Patients First: A Proposal to Strengthen Patient-Centred Health Care


Ministry of Health and Long-Term Care (MOHLTC)

Patients First: A Proposal to Strengthen Patient-Centred Health Care in Ontario Ontario Pharmacy Research Collaboration Summit January 20, 2016

Today’s Objectives


Provide an overview of the MOHLTC’s proposal to strengthen patient-centred care.


Gather your feedback and input on the proposal.


Achievements of Ontario’s Health System • Over the past decade, Ontario’s health care system has improved in a number

of important ways:

Inter-professional models of family health care serve nearly 4 million patients.

94% of Ontarians now have a regular family health care provider.

Emergency room wait times have improved despite substantial increases in volumes.

Long-Term Care

Physicians Care Providers

92% of home and community care clients say their care experience has been good, very good or excellent.

Patients Community Services

LHINs Hospitals 3

Sustained Commitment


Change & Adaptation

The Need for Continued Improvement •

Despite the progress we have made over the past ten years, we still need to do more to ensure that the health care system is meeting the needs of Ontarians. Some Ontarians are not always well served by the system 1

Indigenous peoples, Franco-Ontarians, members of diverse and cultural groups, newcomers), people with mental health and addiction challenges, others


Many Ontarians have difficulty seeing their primary care provider when they need to, especially during evenings or weekends.


Some families find home and community care services inconsistent and hard to navigate; family caregivers experience high levels of stress.


Public health services are disconnected from parts of the health care system; population health not a consistent part of system planning.


Health services are fragmented in the way they are planned and delivered; fragmentation can affect the patient experience and can result in poor health outcomes.


The Ministry’s proposal for health system transformation has four components 1

Effective Integration of Services and Greater Equity


Timely Access to, and Better Integration of, Primary Care

• •

Make LHINs responsible for all health service planning and performance. Identify sub-LHIN regions as the focal point for integrated service planning and delivery (note that these regions would not be an additional layer of bureaucracy).

LHINs would take on responsibility for primary care planning and performance improvement, in partnership with local clinical leaders.


More Consistent and Accessible Home & Community Care

Direct responsibility for service management and delivery would be transferred from CCACs to the LHINs.


Stronger Links to Population & Public Health

Linkages between LHINs and public health units would be formalized.


1. More Effective Service Integration, Greater Equity • The mandate of LHINs would be extended to play a greater

role in primary care, home and community care, and public health. • LHINs would identify smaller geographic regions that follow

recognized care patterns. These LHIN sub-regions would not be the focal point for local planning and service management and delivery. • LHINs and LHIN sub-regions would assess local priorities,

current performance, and areas for improvement to achieve integrated, comprehensive care for patients.

Anticipated Performance Improvements  Care delivered based

on community needs  Appropriate care

options enhanced within communities  Easier access to a

range of care services  Better connections

• The expanded LHIN role would be inclusive of the voices of

Indigenous peoples, Franco-Ontarians, newcomers, and people with mental health and addictions issues in order to better address their health outcomes.

between care providers in offices, clinics, home and hospital


2. Timely Access to Primary Care, and Seamless Links Between Primary Care and Other Services • High quality primary health care is the foundation of any

high-performing health care system. • Each LHIN and LHIN sub-region would be responsible for

organizing local primary care to ensure access to high quality, integrated care for the patients in their region. • LHINs would work closely with patients and primary

care providers to plan and monitor performance, and to identify ways to improve care that are tailored to the needs of each community. • LHINs and LHIN sub-regions would be responsible for

ensuring that local patients have access to primary care. This does not mean that patients would be required to receive care in their region or that patients would no longer be able to choose their provider.

Anticipated Performance Improvements  All patients who want

a primary care provider have one  More same-day, next-

day, after-hours and weekend care  Lower rates of hospital

readmissions; lower emergency department use  Higher patient



3. More Consistent and Accessible Home & Community Care • Essential home care functions would be moved into the

Anticipated Performance Improvements

LHINs to enable better integration with other parts of the health care system. • LHIN boards would have responsibility for oversight of

Easier transitions from acute, primary and home and community care and long-term care

Clear standards for home and community care

Greater consistency and transparency around the province

Better patient and caregiver experience

home and community care. • Home care coordinators would be increasingly focused on

LHIN sub-regions and placed in primary care settings. • Most home care services would continue to be provided by

current service providers. Over time, contracts with these service providers would be better aligned with LHIN subregions. • The ministry’s 10 step plan Patients First: A Roadmap to

Strengthen Home and Community Care would continue with greater support and renewed emphasis under LHIN leadership.


4. Stronger Links Between Population & Public Health and other Health Services Anticipated Performance Improvements

• Population health – defined as the health outcomes of a

particular community – is a core responsibility of local public health units in Ontario. 

Health service delivery better reflects population needs

Public health and health service delivery better integrated

Social determinants of health and health equity incorporated into care planning

Stronger linkages between disease prevention, health promotion and care

• The proposed reforms would integrate population health

and health system planning and delivery. • LHINs and public health units would formalize the

alignment of their work and planning to ensure that population and public heath priorities inform planning, funding and delivery. • The ministry plans to modernize the Ontario Public Health

Standards and Organizational Standards. • The ministry would appoint an expert panel to advise on

opportunities to deepen that partnership between LHINs and local boards of health and to improve public health capacity and delivery.


Questions, Comments, Discussion • Where do you see Ontario’s pharmacists fitting into these proposals? • What opportunities do you see to further improve pharmacist integration in healthcare system if these proposals come to fruition? • What challenges do you see for pharmacists and/or the system overall in implementing these proposals if adopted? • Would these proposals impact (positively or negatively) what you see as challenges facing the patients and populations you serve? Additional feedback and questions can be sent to

[email protected]



Patients First: A Proposal to Strengthen Patient-Centred Health Care

Ministry of Health and Long-Term Care (MOHLTC) Patients First: A Proposal to Strengthen Patient-Centred Health Care in Ontario Ontario Pharmacy Resea...

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