The objective of this paper, Best Advice: Patient Rostering in Family Practice, is to provide guidance for Canadian family physicians who have already implemented or are considering patient rostering in their practices. The paper highlights the benefits and limitations of patient rostering and provides information to help physicians implement rostering in family practice.
The Canada Social Transfer (CST) is the primary source of federal funding in Canada that supports provincial and territorial social programs, specifically, post secondary education, social assistance, social services, and programs for children. In 2007, legislated funding for the CST was extended to 2013-2014, putting it on the same long-term predictable legislative track as the Canada Health Transfer (CHT). As both 2014 and the review of the CHT and CST are fast approaching, conversations have begun at the federal level about the Canada Health Transfer. The Canadian Association of Social Workers (CASW), a national organization that has adopted a pro-active approach to addressing issues pertinent to social policy and social work practice in Canada, calls for a similar approach of review of the Canada Social Transfer (CST) to be undertaken at the federal level.
In light of this approach, the CASW placed a request for a proposal to explore historical, current, and potential roles, policies, and practices related to the Canada Social Transfer. Given that the Canada Social Transfer is the primary source of federal funding in Canada that supports provincial and territorial social programs, specifically in the areas of post secondary education, social assistance, social services, and programs for children, it has considerable implications for the well-being of all Canadians and for the sustainability of Canada’s social programs. While the Canada Health Transfer is attached to a set of conditions through the Canada Health Act, the Canada Social Transfer is a largely unconditional transfer, a fact that has come into question over time by scholars, policy-makers and activists.
The history of health care in Canada is linked to the vital role played by family practice and our nation’s family physicians. As we deliberate the future of our health care system it is essential that we contemplate the place that will be assumed by family physicians and their practices. The vision of family practices serving as Patients’ Medical Homes is intended for the consideration of all who are concerned about the health of Canadians and the health care provided for them. This includes not only family physicians, nurses, and the health professionals and staff who work with them in their practices but also a broad range of other stakeholders in governments, medical schools, and other health care organizations whose responsibilities and commitments intersect with those delivering family practice services. Most important, this vision is intended for the people of Canada, over 30 million of whom are currently cared for by family physicians in urban and rural family practices throughout the nation, as well as the four to five million who do not yet have family physicians.
In October 2009, the College of Family Physicians of Canada (CFPC) presented its discussion paper Patient-Centred Primary Care in Canada: Bring it on Home.3 It described the pillars of a model of family practice focused on meeting patient needs.
Feedback from a broad cross-section of stakeholders including family physicians, other health professionals and their associations, governments, and the public provided important perspectives that are now incorporated into this vision paper describing family practices throughout Canada serving as Patients’ Medical Homes.
The report is the result of a significant effort by a broad cross-section of Canadian health care stakeholders. In October 2010, the Mental Health Table Forum hosted 80 delegates including health care providers, government representatives, consumers of mental health care, as well as organizations representing consumers and providers of care and other NGOs. The purpose of this meeting was to explore issues and perspectives relevant to advancing mental health promotion and front line mental health care delivery in Canada.
Access to health services is a key issue for Canadians and governments at all levels. Providing timely access to high-quality health care by reducing wait times for assessment and treatment is rightly one of the top priorities for health care policy-makers in Canada. Health care priorities need to include a focus on mental health; namely the mental health conditions, like anxiety and depression that affect 1 in 5 Canadians annually as well as the psychological factors that affect how well people maintain their health and manage their illness.
The report provides a synthesis of the working group discussions and the recommendations made by the delegates in attendance about how Canada can do a better job funding mental health services and supports and making them accessible to Canadians.
The recommendations centered around eight key themes:
- Review and improve funding models to ensure access to necessary services and supports.
- Establish national standards for mental health care and develop standards for wait times for mental health services and supports.
- Develop and maintain systems that respond to consumer need and facilitate efficiency and effectiveness.
- Enhance organization, integration and collaboration with stakeholders across all concerned sectors.
- Include consumers at the decision-making table.
- Enhance mental health promotion, prevention and early identification by increasing mental health literacy and reducing stigma.
- Train health care providers to work collaboratively and to respond to needs of populations within a system that supports collaborative practice.
- Advocate for legislative change to enhance access and achieve parity for mental health treatments.
As you will see, this report presents a comprehensive overview of the opportunities and the challenges facing the mental health community in Canada today. With the renewal of the federal-provincial health care transfer arrangements only two years away, now is the time to bring mental health to the forefront of health care discussions. This report and its recommendations can facilitate health care discussions that acknowledge the millions of people in this country who have mental health issues but for whom accessible and affordable services and supports are critically lacking.