The Select Standing Committee has completed its report on rural health care delivery, after a year in the making. The Committee began its work in March 2016, with visits to a number of rural communities, including Prince George.
There are 17 recommendations …
1. Expand access to health care in rural, remote and isolated areas with a full suite of health care services, including, but not limited to: acute care; home supports; respite care; mental health and addictions services; counselling; specialists; testing or imaging; preventative and rehabilitative care; and cardiac, surgical, maternity and pediatric care.
2. Expand or provide transportation options that are accessible, affordable and readily available to enable access to health care, including ground, air and water transportation, as well as public transit and shuttle bus options.
3. Support aging in place through increased home supports, and assisted living and
residential care spaces.
4. Increase the use of alternative models of health care delivery, including interdisciplinary teams, fully-accessible travelling diagnostic and screening clinics, mobile health units, and expanded use of nurse practitioners, nurses and midwives.
5. Expand Emergency Medical Services and community paramedic programs to enable paramedics to provide other health services, in addition to emergency services, in remote, rural and isolated communities.
6. Establish rehabilitative or convalescent spaces to support individuals transitioning back into their communities.
7. Implement alternative compensation models, including salary, population-based funding or other blended funding models, to support new ways of delivering health care, such as the increased use of interdisciplinary co-located teams.
8. Increase flexibility in physician billing to support different models of health care delivery, including in-person, telephone or videoconferencing options.
9. Incorporate rural practice and generalist models of care in education and training curriculums, and work with post-secondary institutions to increase the overall provision of education for doctors, nurses, allied health and other health care providers across the province, including increased seats in programs where shortages have been identified.
10. Encourage British Columbians from rural, remote and isolated communities to pursue health-related careers, and provide increased support for professional development for existing rural health care providers.
11. Work with communities to promote the professional and personal benefits of living and working in rural B.C., and improve scheduling and work assignments to create a stable health care workforce in rural, remote and isolated areas of the province.
12. Accelerate the qualifying and approval process for integrating foreign-trained health care providers to work in British Columbia.
13. Leverage existing public infrastructure, such as hospitals, schools and residential care facilities, to provide co-located health and social services.
14. Improve virtual connectivity with health services, and partner with relevant stakeholders to implement innovative health technologies in rural, remote and isolated communities.
15. Provide increased access to health and wellness supports, such as nutrition workshops, fitness and recreation facilities and prescriptions for exercise, in collaboration with federal and municipal governments and local communities, in order to promote and encourage healthy living and self-care.
16. Broaden opportunities for communities to collaborate with health authorities to identify local needs and concerns and develop solutions through mechanisms such as community advisory committees.
17. Promote the wider application of a rural lens in the development of all health care policies, programs and initiatives.
When it comes to training physicians, the Northern Medical Program has address several of those recommendations from the training side. And it’s working.
“We’re now seeing about two-thirds of the Northern Medical graduates going into rural practice,” says Dr. David Snadden, the UBC Chair in Rural Health. “This is after they’ve been through residency training and they’ve settled into practice. And about a third of those are in Northern BC and another third are in the Interior.”
Northern Health has been using a unique recruitment tool called Candidate Relationship Management, which is a much more inter-personal way of recruiting.
“It absolutely is. It’s hands on. It’s actually building an effective relationship with the candidate so at that time they consider us as an organization of choice, they’ve already met somebody,” says Birgit LeBlanc, the Regional Manager of Recruitment for Northern Health. “They’ve already connected with somebody in the organization, which art this point would be the recruiter.And part of that conversation is that we really get to know them.”
But while there are a number of endeavours underway that are unique to address some of the delivery abnd recruitment challenges, Dr. Snadden has one overriding concern.
“The risk of a report like that is that its got all of these recommendations, and it’s hard to argue with any of tham, but if there’s no action plan, then it becomes a report that sits in a library in the Legislature somewhere and gathers dust.”