Transition to family health teams improves access to primary care, says Horizon, Vitalité

New Brunswick's two regional health authorities say the transition of primary care to family health teams has opened up access for tens of thousands of doctorless patients, with more to come.

Horizon and Vitalité have also set ambitious targets for how quickly patients can get an appointment, and have already seen improvements, according to the latest quarterly data, which covers April through June.

It comes amid a new survey from the New Brunswick Health Council that shows 77 per cent of people had a permanent primary care provider last year.

That's down two per cent from the previous year, but it's the first time in years there hasn't been a sharp decrease, according to council CEO Stéphane Robichaud. He believes the province's shift to collaborative care clinics could be slowing the decline.

Meanwhile, timely access remains a problem, according to the survey, with only one in three patients able to get an appointment with their primary care provider within five days — unchanged from 2022.

4 new Horizon teams take on 4,400 patients

Horizon has added four of the multidisciplinary teams in Fredericton North, Tantramar, Carleton North, and Miramichi since it launched its "transformative" primary care strategy in April, said president and CEO Margaret Melanson.

These teams have taken on 4,400 patients who were registered with N.B. Health Link as not having a primary care provider, she said. This is in addition to the existing patients of the team members.

Five more teams, consisting of physicians, nurse practitioners, and other professionals such as dietitians and social workers, are planned for this year, taking on another roughly 5,600 unattached patients, Melanson said.

The number and types of health professionals within each team will depend on the size and the needs of the community it serves.

Horizon is also "bolstering" 46 existing community health centres to deliver collaborative team-based care.

"Ultimately, this strategy will ensure every patient within the Horizon geographic area is attached to a family health team by 2029," Melanson said at Horizon's annual general meeting Tuesday.

She could not immediately estimate how many more teams will be required, citing the growing population.

But the transition to the family health team-model will be Horizon's "prime focus" in the year ahead, said board chair Susan Harley.

It will ensure New Brunswickers receive the "right care, from the right practitioner, at the right time."

Melanson is feeling "very optimistic" about the transition. "We feel that the family health team model is absolutely the best model to serve New Brunswickers," she told CBC News after the meeting.

"The philosophy of individuals being connected to a team as opposed to a practitioner is absolutely game-changing and will absolutely allow the citizens to be able to achieve care faster … in a way that is best meeting the needs at the time."

It currently takes nearly 18 days for Horizon patients to get an appointment with their primary care provider, according to the year-to-date average. Horizon hopes to see that drop to within five days.

Vitalité up to 26 active teams

Vitalité Health Network says it accelerated its "ambitious shift" toward the family health team-model in 2024-25 and now has 26 active teams, up from six.

The newest team is in the Saint-Isidore-Paquetville region, and work continues on five teams in the Bathurst, Campbellton, Dalhousie and Richibucto areas, according to its annual report, released Tuesday.

Nearly 32,000 doctorless patients have been assigned, said assistant CEO Patrick Parent, raising the total number of patients connected with a family health team to more than 161,000.

Vitalité's goal is to have all of its patients under the model by 2029, Parent said. He estimates about 14 more teams will be required.

The team model is a "key pillar" in Vitalité's plans to transform primary health care, said board chair Thomas Soucy. "This innovative model enables individuals to be cared for by a team rather than a single provider, promoting collaboration, task delegation and quicker access times," he said in a statement.

The transition has already helped improve timely access to appointments by about six days, according to the latest quarterly report. The average has dropped from nearly 17 days in May 2023 to roughly 11 days, the data shows.

Vitalité has set a five-day target for patients with routine, non-urgent issues.

It also aims to provide appointments within 48 hours for patients with "minor emergencies," such as a fever or cut, who can't necessarily wait five days to be seen and might end up going to an emergency department.

Nineteen of the 26 teams are already meeting that goal, Parent said. The other teams do not yet have a common IT platform to allow appointments to be handled by a rotating primary care provider within the team, he said.

Vitalité is working with the teams to support their transition to shared electronic medical records, optimize professional roles, integrate mental health and public health services, and add other professionals, based on community needs, Parent said.

Team numbers 'don't really tell the whole story,' minister says

The provincial government has pledged to open at least 30 collaborative care clinics over four years, including 10 this year.

Asked whether they've already hit their target, given the new Horizon and Vitalité family health teams, Health Minister John Dornan said "the numbers don't really tell the whole story."

Vitalité had started a version of collaborative care clinics before the Liberals formed government, he told reporters Wednesday, and Horizon has been doing the same, in terms of community health teams.

"So to say that there hasn't been any and we are going to add on 10 would be not quite accurate," Dornan said.

"While people have tended to focus on the 30 over four years and 10 [this] year ... it's a moving number in that different clinics are at different phases of providing optimal care for New Brunswickers.

"At the end of the day, we hope on providing collaborative care to all New Brunswickers. Some practices will still be solo practice, but we want all patients to be attached. And we are very bullish in that," he said.

"To say that it's a finite number misrepresents what we are doing."