The Saanich Peninsula Outreach Team (SPOT-SDELK) has launched a “much-needed” community health clinic at the Peninsula Health Unit, located on the grounds of the Saanich Peninsula Hospital.
After five years of planning and organizing involving various local stakeholders, the clinic officially begins its work on April 1 to help bridge a critical gap in health-care access for vulnerable populations within the region.
It will focus on providing consistent and comprehensive care to patients facing pre-existing conditions, socio-economic challenges and mental health and substance use issues, including those battling opioid use disorder.
SPOT-SDELK Society oversees the outreach team in partnership with Saanich First Nations Adult Care Society. Island Health will provide crucial funding for the clinic's space and essential supplies.
“This has been such a good idea and needed support to improve health outcomes, particularly for the First Nations folks in WSANEC communities who have been disconnected from sustained relationships with health care,” said Mavis Underwood, board chair of SPOT-SDELK Society, highlighting the clinic's importance for Indigenous communities.
“It's a great location because it's so close to our acute care hospital, which has medical imaging and a lab,” says Dr. Brendon Irvine, Saanich Peninsula Hospital medical director. “It's also nicely situated here in Central Sanich in the heart of the four First Nations on the WSANEC – Pauquachin, Tseycum, Tsartlip and Tsawout.
The clinic will offer a patient-focused, trauma-informed and culturally sensitive model of primary care.
Patients will have immediate access to care when needed and can choose to receive support through outreach programs, remote consultations, or in-person appointments with the most appropriate clinician.
This flexibility ensures health care is accessible "where they are at" in the community.
The team
The Community Health Clinic (CHC) will be led by Drs. Michal Pawlik and Kate Evans.
“I've been meeting with Michal and Kate over the past three years,” Irvine said. “Part of our primary care network mission is to put care where it's needed and this is a great option for people to have access to the dedicated board and physicians who will be working there, as well as the medical office assistant and other health care team members.”
Pawlik, a family physician with eight years of experience with Shoreline Medical on the Peninsula, identified the critical need for this service.
"Through some of my walk-in shifts, I discovered that there are a lot of high-needs patients who don't have family physicians,” he said.
These "high-needs" patients often grapple with multiple health issues, including mental health and substance use disorders like alcohol and opioid addiction, as well as conditions like liver and heart disease. They frequently rely on emergency departments for primary care due to a lack of alternative options.
There are roughly 13,648 patients who are not under the care of a physician on the Saanich Peninsula, with 1,356 believed to be vulnerable and fall into the highly complex category.
According to Pawlik, Indigenous community members are "represented disproportionately among victims of the opioid crisis."
"They have six times higher rate of death from toxic drug poisoning compared to the general population."
Team-based model primary care
With this clinic, they're looking to introduce a CHC model to the Peninsula like Dr. Spencer Cleave's High Complexity Care Team or West Shore CHC and Victoria Cool Aid Society, where Dr. Evans also works.
While currently operating with a lean staff of two family physicians and one medical office assistant (MOA), the clinic envisions a future where a multidisciplinary team addresses the diverse needs of its patients.
"There's plenty of evidence that a team-based approach saves money by keeping people out of the emergency department, hospitals and most importantly, it saves lives, improves patient care and reduces bureaucracy," said Pawlik.
At full capacity, SPOT-SDELK hopes to incorporate a social worker, a part-time community outreach worker, one full and one part-time registered nurse, a mental health and substance use clinician, an Elder in residence, and a medical director consultant, in addition to its existing staff. However, the clinic currently faces space constraints, operating with only one exam room and reception area.
To fully realize its potential and conduct vital outreach visits, the clinic requires additional space and a medical van.
Improving healthcare delivery
Pawlik expressed hope that the Ministry of Health will provide the necessary resources to support the clinic's expansion.
He believes that by effectively managing complex patients and reducing unnecessary emergency room visits, SPOT-SDELK can contribute to a more efficient and effective healthcare system.
“We do hope to have a shorter wait time now that we’ve diverted some patients from the emergency department,” he said.
The doctor also acknowledged the challenges of providing comprehensive care with limited resources, especially for marginalized populations.
"We want to help the most disadvantaged patients, yet budget cuts often impact marginalized groups, which is frustrating," he stated. "I believe as a society we need to provide services to marginalized people. It really shows the caring nature of Canadian society when funding for those in most need, so I think that's the most important reason why the ministry should provide funding for this.”
Despite the challenges, SPOT-SDELK remains committed to its mission and is even exploring alternative funding sources, such as hospital foundation donations, to support its allied health services.
"We're here, we're starting and we're optimistic that we will get more funding," Pawlik concluded.
The clinic's opening represents a significant step towards a more patient-centred and holistic approach to primary care in the region.
