BC Gov News

Communities throughout the province are coming together to plan and create primary care networks (PCNs). PCNs are local community-based networks of family practitioners that plan and deliver all the primary care needs of a community - in some ways, this is similar to how school districts work together to plan and deliver education services for communities. 

PCNs can include family doctors, nurse practitioners, registered nurses, pharmacists, physiotherapists, social workers, midwives, mental health professionals, First Nations and community providers and others, depending on the needs of the people who live there. These teams will include existing family doctor offices, nurse practitioners, services offered at health authority facilities, community health service organizations and more in a community.

Each PCN will offer programs and services to help patients manage their health. Family doctors and nurse practitioners, working with a team of health professionals, will work together to address health and wellness concerns and help you and your family achieve your health goals.

Each PCN designs programs and services to best meet local needs, which vary by community and region, while also integrating into the broader health system to provide wraparound care.

According to BC Stats data, the communities that the Victoria primary care networks will serve have a combined population of 208,000. 

The PCNs were developed to better meet the specific needs of the communities by strengthening already established services identified as high priority and adding new resources. These include:

• improving health care services for people experiencing homelessness, mental health and substance use conditions and other challenges through access to primary care services, including addictions medicine, at various BC Housing sheltering sites.
• adding a high-complexity care team, dedicated to providing ongoing, long-term team-based primary care to people with complex needs.
• supporting culturally safe care for Indigenous peoples, including an Indigenous health team to support patient advocacy, access to care and traditional healing. The PCNs will expand the Victoria Native Friendship Centre (VNFC) by recruiting more family physicians, nurse practitioners and registered nurses. The new health-care providers will offer services out of VNFC, as well as at five First Nation communities, including: Songhees First Nation, Esquimalt First Nation, T’Sou-ke First Nation, Scia’new First Nation and Pacheedaht First Nation.
• In addition, and through the primary care networks, people who are economically vulnerable, have complex medical needs and face challenges to accessing care will benefit from two mobile medical vans that will provide care throughout the communities in Victoria. Care will be given by a team of trauma-informed health-care providers, including family physicians, nurse practitioners, nurses and allied health professionals.

Distribution of 96.5 full-time equivalent (FTE) new health-care providers across four PCNs:

• 10.0 FTE family physicians
• 15.5 FTE nurse practitioners
• 31.0 FTE registered nurses
• 0.5 FTE licensed practical nurse
• 9.3 FTE social workers
• 8.0 FTE mental health and substance use clinicians/social worker
• 2.6 FTE occupational therapists
• 2.5 FTE physiotherapists
• 2.2 FTE registered dietitians
• 2.0 FTE outreach workers
• 1.0 FTE respiratory therapist 
• 8.0 FTE Indigenous health roles
• 4.0 FTE clinical pharmacists

The Indigenous health team will include eight full-time equivalent (FTE) Indigenous health providers. As part of the Victoria Native Friendship Centre expansion, family physicians, nurse practitioners and two FTE registered nurses will be recruited.

Through the Victoria PCN, two mobile medical vans will be available. The first van will be available through the Seniors Mobile Primary Care Outreach Strategy, which provides in-home visits for patients who have difficult accessing primary care services. The team is composed of 1.5 FTE registered nurses, 0.5 FTE occupational therapist, 0.5 FTE physiotherapist and 1.0 FTE social worker, and will assist patients who require longer appointments and alternative arrangements to receive necessary and holistic care. It will serve mainly the Gordon Head and Oak Bay areas, but will travel on an at-need basis.

The second van will be used in the Low-Barrier Primary Care Clinic and Encampment Parks Outreach Strategy and is owned by Cool Aid. It will be significantly retrofitted as a mobile medical clinic that serves people in the downtown Victoria region who are not attached to any primary care supports or who migrate between acute and community care with no home-base. This team is composed of 2.0 FTE family physicians, 2.0 FTE registered nurses and 2.0 FTE outreach workers.

The PCNs will build on other investments in the region:

• The publicly funded PET/CT scanner suite at the BC Cancer centre in Victoria, which opened in 2019.
• Esquimalt Urgent and Primary Care Centre – Victoria
  • Currently offers limited health services provided by a registered nurse, certified practice nurse or a mental health and substance use consultant. Work underway to expand services.
• James Bay Urgent and Primary Care Centre – Victoria
• Nanaimo Urgent and Primary Care Centre
• North Quadra Urgent and Primary Care Centre – Victoria
• Westshore Urgent and Primary Care Centre – Langford
• Expanded team-based care at the West Coast Family Medical Clinic in Sooke
• A 3T MRI at Royal Jubilee Hospital
• Island Sexual Health Community Health Centre

