Healthcare reform takes a step forward in Nova Scotia with the homes model approach
Nova Scotia's Primary Care Transformation: A Steady Progress
Nova Scotia's healthcare system is undergoing a significant transformation, with a focus on improving access to primary care services. This evolution is marked by the integration of technology, expanded roles for nurse practitioners, and strategic physician recruitment.
Dr. Colin Newman, president of Nova Scotia's College of Family Physicians, advocates for education as a key solution to increase the number of family doctors. He proposes a pathway that includes increasing medical school enrollment, creating positive learning environments in family medicine, and providing high-quality community-based family medicine training to graduates.
One of the most notable innovations is the Care Coordination Centre (C3), launched province-wide to streamline patient transitions between care settings, manage hospital bed availability, and expedite appointment scheduling. This initiative has reduced wait times and smoothed care delivery, thereby enhancing patient access to timely care.
Nurse Practitioners (NPs) like Alison MacMellon are leading new team-based service delivery models, focusing on transitional health care and supporting patients discharged from hospitals who need continuing care before returning home. NPs serve as the Most Responsible Practitioners, coordinating comprehensive care and improving outcomes within community-based and transitional settings.
Nova Scotia Health has actively recruited physicians, both hospitalists trained in and outside Canada, to bolster primary and inpatient care teams. This has strengthened capacity to deliver timely, patient-centered care, ensuring patients receive coordinated and focused management throughout hospital stays.
While direct statistics on waitlist reduction are not detailed, the implementation of C3 and nurse-practitioner-led care teams indicates progress by enhancing patient flow and increasing care capacity. As a result, the waitlist for a family doctor has decreased by approximately 70,779 people since July 2021.
Last year, the number of family medicine school seats in Nova Scotia was increased from 58 to 114. Nova Scotia Health interim president and CEO Karen Oldfield acknowledges that progress is being made in this transition, with 118 health homes currently operating across the province.
Primary health care in Nova Scotia is now delivered by teams that include family physicians, nurse practitioners, nurses, social workers, dietitians, pharmacists, physiotherapists, and many others. The province added 253 new doctors last year, resulting in a net gain of 187 doctors, almost double the number of physicians added the year before.
Despite these advancements, 89,455 people, or 8.3% of the population, are still on the waitlist for a family doctor in Nova Scotia. Dr. Oldfield attributes the decrease in the family doctor waitlist to a range of strategies, including recruitment and retention, new technology, and effort from people across the province.
The Progressive Conservative government, which was elected in August 2021, largely campaigned on a promise to fix health care in Nova Scotia. The number of Nova Scotians who have been connected to primary health care has increased under the current administration, according to Dr. Oldfield. The shift in Nova Scotia's health care system is a testament to the government's commitment to addressing healthcare concerns and improving access to primary care services for its residents.
References:
- Nova Scotia Health Authority (2022). Care Coordination Centre (C3). Retrieved from http://www.nshealth.ca/care-coordination-centre-c3
- Nova Scotia Health Authority (2022). Nurse Practitioner-Led Clinics. Retrieved from http://www.nshealth.ca/nurse-practitioner-led-clinics
- Nova Scotia Health Authority (2022). Physician Recruitment and Retention. Retrieved from http://www.nshealth.ca/physician-recruitment-and-retention
- Canadian Institute for Health Information (2021). Wait Times in Canada: A Report Card. Retrieved from https://www.cihi.ca/en/wait-times-in-canada-a-report-card
