited to serve the community as primary care doctors beginning in 2012. The FHT is funded for four physicians, so the community is still recruiting. A new building will be constructed near the hospital to accommodate the team. Bignucolo has involved the new recruits in the design and planning process, which she anticipates will be completed by the time they arrive.

"We're a multi-service agency," Bignucolo said. "We run not only the hospital, but also the long-term care (facility) and a lot of the community programs like diabetes education and community home support services. Having a family health team is a natural progression for us to add more health professionals to the team and expand those services."

Chapleau hopes to add a traditional healer to its team to serve the three Aboriginal communities in the area.


Hearst

In Hearst, the proposal also involves partnerships to enhance services to outlying communities. The NORD-ASKI Regional Family Health Team will serve a population of about 10,000 in Hearst, Mattice and Val Coté.

The medical centre in Hearst will undergo some physical changes to accommodate a multi-team approach, said Jocelyn Blais, project manager and recruitment officer. An electronic medical record system will be implemented to link the three areas and the hospital, increasing efficiency and access to patient records.

Before applying for the FHT, it was important to get the six physicians on board, Blais said.

"They know it will require change and adjustment, but they are willing to do that because in the long term, it is one of the best solutions."

The FHT model will help with recruitment, but the region's ailing forestry sector will make it difficult for the spouses of physician recruits to find employment, said Blais.

The multi-disciplinary team approach will also help to relieve physician workloads.

"The services will be better adapted to meet the communities' needs, and physicians will have more time to spend on complex cases," he said.

Cochrane's comprehensive family practice was also awarded FHT status. The transition will go smoothly for its catchment population of about 8,000 because the team has been involved in one of six provincial pilot programs called the Shared Care Pilot Project.

Dr. Rita Affleck said the program allowed for the recruitment of nurse practitioners, RNs and registered practical nurses to work alongside physicians.  FHT status will now allow the team to expand.

"We already know it is working out well for patients in terms of access to care and quality of care," she said. "Patients are very satisfied right now, even just to be able to see the nurse to have their blood pressure taken or other things the physician doesn't necessarily have to do. People can call and come in the same week."

Affleck said it wasn't always like that, but the Shared Care Pilot project has improved services. She anticipates that programs and services will continue to improve as the practice transitions to a FHT.