April 24, 2018
President of SOHC (Support Our Health Care) and
BC Rural Health Network Lead.
Vancouver Hyatt Regency April 13, 2018
Achieving High-Performing Primary and Community Care: the Critical Role of Health Science Professions
The conference opened with a welcome from Val Avery, Health Sciences Association (HSA) President and a First Nations Welcome from Coast Salish Elder Roberta Price.
The keynote speaker was the Honourable Judy Darcy, BC Minister of Mental Health and Addictions. She gave a brief overview of her first 9 months in office and made the following points:
• collaboration and team building on the “front lines” is critically important to address the opioid crisis
• addressing the crisis will require “all hands on deck”
• the focus of the Ministry is on child and youth prevention, First Nations, and the high rate of death associated with substance use
- most people who die from opioid overdose die alone
- 3 out of 4 are male between the age of 30 and 59
- 1 in 10 are indigenous
• problems with the current system:
• “no coordination of services”
• gaps in the service – fragmentation lack of a team approach
• the goal is to develop an “ask once” system that will take you where you need to go
• addressing the problem by building a better system; funding for:
• naloxone dispersal
• establishing overdose prevention sites
• establishing designated teams in each Health Authority
• recognizing that parents are often the “first responders”
• province wide coverage by “robust, interdisciplinary teams”
• addressing the social determinants of health
• making connections
Minister Darcy closed her remarks by recognizing the valuable work being done by the HSA and asked for advice and direction from HSA members on how to “close the gaps”.
Andrew Longhurst, HSA Researcher and Policy Analyst, was the next speaker who outlined the aim of the conference and made the case for change in achieving a system of high-performing primary and community care in BC.At registration, each participant was assigned a table location. For the first workshop, entitled Understanding the critical role of each discipline in primary and community care, it became apparent that each table consisted of health workers from the same or similar disciplines. Each table identified their roles and reported back to the entire group. This gave a good overview of the scope of health services represented at the conference.
There were three excellent panels assembled to present at the conference. The first identified several exemplary primary and community care models in BC. Panelists were:
• Cayce Laviolette – Social Worker with the Division of Family Practice on the Sunshine Coast
• Cindy Roberts – Consultant and co-founder of the Osteoarthritis Service Integration System (OASIS)
• Elise Durant – Social Worker and Clinical Coordinator of Providence Health’s Innter City Youth Program
• Yasmin Jetha – Vice President, Community Services, Vancouver Coastal Health (VCH)
• Chris Petrus – Physical Therapist with the Visiting Vancouver’s Elders (ViVE) program – operated by VCH
The panel was facilitated by Edith MacHattie, Occupation Therapist and Co-chair of the BC Health Coalition
My reaction to the first panel was one of envy. Each of the “promising models of care” consisted of robust primary and community care teams that provided a full range of services to people living in a specific urban geographic area. From the rural perspective, my question was “how do you provide a multi-disciplinary team based approach when key elements of the team are missing?”
The second panel provided frontline stories on the overdose crisis and how to strengthen team-based addictions care. Panelists were:
• Dr. Rupinder Brar – Primary Care and Addictions Medicine Physician, PHS Community Services Society
• Kaye Robinson – Social Worker, Rapid Access Addiction Clinic
• Sheri Steffen – Recreation Therapist, Rehabilitation and Recovery Services, Fraser
• Tammam El-Khodor – Occupational Therapist, Community Rehabilitation and Resource Team, VCH
The panel was facilitated by Nicki Khanamoui, Independent Consultant and Facilitator and Director of Strategic Initiatives at PainBC.
Panelists shared their knowledge and frontline experience with clients who have addictions. The overdose crisis provided some compelling stories that underscored the need for improved team-based addictions care.
The topic for the final panel was Achieving team-based primary and community care in BC: overcoming health system barriers. The panelists were:
• Adam Lynes-Ford – Campaigner with the BC Health Coalition and co-chair of the Catherine White Holman Wellness Centre
• Dr. Margaret McGregor – UBC Department of Family Medicine
• Pam Mulroy – Northern Health Authority
• Kimberlyn McGrail – Associate Professor, UBC
The panel was facilitated by Marcy Cohen, Health Policy Analyst and supportive worker with the Canadian Centre for Policy Alternatives.
The panelists focused on the success stories and challenges that exist in the delivery of primary health care. The major points included:
• a physician dominant model where the General Practice Service Committee (GPSC) is cemented as the model of negotiation between the government and doctors – the result: primary physician care rather that primary health care
• physicians have a very powerful lobby and stand to gain from a physician-centric model
• rural and especially rural remote areas lack adequate resources – primary health care model is what works best for rural remote communities but without adequate resources it is difficult to make the model function
• the fee-for-service model doesn’t encourage multi-disciplinary care – there is change, but minimal (the metaphor of an ocean liner changing direction)
• a team-based identity requires efficient ways to share patient information – incompatible electronic medical record systems make this a big challenge
• the community has a role to play in decision making – community consultation is needed to determine what an effective primary health care model looks like
• there needs to be a paradigm shift
• group medical visits have been shown to be an efficient way to provide care to
patients with the same or similar chronic conditions e.g. diabetes
• the Community Health Centre model has a proven track record with health care and social care working together.
The conference was well organized and provided participants with a vast amount of “food for thought”.
The HSA is to be commended for this ground breaking approach that brought together health science professionals, staff from the Ministry of Health and the Ministry of Mental Health and Addictions, physicians, and community healthcare advocates.
For me, the message was clear: health science professionals are important members of the primary health care team and they represent an important voice in the transformation of health care delivery in the province.