Context. Background. Draft for Discussion

Transcription

1 Executive Summary Toronto Central LHIN Primary Care Reform Submission to Ministry of Health and Long Term Care (MOHLTC) Updated Summary January 18, 2016 Context Strategic Plan The Toronto Central LHIN submission reflects the LHIN strategic plan and builds on its ongoing dialogue with primary care providers. One of our four strategic priorities is: Transforming Primary Health and Community Care. A patient s long-term relationship with their primary health care team is the cornerstone of care. It has the potential to anchor efforts to drive integration and coordination of the patient journey. In order for primary health care to make a meaningful contribution to system integration, the LHIN will need to find ways to engage primary health care providers in a shared accountability for patient outcomes. Transforming primary health and community care means creating conditions that empower patients to get the care they need with ease. The LHIN will invest in strategies that make every door the right door, simplifying access and driving integration. Ontario Patient s First Discussion Paper The Minister of Health and Long Term Care released a discussion paper on December 17, 2015 to obtain input on a proposal that would see considerable change to the role and responsibility of LHINs. If approved, LHINs would be asked to identify smaller sub-regions to be the focal point of planning and service management and delivery and work with local clinician leaders to take responsibility for local planning and performance management. In addition, direct responsibility for service management and delivery of home care services would be transferred from CCACs to LHINs and linkages between the LHINs and public health would be formalized. Background In early October 2015, the TC LHIN responded to a request from the Ministry of Health and Long Term Care to complete a draft template outlining our planned implementation framework to advance primary care access and performance. 1

2 Since submitting this template the LHIN has continued consulting with health system partners and advisors and based on the input received from these consultations key elements of the submission have evolved and the direction has been updated. The TC LHIN is continuing the dialogue and the framework and direction will continue to evolve as it works with providers from across the health system to find the best way to implement its strategic plan and improve local primary care service delivery. In the interests of continuing transparency and openness in the processes the submission summary has been updated below. Updated Executive Summary The Toronto Central LHIN will build on its Health Links experience with 9 sub-lhin geographies to move towards integrated planning and service delivery in 5 Sub-LHIN regions. This is consistent with our Strategic plan priorities: Designing health care for the future; Taking a Population Health approach; Transforming Primary Health and Community care and achieving excellence in operations. We will be moving on multiple tracks simultaneously to advance more quickly to a mature state model. The key elements of our plan are: 1. Organize Primary Care around our 5 sub-lhin regions. 2. Integrate Home and Community Care into our sub-lhin population model working in close collaboration with TC CCAC. 3. Establish local resource supports to anchor planning and service delivery in the emerging 5 Sub- LHIN regions. This submission focusses almost entirely on the first element which is to organize Primary Care and coordinate supporting services at 5 sub-lhin population level. We intend to spend the next 3 to 6 months developing a work plan with our current Primary Care and Health Links leadership and consulting broadly with physicians, primary care providers, other health service partners, patients and residents; and at the same time creating a sub-lhin regional support structure as a starting point towards integrated service delivery and planning within our 5 sub-lhin regions. Primary Care within Toronto Central LHIN To advance primary care in the TC LHIN, the system must be viewed as part of the broader primary health care continuum which includes the many providers who work together to contribute to the health of the 2

