Vitalité's new primary-care teams rollout on 'pause' amid funding shortfall

Vitalité Health Network says its new primary health-care teams are working as planned, but it has to "hit pause" on creating any more because it has already run out of funding for 2024-25.

There are currently 12 of these local family health teams, made up of 153 family doctors, 17 nurse practitioners and 45 other health professionals, according to the quarterly report Rising Above Challenges, presented at the board of directors' meeting Tuesday in Moncton.

Together, the teams have accepted about 14,000 "orphaned" patients within the past six months — about half of all Vitalité's doctorlesss patients — and reduced the average wait for patients to eight days from 12, said assistant CEO Patrick Parent.

Another 14 teams were in the works, with enough interest from doctors for at least 20, he said.

"Unfortunately at this point we have reached the cap of the budget that was allotted by government and we're going to have to press pause essentially for any new teams," Parent told CBC News.

Some of the communities being "put on hold" for new or additional teams include Moncton-Dieppe, Saint-Quentin-Grand Falls, Kent County, and Caraquet, he said.

Amount requested in dispute

According to Parent, Vitalité had requested a budget of $56 million "to be able to properly deploy across the entire network," but the provincial government provided only $13 million.

Department of Health spokesperson Sean Hatchard told CBC Wednesday that the health authority requested $20 million, not $56 million. He confirmed $13 million was provided "to enable the health network to continue to execute on their plan and demonstrate its impact."

Vitalité officials could not immediately be reached to explain the discrepancy.

But Parent contends they need "far greater funds to be able to commit to these family physicians because … they're leaving, you know, solo practices and they have to make a commitment to completely remodel.

"So we have to be serious in that intent and provide them with some comfort" through multi-year deals, he said.

Good return on investment, argues assistant CEO

While the communities put on hold are disappointed, Vitalité isn't giving up, said Parent. Just last week officials met with members of the Department of Health and provided a "deep analysis" on the return on investment.

"It basically highlights the fact that the model will pay for itself and additionally will generate savings to the rest of the health-care system," by helping to reduce costly hospital visits and also reduce hospital wait times.

The department had been requesting more information about Vitalité's primary health-care teams for "several months," according to Hatchard.

"Government has a process to consider requests for additional funding that occur during the fiscal year. When such a request is made, it is important that there be accompanying information that demonstrates the impact of the investment," he said in an emailed statement.

The department received a "substantial submission" from Vitalité on June 21, which is being reviewed and officials are working with Vitalité to receive "additional information,' he said, without offering any specifics.

Province's plan may be 'creating challenges'

As of last year, only 79 per cent of New Brunswickers report having a permanent family doctor or nurse practitioner, according to the New Brunswick Health Council's survey on primary care released last week. Only about 31 per cent of the more than 5,000 adults surveyed said they could get an appointment with their primary care provider within five days.

The province's primary health care action plan centres around creating incentives for providers to join team-based practices under the Family Medicine New Brunswick model, which was launched in 2017 and has failed to grow as expected.

In the meantime, the government has implemented some short-term solutions, such as N.B. Health Link, which provides people with access to a network of family doctors and nurse practitioners while they wait to be matched with a permanent provider. About 59,000 people have registered so far and roughly 7,600 of them have secured a permanent care provider, officials have said.

Vitalité's teams are community-specific "operational models" that provide doctors with the support they need, said Parent, noting 71 per cent of the health network's family doctors have enrolled within less than a year.

Every team is connected to its own referral group responsible for quickly guiding patients to the right service provider, according to the report, which covers April to June 2024.

"The objective is to provide access to service within five days along with enhanced follow-up by developing an interconnected system," it states.

International recruitment may include Vietnam

Meanwhile, international recruitment efforts to address nursing shortages continue, said vice-president of employee experience Frédéric Finn.

Vitalité representatives attended job fairs in Morocco, France and Belgium in the fourth quarter of 2023–2024. Nearly 200 potential hires were identified at these events, and Finn said the recruitment team is working to confirm them.

Additional missions are planned for Morocco, France, Belgium and Tunisia this summer and fall.

"And a new market we're exploring with our partners at Department of Health and [Post-Secondary Education, Training and] Labour is Vietnam, which has a large sort of French as a second language component," Finn told CBC. "So it could be a potential pool for us that we haven't quite tapped into yet."

He could not immediately say how much Vitalité has spent on travel, or how much more it plans to spend.

166 international recruits

But between April 1, 2023 and March 31, 2024, 166 international recruits accepted job offers, he said. Of those, about 100 have already started working as patient care attendants until they're accredited as registered nurses.

Vitalité has also created an immigration support service for new international employees, to "promote a smooth integration and ensure retention," said Finn.

Four immigration advisors, two administrative assistants and a team leader ensure compliance with immigration laws, regulations and policies. They also provide pre-arrival information sessions covering various aspects of life in Canada, help finding accommodations and childcare, and job search support for spouses.

Vitalité has 435 international employees on temporary work permits, including international recruits, as well as students or other international candidates recruited locally. That's about seven per cent of all staff, said Finn.

"And it is going to increase in the next few years because we know that the domestic supply is not enough for all our needs."