Program Overview

There are 4 FPNs in the province, with over 400 family physician members!

Become a member

Research strongly suggests that enhancing community patient care services, with a local focus, leads to better patient outcomes and health system savings. Family Practice Networks (FPNs) provide mechanisms to enable community-based family physicians at the sub-regional or regional levels to identify and address common health care goals/gaps in local communities to improve population health outcomes. This may be in collaboration with their Regional Health Authorities, community-based organizations or municipalities. The structure also provides mechanisms for physicians to pursue opportunities to enhance recruitment and retention efforts in their local areas.

Each Family Practice Network is a not-for-profit corporation organizing and promoting the participation of physicians in their region in activities that ultimately improve the delivery of primary health care services.


 

Why become a member?

A Family Practice Network provides you with a supported structure to address practice issues in your local area and ultimately aid in recruitment and retention. Benefits can include:

  • Facilitating use of shared resources to meet local patient population needs;
  • Leveraging family physician colleague expertise;
  • Improved communication and coordination with regional health authorities;
  • 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;
  • Taking part in structured rotations to increase patient access in your local area.

Membership is voluntary and free.

What each Family Practice Network focuses on depends on the needs and interests of the local physicians in that Family Practice Network.


 

Collaboration

As one of three core Family Practice Renewal Program initiatives, Family Practice Networks provide formalized structures and tools to enable community-based family physicians, in collaboration with their regional health services, to identify and address common health care goals/gaps in local communities, and in so doing, ultimately contribute to population health outcomes.

  • Family Practice Networks provide formal structures (networks) for coordination and collaboration between family physicians.
  • They are non-profit physician-controlled entities, established on large area, regional or sub-regional basis.
  • FPNs provide honoraria funds to facilitate physician input, involvement and engagement on health system design.
  • Family Practice Network physician groups participate in Collaborative Services Committees with Regional Health Authorities to identify and solve unmet needs at the community level, including physician services within and connected to the regional health service.

 

Program Goals

The goals of a Family Practice Network are ultimately about contributing to an integrated system of care. The overarching intent is to build capacity in a system focused on the patient.

Family Practice Networks contribute to this effort through the following goals:

  • Improved coordination of patient care across the continuum of care, and between providers and community-based services and supports.
  • Improved identification and management of a full range of comprehensive care services.
  • Enhanced access to primary care services.
  • Improved health outcomes, particularly among high-needs populations and those living with chronic disease(s).
  • Increased collaboration between local family physicians, and between family physicians and other primary health care providers.
  • Greater collaboration between family physicians and regional health authorities leading to improved alignment on priority issues.
  • Improved recruitment and retention of family physicians, particularly in rural and under-serviced communities.
  • The establishment of collaborative, community-based multidisciplinary teams.

 

Examples From Our Networks

The following are examples of network-based program successes from our province:

Allied Health

Based on chronic disease data collected by Newfoundland & Labrador Centre for Health Information (NLCHI), the Deloitte Report, and discussions amongst local Family Physicians, patient access to community physiotherapy was identified as a Collaborative Services Committee (CSC) priority. Family physicians noted the presentation of back pain was common within their clinics with no resources to share with their patients or access to community physiotherapy. Through partnership between the FPN and Regional Health Authority (RHA), The Back2Fitness! program was developed to help address this need.

FPNs and RHAs have also been discussing the opportunities to build in capacity for community FFS clinics to receive better access to dedicated allied health resources (RHA resources). The intention is to bring together allied health professionals and family physicians within the community to act as a Health Home Model of Team-based Care for attached patients, where community family physician can send their patient referrals directly to dedicated allied health resources.

Working Groups & Initiatives

There are several working groups and initiatives with each FPN – some regional and others provincial. The Less Paperwork, Locum Group, and Care of Older Adult initiatives are just three examples of many. To get involved or learn more, please reach out to your FPN Executive Director.

Less Paperwork – In response to the increasing frustration and ever-growing volume of paperwork within physician’s clinics, the Less Paperwork working group supports the development of tools such as example response letters (i.e., sick days), and tips and tricks such as special authorization form guidelines.

Locum Group – FPNs have helped support locum planning within regions of NL including the creation of self-managed email group, a networking engagement session with locums in the region, and the creation of orientation handbooks to help encourage locum coverage and address barriers to practice.

Care of Older Adult (COA) – The FPN has supported and funded a two year family practice resident to complete a Certificate of Advanced Competence in Family Medicine in Care of the Elderly from the CFCP to help support a Care of the Older Adult Program (including a Home Dementia Program).

Team-Based Care

FPNs and RHAs across the province have been working together to define partnership and collaboration for the development of interprofessional teams. Through this work, facilitating care transitions in primary care has become a focus to help integrate primary care with the greater health system and health-minded organizations.

Wait Times

FPNs and RHAs are working together to define what access means (i.e., wait times, access to specialties, etc.) and how to better align services with population health needs. The CSCs are working on ways to collaborate with family physicians and Medical consultants, to identify what is an appropriate, complete referral and what is not. As well, FPNs are developing a filtering process for referrals, considering ways to education FPs through continuing professional development (CPD) opportunities, sharing best practices (EMR tips, clinic processes, etc.) and opening lines of communications between FPs and consultants.

Recruitment & Retention

FPNs across the province have been working to improve patient access by focusing on inclusive approaches to recruiting, welcoming, and retaining family physicians through providing social, supportive mentorship and wellness activities. 

Physician Wellness

The FPNs, RHAs, and other community partners have been working together to identify and agree on specific collaborative roles and actions with the goal to reduce family physician barriers and ensure appropriate mechanisms are leveraged to increase family physician satisfaction and wellness across our communities.

Community Engagement

FPNs have been reaching out to local municipalities to create mechanisms for open communication and work collaboratively to help support the family physicians within their communities. FPNs have been advocates in ensuring Family Medicine is being represented at all relevant tables to highlight and support the voice of family physicians.

FAQs

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
  • Funding will be provided in the form of an annual budget allocation.
  • 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. Click here for By-Laws.

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.

  • Honoraria is 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 requires time from physicians interested in taking a lead role. However, Family Practice Renewal Program staff provide you with direct and on-the-ground training and support.
  • An FPN Executive Director has been hired for each FPN. This position 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 is 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.