A Family Practice Network, or FPN, provides a mechanism through which a physician group can address common practice and patient needs, have a collective voice on issues facing family practice, and address local population health needs, in coordination with the Regional Health Authority (RHA). The FPN structure is a physician-led, non-profit organization.

• Within the overall goals of the program, FPNs can decide their priorities and which initiatives will best suit their Network and patient population.
• Examples of priority areas currently being worked on:
  • Improving working relationships amongst family physicians, and between family physicians and other providers
  • Team-based approaches to care & sharing of resources
  • Cross-referral to other family physicians with different skill sets
  • Improving physician recruitment and retention, as well as locum coverage
  • Access to, and knowledge of, community resources
  • Better communication and collaboration with the Regional Health Authorities
  • A collective voice in decisions involving community family practice
• We will be sharing more about the plans of FPNs as we work through the development process.

• Funding will be provided in the form of an annual budget allocation, based on acceptance of a proposal from the FPN by the Management Committee (with support provided by program staff).
• Funding will be used for administrative expenses such as the hiring of an Executive Director to run the FPN, and for administrative and governance services provided by the physicians who take on a leadership role.
• Annual funding will be based on physician membership numbers, from $125,000 (for 20 physician members) to a maximum of $275,000 for 70+ physicians.

• Membership in FPNs will be categorized into voting and non-voting.
• Voting members will be practicing General Practitioners (GPs) who deliver the majority of their services in the geographic area (this includes locums) and who are licensed and in good standing with the College of Physicians and Surgeons of Newfoundland and Labrador (CPSNL).
• A non-voting member can be a Medical Resident holding a full or educational license or can be a retired GP.
• The By-laws for the FPN outline the specific membership classes and requirements.

Yes, salaried family physicians can participate within local Family Practice Networks, if identified and in development in your area, and we do encourage participation to facilitate increased collaboration with your physician colleagues and other providers on common needs. In addition, salaried physicians can take advantage of the Practice Improvement Program offerings.

The Family Practice Network may have physicians or link with physicians who provide in-patient care, however, hospital privileges will not be a requirement.

• Complete the Shalloway FPN Membership Application Form. 
• Complete the Long Range FPN Membership Application Form. 
• Complete the Endeavor FPN Membership Application Form. 
• Complete the RE-Boot FPN Membership Application Form. 

• Honoraria will be paid to physician leaders for FPN administration and governance services, and program development and implementation functions.
• Payment Method: A provincially standardized hourly honoraria rate of $114 per hour to a maximum of $800 per day, with this including preparation time, travel, and meeting attendance.

• As part of our program consultation process, we’ve talked with close to 200 family physicians as the program was being developed. Family physicians continue to be engaged and consulted on a variety of topics through mechanisms such as  Collaborative Services Committees, Board meetings, ad hoc meetings, provincial engagement meetings, one-on-one discussions, etc.
• Between 2016 & 2017, through a combination of group sessions and interviews, you gave us your ideas and priorities for the development of FPNs in NL.
• You told us you are challenged in meeting increased demand for patient care services, both in relation to patient volume as well of complexity of care. You talked specifically about:
  • Supporting patients with mental health issues and chronic diseases
  • Care of older adults, especially the frail elderly
  • The worsening problem of chronic opioid use
  • Meeting patient access needs
  • Lack of supports for team-based approaches to care
  • Managing administrative responsibilities/workload
  • Lack of communication with your Regional Health Authorities (RHAs)
  • Lack of consultation with family physicians in decisions that affect community family practice
• You see FPNs as providing opportunities for:
  • Improved working relationships amongst family physicians, and between family physicians and other providers
  • Team-based approaches to care & sharing of resources
  • Cross-referral to other family physicians with different skill sets
  • Improving physician recruitment and retention, as well as locum coverage
  • Access to, and knowledge of, community resources
  • Better communication and collaboration with the Regional Health Authorities
  • A collective voice in decisions involving community family practice

• An FPN will provide you with a supported mechanism to address physician and practice issues in your local area and ultimately aid in recruitment and retention.
• Benefits could include facilitating use of shared resources to meet local patient population needs (e.g. frail elderly, adolescent mental health, group appointments); leveraging family physician colleague expertise; improved communication and coordination with Regional Health Authorities (RHAs); accessing and linking to interdisciplinary teams; working together to purchase supplies for a group of clinics; coordinating locums for a grouping of physicians; coordinating common education needs; working to streamline communication processes with other aspects of the health system; and taking part in structured rotations to increase patient access in your local area, etc.
• What you focus on will depend on the needs and interests of the local physicians in your FPN.

• Family Practice Network development will require time from physicians interested in taking a lead role. However, Family Practice Renewal Program staff will provide you with direct and on-the-ground training and support. The time requirement depends on your local physician group and how you decide to move this forward. You may decide to have a planning meeting every month, bi-weekly, weekly. It will depend on what is realistic and what works for your group.
• An FPN Executive Director has been hired who is dedicated to FPN Board operations, management, and implementation of all FPN priorities.

• Family Practice Networks work with their local regional health authorities to address common health care goals and gaps in local communities, with the goal to contribute to improved population health outcomes. For example, the program contributes to:
• Better patient access to appropriate care
• Better coordination of services between doctors and the regional health authority and other health care providers
• A more comprehensive range of services
• Increased focus on health promotion, disease prevention, and care for patients with chronic diseases

• A Collaborative Services Committees (CSC) is a joint committee representing the Family Practice Network (FPN) and the Regional Health Authority (RHA), whose mandate is to identify and respond to primary health care needs of the community.
• The FPN and the RHA will work collaboratively as CSC Partners to develop solutions to address local gaps in care, calling on additional voices from patients and the community, as appropriate.

• The CSC shall be composed of:
  • Three (3) FPN members, appointed by the FPN Board of Directors, with at least one member being a current member of the Board.
  • Three (3) RHA representatives, appointed by the RHA, with at least one being an Executive with primary care responsibility.
• The CSC may also invite patients, local community representatives, and other stakeholders to participate as ex-officio members, to ensure the CSC is addressing issues that reflect community concerns for primary care.

Each Family Practice Network is unique, developed by local family doctors. While the provincial program provides standard structures and general direction, the local approach allows, and encourages, the Family Practice Networks to focus on the needs of its own physicians and patients.