Case Example

British Columbia has set up a number of models of service delivery that support public health and primary care collaboration.

Case Example
A model recently introduced in British Columbia is the Divisions of Family Practice. The Divisions arecommunity-based groups of family physicians working together to achieve common health care goals. See www.divisionsbc.ca/provincial/home.

Requirements for a division: family physicians must participate in a network or have a practice; the practice must provide comprehensive care; most importantly, physicians must also work as partners with their Health Authority, the General Practice Service Committee (consisting of tri-lateral representation from the Ministry of Health, the British Columbia Medical Association and the Health Authorities) and the Ministry of Health to make practice and system level changes. See www.divisionsbc.ca/provincial/devstages.

As you can see, this model has the potential to facilitate collaboration, not just with public health, but with others in the health care system and community. Initially, there was concern by some people working in health authorities that the focus of the Divisions would be primarily on medical care within the practice, and on benefits to physicians.

However, as the Divisions have evolved, there is evidence from one research project on public health renewal in BC that many Divisions have engaged with public health practitioners in health authorities to collaborate, for example, on the determinants of health, promoting health equity, addressing housing issues, and improving prevention services within their practices. (MacDonald et al, 2013)

Case Example
Still another example from British Columbia is the Integrated Health Network. Integrated Health Networks  provide services to support participating family physician offices, patients, and practice teams in managing chronic disease.

An Integrated Health Network is the mechanism to support and formalize the critical links between community organizations and resources with primary health care and to re-align health authority and specialist services to integrate with primary health care. Improving population-health outcomes is the key that drives the development and implementation of each network.

The practice teams in Integrated Health Networks can include a variety of other health care professionals including public health practitioners. One Integrated Health Network worked very closely with the regional health authority’s Population Health Observatory to provide necessary data to inform population-based services in the Integrated Health Network, particularly to First Nations and rural populations. It also collaborated with a variety of community partners to offer programs and services related to the prevention and management of chronic disease, some of which involved the local health units/health authorities.