Improving access to primary healthcare in New Brunswick:  the implementation of an Integrated Services Network

Canada’s healthcare system faces persistent challenges in access, navigation, and population health outcomes. In response, the Vitalité Health Network (VHN) in New Brunswick launched an Integrated Services Network (ISN) to deliver coordinated care through local family health teams, providing accessible, comprehensive, collaborative and tailored care to the New Brunswick population. Patients are directed via a centralized referral center to appropriate community-based primary care services. Rooted in the principles of integrated care, the ISN aims to improve patient navigation, ensure continuity of care, and strengthen the connection between primary and community health services.

Adhering to the RE-AIM framework (Glasgow et al., 2019), the initiative was developed by VHN's primary healthcare, research, planning, and performance teams. The co-construction process of Family Health Teams brings together primary care providers, health professionals, and network administration to jointly design integrated care models grounded in equitable access, interdisciplinary collaboration, and shared decision-making. Through administrative and medical co-leadership, this approach ensures alignment between clinical realities and organizational priorities to optimize patient-centered care. Local services committees (comprising managers, professionals, community members and patient partners) ensure effective community integration and coordination. Key indicators include onboarding of family physicians and nurse practitioners, patient wait times and attachment rates to primary healthcare providers.

To date, 28 local family health teams have adopted the ISN model, with 7 additional in progress in a co-construction phase. The implementation in 12 of 13 communities led to a reduction in average patient wait times for routine appointments (16.43 to 10.1 days). Access to mildly urgent and routine appointments now averages 0.15 days with a total of 20 teams. The attachment rate to healthcare providers has increased from 131 425 to 168 004, representing an additional 36 579 patients. A total of 160 family physicians (70.47%) and 43 nurse practitioners (84.31%) are engaged. Practice support teams have been added to enhance administration, IT, and organizational and operational efficiency. The model has encouraged more resident physicians to choose family medicine by providing strong administrative support for logistical and management tasks, allowing them to focus on clinical care and enjoy a more sustainable, team-supported practice.

Ongoing results indicate that the ISN is an effective strategy to improve timely access to primary healthcare, facilitate patient navigation, and ensure multidisciplinary patient management. This model demonstrates the potential of scalability and interdisciplinary community-based solutions to improve healthcare access and quality.

Next steps: (42): Continuous efforts and resources are deployed to implement, operationalize, scale up and evaluate the ISN, including: 1) facilitating coordination and care continuity by linking patients to broader healthcare professionals in the community and 2) evaluating health professional and patient satisfaction and feedback.