Community Health Centres

Background

Strengthening primary health care remains one of the top healthcare priorities for B.C. While there are many models and policy initiatives that can be undertaken to achieve this, community health centres have been shown to deliver superior health promotion services as well as chronic disease prevention and management. Community health centres are comprehensive and integrated primary health care organizations where services are provided by a collaborative and interdisciplinary team.

While there are hundreds of community health centres across Canada, most are situated in Ontario and Quebec. According to the British Columbia Federation of Community Health Centres, community health centres in B.C. fall into three categories:

• Independent not-for-profit corporations or cooperatives, which are governed by independent Boards of Directors that have organizational funding relationships with the Ministry of Health and Regional Health Authorities.
• Independent not-for-profit corporations or cooperatives, which are governed by independent Boards of Directors that foster a community health centre environment. This is done by coordinating individually contracted healthcare providers, volunteers and complementary services within a shared space and organization.
• Community health centres that are operated directly through Regional Health Authorities and are governed by the structures within these Health Authorities.

While there are numerous types of community health centres, many of which are named differently in other jurisdictions (i.e.: Community Clinic, Cooperative Health Centres, Aboriginal Health Access Centres etc.), four essential features are common to all community health centres. These include: providing team-based primary care, providing integrated and comprehensive primary health care, being publicly funded and emphasizing community engagement and participation. This model focuses on ‘upstream' population health approaches, which address the root causes of health issues and health inequities by focusing on the social determinants of health. As a result, community health centres often focus on being proactive rather than reactive to needs of community members. Moreover, the community health centre model places greater emphasis on keeping people healthy as opposed to treating them when they are sick, and tends to prioritize those who have complex medical and social problems.

B.C. nurses understand the need for comprehensive and integrated primary care that is provided by a multidisciplinary team. Nursing also knows that being proactive, utilizing ‘upstream' approaches and tackling the social determinants is fundamental to improving the health outcomes of British Columbians. While this model does exist in B.C., access to, and availability of community health centres continues to be a challenge. Like many aspects of our healthcare system in B.C., the delivery of healthcare services continues to be focused on treatment rather than prevention.

According to the British Columbia Federation of Community Health Centres, there is currently a patchwork of community health centres across B.C., which provides a diverse scope of services within each community health centre. Additionally, these community health centres are only available to a small portion of British Columbians. Current obstacles that are creating barriers for community health centres to fully optimize care include lack of comprehensive core funding arrangements, the current remuneration model for physicians and lack of policy to guide collaboration between the various types of community health centres.