• People can self-refer to urgent and primary care centres (UPCCs) for their urgent and primary care needs.
• Patients can be referred by community service providers, other health-care professionals and clinics.
• People can schedule appointments. However, during busy periods, appointments will be prioritized based on urgency.
• Patients requiring laboratory testing beyond the simple specimen collection will be provided with requisitions for lab tests to be completed at nearby laboratories.
• The top identified health conditions in the Greater Victoria region are hypertension, episodic mood and anxiety disorders, asthma, osteoporosis and osteoarthritis.
• UPCCs are part of a comprehensive provincial strategy to transform B.C.'s health system by bringing together and co-ordinating with health-care providers, services and programs to make it easier for people to access care, receive follow up care and connect to other services they may need.
• Five UPCCs are open in the Island Health region, including in Nanaimo and Westshore, James Bay and North Quadra in Greater Victoria. The Esquimalt UPCC opened in a temporary location in June 2021. Government also provided funding to expand team-based primary care at the West Coast Family Medical Clinic in Sooke.

Victoria downtown UPCC

• Once fully staffed, longitudinal care will be available Monday to Friday from 8 a.m. to 8 p.m., and Saturdays from 8 a.m. to 2 p.m. (closed Sundays and holidays).
• Urgent care, once the UPCC is fully staffed, will be available 8 a.m. to 8 p.m., 365 days/year (including holidays).
• Of the 66,600 people in the downtown region, approximately 12,600, or nearly 19%, of residents are considered unattached to family physicians.
• In 2019-20, almost 30% of the emergency department visits to local emergency departments were triaged at a lower acuity level according to the Canadian Triage Acuity Scale, meaning many of these patients could have been treated in the community.
• Total capital costs for the UPCC are estimated to be approximately $5 million, of which $1.4 million is contributed by Capital Regional Hospital District and $500,000 by Landlord Tenant Improvement Allowance.
• The UPCC will include exam rooms, a procedure room, COVID-19 exam rooms, consult rooms, medication rooms, collaborative workspaces and medical office assistant work areas, among others.

Sheila Malcolmson, Minister of Mental Health and Addictions –

“Embedding mental health and addictions care into urgent and primary care centres and primary care networks across B.C. is vital to removing stigma and barriers to care. I’m encouraged that, along with so many other B.C. communities, people in Greater Victoria will now be able to connect to the mental health and addictions supports they need and deserve.”

Leah Hollins, board chair, Island Health –

“Our teams have been working hard to contribute toward the advancement of Island Health primary care networks. The Victoria PCN, along with four other recently announced primary care networks across Vancouver Island, will help health-care providers place people at the very centre of our care and serve to foster healthier communities. Further, the new urgent and primary care centre will improve access to health and care services for those living in the downtown Victoria areas for years to come.”

Jeneen Hunt, Esquimalt Nation, interim health director, Esquimalt Nation and co-chair, Victoria PCN Steering Committee –

“In partnership with the Ministry of Health, Victoria Division of Family Practice, Island Health, First Nation Health Authority, Indigenous organizations (health directors), Métis Nation and Patient Voices Network, we have been working together to guide the health-care transformation that provides professional, culturally safe and respectful health-care services for all. It is exciting to have the primary care network plan approved by the Ministry of Health, and know we are working towards a goal of fair and equitable care for all individuals.”

Dr. Katharine McKeen, co-chair, Victoria Division of Family Practice and co-chair, Victoria PCN Steering Committee, and Dr. Tim Troughton, co-chair, Victoria Division of Family Practice –

“We have enjoyed working closely with our partners to ensure that primary care networks and the Downtown Victoria UPCC improve patient services in line with priority needs. Our vision is to build more capacity for strong patient-provider relationships and attachment. Family physicians on a team with nurses, social workers and others will be able to offer additional, patient-centred support, especially for vulnerable patients and those with complex health conditions. The network’s Downtown Victoria UPCC creates opportunities for local family physicians to relocate to a new team-based environment, with their patients. Our hope is to see more sustainable models like this to encourage new doctors to work in community practice.”

Dr. Matthew Chow, president, Doctors of BC –

"The best health-care systems in the world have strong primary care and we hope that the primary care network initiative provides additional needed resources to doctors serving their community, especially those who strengthen longitudinal care. A primary care network will collectively increase a community's capacity to provide greater access to primary care for those who need it, especially for vulnerable patients and those with complex health conditions."

Michael Sandler, executive director, Nurses and Nurse Practitioners of BC  –

“The Association of the Nurses and Nurse Practitioners of BC is pleased that the knowledge, skills and expertise of the entire health-care team will improve access to health care for British Columbians through the new primary care network and urgent and primary care clinic. We believe that this approach will be pivotal in ensuring B.C. families feel connected to their health-care team and we are excited to see the launch of four new primary care networks and new urgent and primary care clinic in B.C.”

Denise Blackwell, chair, Capital Regional Hospital District Board –

“The Capital Regional Hospital District is pleased to provide capital funding for the urgent and primary care centre on Pandora. This new center will mean our residents will have increased access to the care they need and will be able to get it in a timelier fashion.”