On October 11, 2022, the Dakelh Dene, Tŝilhqot’in and Secwépemc Nations, in collaboration with the First Nations Health Authority (FNHA), opened the Williams Lake First Nations Wellness Centre and 1,300 new Indigenous patients are able to access longitudinal primary care in a culturally safe team-based care setting. On March 17, 2023, a ground-breaking and traditional ceremony was held for the new Sts’ailes Community Care Campus (SCCC), in Harrison Mills, B.C. The SCCC will be the third First Nations-Led Primary Health Care Centre (FNPCC) to launch in the province and, once fully operational, will provide 1,400 new Indigenous patients with longitudinal primary care. Progress continues to be made on moving the remaining 13 FNPCCs into implementation across the province, with nine centres planned to open in 2024.
Local community Primary Care Networks (PCNs) are engaging with First Nations and Indigenous health serving organizations in service plan development and implementation. Representatives from each are members of Primary Care Network Planning and Steering Committees, and are active in PCN governance, and in some cases, are serving as committee co-chairs. In Primary Care Network Service Plans to-date, 149.2 full-time equivalents (FTEs) have been approved to directly support Indigenous Peoples. Of these, 49.2 FTEs are Elders, Traditional Healers, Knowledge Keepers and Aboriginal Patient Navigators who will be included on local primary care teams.
- Implementation project underway: Planning and implementation status is underway of PCNs and FNPCCs across the province involving First Nations, Inuit and Métis partnerships as appropriate to the local community context; at the time of this reporting, 63 of 99 PCNs are launched (64%) and 6 of 15 FNPCCs are approved or in approval (40%).
How are we working together?
FNPCCs are created in partnership with the FNHA and local First Nations to provide culturally safe care to Indigenous Peoples living in B.C. For the Guidelines and Protocols Advisory Committee, a permanent committee representative from the Chief Medical Office at the FNHA was added in 2020. In response to In Plain Sight, the Ministry of Health and the FNHA collectively established a provincial working group on Indigenous Cultural Safety and Humility in Primary and Community Care, with Indigenous and non-Indigenous members representing clinical committees, professional practice organizations, regional health authorities and Indigenous health and wellness organizations.
Are there challenges?
PCNs and FNPCCs have experienced service planning delays due to community capacity constraints and COVID-19 challenges. Health human resource shortages across the province are also significantly impacting progress in some regions. Additionally, growing patient attachment gaps are commonly outpacing physician and nurse practitioner recruitment in Indigenous, rural and remote communities.
Obstacles to PCNs and FNPCCs implementation progress relate to physician compensation issues and PCN governance structures. Actions are being taken to address these issues through the new Physician Master Agreement, refreshed Primary Care Strategy compensation models and the Ministry of Health’s restructuring of PCN governance requirements.