3 population. Primary health care plays a central role in building a health system that is sustainable, accessible, provides quality care, and is relevant to individuals requiring services. Primary Care will be aligned in 5 sub-lhin geographic areas within the LHIN to ensure that residents within the LHIN and those that come into the LHIN can access the services, and receive the quality care they need in a sustainable manner. Secondly the Primary Care Strategy will be fully integrated in conjunction with other core TC LHIN identified strategies to integrate and coordinate the delivery of home and community care, and mental health and addictions services. The goal of this work is to ensure the system is designed cohesively and in tandem to provide for a mature model that is responsive to the needs of providers and fully integrated and accountable for the patient outcomes it serves. The movement to a mature system design encompasses 5 integrated health service delivery regions that provide a core basket of services that have a particular expertise on the health needs of the populations that reside in each. Whereby the providers contained within have the ability and resources to successfully deliver better health outcomes while being accountable through collaboratively developed and transparent performance reporting to ensure the LHIN and MOHLTC strategic outcomes are achieved. Creating the structure and Framework for Success The information contained within the template outlines the initial thinking on re-alignment of existing, and new structures that TC LHIN will enact as we move to a delivery model that is tailored for a local approach. A key principal of the design is to work in partnership with local leaders to maximize the current resources, utilize the extensive infrastructure, capabilities and expertise that is unique to Toronto Central LHIN such that the dichotomy is reached; Patient outcomes continue to improve and the system is sustainable in the longer term. The TC LHIN recognizes that improvements in primary care access and outcomes requires a system-wide approach to change. All local health care providers through the spectrum of care touch and impact on the success of primary care from home care, community services through specialist consultations, diagnostics and hospital care for the outcomes described below to be achieved there will need to be collaboration and change across the system. TC LHIN Mature Model Outcomes With the implementation and move to a model consisting of 5 Sub-LHIN regions the LHIN continues to plan with the following draft vision in mind. For Patients: Every resident will have access to a primary care practitioner who provides them with accessible, high quality care regardless of where they reside within the TC LHIN. As part of their primary care 3

4 experience, patients will receive access to all necessary primary care health professionals, with care coordinated by their primary care provider; TC LHIN residents will be able to receive primary and community care services closer to their homes. Their satisfaction with the services they receive will be measured and used to continuously improve our health care system. The patient voice will be active in both their personal care and for system planning and design. Patients will receive seamless and connected care no matter how many care settings and health care providers they have contact with. Their medical information will follow them through their health system journey and they will feel as though all of their health providers are working toward one care plan. Culturally aware and culturally competent health services will be proactively available to ensure positive patient experiences and timely care for all individuals. The health system is there for patients at their time of need and remains consistently available and supportive over the course of their health care journey. For Physicians and Nurse Practitioners: Physicians will have readily available mechanisms for connecting their patients to other health care services within their community including support services delivered by non-health service providers such as those provided by the City of Toronto or the United Way. Physicians will receive improved and seamless information about the other health care services that their patients are receiving. Medical records will follow the patient and be accessible to physicians so that they are supported with a more complete patient profile. Health human and other infrastructural resources are matched to population need to ensure physicians are appropriately supported with inter-professional resources available to their practices that will support both care delivery and improved capability. For Caregivers/Families: Caregivers, families, and patients will be treated as one. Caregiver and family involvement in planning and decision making is encouraged so that they can better support their loved ones at home. Caregivers/families will have easier access to the services that they need as providers are better connected with one another. Improved information flow among health service providers, patients and caregivers/families. Caregivers/family members satisfaction with services will be measured and will influence continuous health care quality improvement. We look forward to your comments and working in partnership to ensure success. 4

5 Next Steps The TC LHIN will be consulting with primary health care and other local health system providers during February and March These consultations are the beginning of an ongoing dialogue at the local sub- LHIN level that will inform and shape the vision and how the LHINs strategic plan is implemented. Following the initial consultations the LHIN will develop a sub-lhin level coordinating and support structure that will encompass the work from the Health Links and build local planning, collaboration and integration capacities. During, and throughout the implementation, the LHIN is committed to transparency and ongoing dialogue with providers and residents. Local primary care integration must be led by local health care leaders and informed by residents and health care providers from across the system. To be successful, all health system partners must be prepared to participate, collaborate and make the changes needed to achieve the draft vision. An initial planning goal is to engage at the sub-lhin level, supported with necessary data, analytics and resources, to allow for the submission of initial recommendations to the LHIN on priorities for change in the 2016/2017 fiscal year. Work on other complementary changes will continue in parallel and will be aligned and coordinated through the LHINs existing and emerging structures. We welcome your input and feedback on this process and the proposed vision by visiting our website at torontocentrallhin.on.ca or contacting greg.stevens@lhins.on.ca. 5