#A vision for community-based health system integration founded on primary health care.

Ontario’s primary care system is at a pivotal moment, with growing demand for attachment, increasing population complexity, and significant variation in access to comprehensive team-based care. The Alliance has developed three complementary papers that together outline a population-based approach to strengthening primary health care in Ontario.
 
 
Together, these papers offer a coherent framework that will improve  access, attachment, integration, and health outcomes while supporting a more accountable and sustainable primary care system.
 
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Vision for a Neighbourhood Health Home

For over 50 years, community health centres (CHCs) in Ontario have delivered comprehensive primary health care according to the shared principles described in our Model of Health and Wellbeing (MHWB). Like a neighbourhood home, our member organizations reach beyond their doors to improve the lives of people in their communities. Although it began with CHCs, this approach is now embodied by organizations from multiple primary health care models, who together form the Alliance for Healthier Communities. 

This document elaborates on a vision of primary health care based on the MHWB, bred in our bones. If implemented, it will improve the health and wellbeing of people across Ontario. 

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Aligning Ontario Health Teams and Primary Care Networks to Advance Primary Health Care

Ontario Health Teams (OHTs) were established to advance integrated, people-centred care by improving coordination across local health and social services. Evidence from Ontario and internationally demonstrates that a strong, engaged primary care sector is essential to achieving this goal. The introduction of Primary Care Networks (PCNs) in 2025 provides a critical opportunity to strengthen primary care leadership, coordination, and participation in system decision-making. 

As Ontario continues to shift care from hospitals to communities and from treatment to prevention, clearer definition and alignment between OHTs and PCNs is necessary to improve access, attachment, population health, and health equity.

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Regional Attachment for Primary Care

Ontario's goal of improving primary care attachment cannot be achieved sustainably through uniform panel size assumptions alone. Patients differ substantially in their levels of medical and social complexity, and these differences shape the real workload required to provide timely, comprehensive, team-based care. In a model that accounts for complexity, an OHT/PCN would be assigned responsibility for regional accountability with regional targets that would be set based on attachment goals. A regionally-based centralized intake process would be used to assess clinical and social complexity match people with the best provider.

This paper argues that Ontario should adopt a regional, complexity-adjusted, population-based framework for attachment planning, funding, and accountability, while simultaneously achieving the goal of 100% attachment.