Environmental Scan - Government of Nova Scotia

Physician Resource PlanningAn Environmental ScanFigure 31 Collaborative Care - Cost comparison between Nova Scotia Current State and U.K. ModelPositive financial benefits are achieved if the U.K. Primary Care Trust experience of a GP to GP Practice Nursepatient ratio of 1.9:1.0 is applied compared to 2.8:1.0 (1,124 to 400) in the preceding costing analysis based onlimited experience in Canada. Applying a ratio of 1.9:1.0 implies a collaborative care practice of 1,728 patientsper GP/NP, well above the provider financial payments breakeven point. A saving of $28.4m (next figure) ispotentially achievable using the U.K. model of collaborative care.Collaborative care is integral to the Nova Scotia long-term health system strategy. The above analysisunderscores the need for evidence-based quantitative and qualitative research and analysis on collaborativecare teams to ensure value for money in both the qualitative and quantitative sense is achieved.The same Ontario Panel noted that about 197 midwives were licensed to practice in Ontario and approximately40 more enter practice each year. At the time, the typical caseload for each midwife was 40 deliveries per year(less than one per week) and a significant proportion of those deliveries (25% to 30%) involve shared care withan obstetrician/gynecologist. Anecdotal reports indicate many of the obstetrician/gynecologist interventionswere required for administrative rather than clinical reasons.8.5 Primary Health Care RenewalHealth Canada, through the primary health care transition fund, has invested in the belief that the RomanowCommission 29 statement of “…high-quality, effective primary health care services have profound implicationsfor the entire health care system.” The final report states, "there is almost universal agreement that primaryhealth care offers tremendous potential benefits to Canadians and to the health care system ... no otherinitiative holds as much potential for improving health and sustaining our health care system." A target was setand agreed by first Ministers to a Health Care Accord that identified to a target of 50% of Canadians having24/7 access to an appropriate primary health care provider by 2011.The College of Family Physicians of Canada (CFPC) strategic plan emphasizes that access to comprehensivecontinuing care in a family practice setting is the cornerstone of high-quality health care for the people ofCanada.The Canadian Medical Association (CMA) in its policy for principles to guide health care transformation inCanada states unequivocally, “A strong primary care foundation and collaboration and communication withinand between health professional disciplines along the continuum are essential to achieving patient-centredcare.”The American Academy of Family Physicians conducts a regular assessment of PRP. Among its chief concerns isthe increasing generalist-specialist imbalance in the United States, undermining the nation’s ability to achieve29 Romanow, R., Building Values The Future Of Health Care In Canada, Nov/2002.62 | Page Social Sector Metrics Inc. & Health Intelligence Inc. | 12/31/2011