PCN governance framework implementation

Alberta is committed to Primary Care Networks

Enhancing primary health care is a priority for Alberta Health, and Primary Care Networks (PCNs) are the most common primary health care model in Alberta. Alberta Health is committed to working collaboratively with PCNs to achieve the strategic directions for primary health care.

Implementing the PCN governance structure

The new PCN Governance Framework is being implemented collaboratively, in partnership among Alberta Health, Alberta Health Services, PCN Physician Leads, and the PCN support programs housed within the Alberta Medical Association.

The PCN Governance Framework implementation plan has 3 core tasks:

  1. Establish a Provincial PCN Committee that will advise the Minister of Health on PCN-related issues, seek feedback from, and provide direction to, Zone PCN Committees on PCN-related issues.
  2. Establish five Zone PCN Committees that will provide the Provincial PCN Committee with zone-wide service plans aligning individual PCN services with population health needs. The Zone Committees will communicate provincial strategic directions and local needs and considerations, as well as report progress on issues.
  3. Formal evaluation of the process of implementing the new leadership/governance structure.

Improving PCN services for Albertans

The new governance structure will enhance the delivery of integrated primary and community care services to Albertans through:

  • improved integration between PCN services, Alberta Health Services’ programs, and services provided by community-based organizations (for example, less duplication and more comprehensive care);
  • increased alignment of services across communities within a zone through zone-wide service planning (for example, primary and community services provided in the right places at the right times by the right providers across the zone, leading to better access and easier navigation for Albertans); and
  • shared administrative services across the zone, where deemed appropriate by mutual agreement between joint partners, leading to more PCN resources applied to direct patient care.

For example, in home care, many PCNs and Alberta Health Services’ have duplicative home care services. By integrating and/or aligning Alberta Health Services home care and PCN seniors’ services, Albertans can be supported to live at home longer with appropriate services, and avoid long-term care and acute care admissions.

What continuity of care means for patients and providers

The PCN Framework partners want Albertans to have a continuous relationship with a specific primary care provider within a team, or to a team of providers, to improve continuity of care throughout their health care journey. This relational continuity helps establish a “health/medical home” for individuals so they can get the primary health care supports they need, especially for those with chronic conditions or diseases, or other complex needs.

It is important that these attachment relationships are mutually agreed upon through conversation, so the individual and the family physician both understand their commitments to each other.

Continuous relationships mean Albertans know where to go and who to call for their health care needs, which reduces the need of repeating their story or undergoing duplicate tests. It also means reducing Albertans’ risk of falling through the cracks in their health care journey.

For providers, it means they are better able to provide continuous patient care management over time, including proactive screening and follow-up.

No changes in governance and leadership structure within PCNs

The governance and leadership structure within a PCN will remain the same. The new leadership structure will not affect the PCN’s Joint Venture Agreement, the non-profit corporation (NPC) as a legal entity, the legal models, and the number of PCNs in the province or PCN physicians’ roles.

Expectations of PCNs under PCN Framework

PCNs are expected to work together to support the creation and implementation of Zone Committees, take part in creating and updating zone service plans, abide by Provincial PCN Committee direction with respect to services and operational policy, and ensure their business plans align with zone service plans. PCNs will continue to be accountable directly to Alberta Health for individual grants, and will continue to abide by grant agreements and PCN program policy.

Supports for PCNs implementing PCN Framework

Alberta Health is working in partnership with Alberta Health Services and the PCN support programs housed in the Alberta Medical Association to create zone support teams that will work with zone dyads (made up of Physician Executive Leads and senior Alberta Health Services partners) to create zone committees. In addition, Alberta Health will align PCN program policy with the new structure.

Relationship between Provincial and Zone PCN Committees

The Provincial PCN Committee will seek feedback from, and provide direction to, the Zone Committees regarding PCN policy and objectives, areas of PCN priorities, areas of standardization, and zone-level service planning. The Zone Committees, which report to the Provincial PCN Committee, will create zone-wide service plans that will assist individual PCNs to align business plans to population health needs within the zone. All levels are designed to promote communication bi-directionally, where communication flows up from zones to the Provincial Committee and vice versa.

Membership for zone committees

Zone Committees will be comprised of PCN Physician Leads, Alberta Health Services staff members and public members.

Relationship between zone committees and PCNs

The Zone Committees will work to align planning across PCNs in a zone, create and implement a zone-wide service plan, optimize service delivery for populations across zones, and create efficiencies through shared services. PCNs will provide information to their respective Zone Committees to support zone-wide service planning. Alberta Health will develop policies to support the work of Zone Committees and PCNs.

PCN business planning processes and business templates

PCNs will continue to submit their business plans, business plan amendments, annual report, mid-year reports and annual budget to Alberta Health as per their Grant Agreements. When Zone Committees are established, PCNs will be expected to abide by zone-wide decisions with respect to services and operational policy, and to ensure their business plans align with the zone service plans. The business planning templates will eventually change to reflect the new process.

PCN Framework supports primary care attachment

PCNs are committed to supporting attachment, which refers to a continuous and mutually agreed upon relationship between an individual and a primary care provider. The PCN Framework will position PCNs to exercise better leadership on relevant health system initiatives, for example, the Central Patient Attachment Registry being created by Alberta Health.

The registry will help primary care providers identify who their attached patients are, and also help other health care providers (for example, emergency department staff) identify a patient’s primary care provider. Success of the Central Patient Attachment Registry will rely upon the support of PCNs; the PCN Framework will facilitate the active participation of PCN physicians and nurse practitioners from across Alberta.

Some PCNs have already developed local-level attachment registries, and through the PCN Framework, their experiences will inform the implementation of the provincial registry. The registry is planned to be online in the spring of 2018.