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Public priorities for primary care in Canada: Report on insights and actionable recommendations from 5 provincial
Tara Kiran1, Rachel Thelen2, Kirsten Szymanski3
1Staff physician in the Department of Family and Community Medicine and Scientist in the MAP Centre for Urban Health Solutions at St Michael's Hospital, Unity Health Toronto in Ontario; is Fidani Chair of Improvement and Innovation at the University of Toronto; and is Associate Professor in the Temerty Faculty of Medicine and the Institute of Health Policy, Management and Evaluation at the University of Toronto.
Objective:
To present recommendations from 5 provincial reference panels conducted as part of the OurCare initiative, the largest-ever national effort to engage the public about the future of primary care in Canada.
Composition Of The Committee:
Each provincial reference panel included 30 to 36 members of the public who were randomly selected to represent the demographic characteristics of that province. Panels were held in Nova Scotia, Quebec, Ontario, Manitoba, and British Columbia.
Methods:
OurCare panelists spent up to 40 hours learning about primary care from experts in each province and deliberating to reach consensus on values, issues, and recommendations. Provincial advisory committees were composed of clinician leaders, policy-makers, and researchers. In each province, OurCare panelists collectively developed a report summarizing the results of their deliberations.
Report:
Panels in all 5 provinces identified 3 major challenges affecting primary care: a growing health workforce crisis, inequitable access to care, and fragmented services. Participants emphasized that everyone in Canada should have timely, equitable access to primary care, and called for a system that is prevention-focused, inclusive, patient-centred, and accountable. In all provinces, panelists recommended expanding team-based care, improving health professional retention and recruitment, ensuring patient access to health records, addressing the social determinants of health, and educating and empowering patients.
Conclusion:
Results from the reference panels provide actionable direction for health system leaders, policy-makers, family physicians, and others engaged in health system improvement.
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