By: Linda Wilhelm 

There is very good news for patients living in Northern Ontario who need better access to rheumatology care! In December 2022, the Ontario Rheumatology Association (ORA) submitted a business case to the Ministry. They proposed “hub-and-spoke” model, where Advanced Clinical Practitioner in Arthritis Care-trained extended role practitioners (ACPAC ERPs), based in core northern communities provide in-person rheumatological care, centralized triage, and virtual consultation in partnership with affiliated rheumatologists across southern Ontario.

The Ministry was receptive to the proposal. A small amount of funding was provided to identify a pilot site to deliver proof of concept metrics. Funding was also issued for capacity building costs (i.e. tuition for future ACPAC trainees, equipment, etc.).  

The first quarter of 2023 was a busy one!  The pilot work had to be completed by March 31st. Given this, it made sense to establish Thunder Bay as a pilot site as there already existed an unfunded Model of Care (MoC) that mirrored the proposal. Beyond Thunder Bay, a physiotherapist has been identified in North Bay (another regional hub) and is enrolled in the ACPAC training course. Recently, another physiotherapist was recruited in Timmins to begin training in the Fall of 2024. The ORA continues to work with other regional hubs (Sudbury and Sault Ste Marie) to identify candidates there who can also take the ACPAC training.

With phase 1 implementation underway, the ORA re-engaged with the Ministry to request funding for phase 2 of the project, which involves implementation of the funded model in Thunder Bay. Funding was again granted for this fiscal year (2023-2024). Everyone involved in the model, including hospital administrators, a newly trained ACPAC, visiting rheumatologists and those who consult virtually, all are very excited about the project! 

Looking forward, the team will begin focusing on phase 3 of the project, which will include an expansion of the hub and spoke model to all of the northern regions identified in the proposal. The ORA expressed their gratitude to CAPA for supporting the model. We will share further updates on this exciting project as it continues to unfold. 

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