For many years it has been apparent that there was not a system in place to support Primary Care in Ontario. This has also been true in Hamilton. Individual practices or small groups of clinicians would concentrate on the health and medical needs of their own patients. In fact, not too long ago clinicians focused on the patient they were seeing at a given point in time. There was little opportunity to focus on the broader health and well-being of a panel of patients, much less an entire community.

Primary Care leaders have had excellent relationships among themselves and have been working to develop a patient-centred healthcare system. The goal has been to look after the health needs of everyone in the Greater Hamilton region. The first steps have been to start to meet on a regular basis. Meetings take place twice a month and are open to all primary care practitioners in the greater Hamilton area. It made little sense to divide physicians based on hospital affiliation when our patients and their families went to different hospitals depending on individual needs.

There has also been a realization that primary care and family practice are not the same things. To build a cohesive group of primary care providers we need to include Nurse Practitioners, Mental Health Counsellors, Midwives, Primary Care Nurses, Pharmacists, Registered Dieticians, and many others. We also need to include a variety of practice settings and styles, including CHCs, FHTs, Walk-in-Clinics, Family Health Groups, and of course fee-for-service physicians.

Our geography is also quite fluid as people and their families often work, go to school and live in different communities. We have expanded beyond Hamilton’s borders to include Haldimand and North-West Niagara.

The Primary Care community played an important role in identifying short- and medium-term goals for the GHNN. We recognize the need to improve access and care to adults and children with mental health and substance use challenges. We also must do a better job of helping older adults with multiple medical problems.

Our next step will be to formalize a governance structure for primary care in the Greater Hamilton area. We will play important roles in governance, policy development and care provision within the GHNN in the years to come.

These changes will benefit the people at the center of our system, the patients, families and care partners, our health partners and the communities we serve.