Table 3 Quotations on policy advocacy

• AFHTO has been very engaged and very involved. They have pushed because they knew there was a gap there. And they solved that for our organization, so they need … That involved from AFHTO is really, really important. Even if this is something that is taken over by the ministry, I think having them involved as speaking on behalf of the family health teams is really, really important. (ID = 012)

• Getting back to what I was saying before, I’d rather be leading the way than told what to do and how to do it. So I see D2D as our opportunity to really put it out there and say look, to the government, if you’re going to try to measure how well we’re doing and the quality of our healthcare, I’d rather be the one saying this is a known shown evidence-based way to do it. I think we’re working on that with D2D. (ID = 014)

• I need a need for D2D, I think it depends on what the raison d’etre of D2D is. My understanding, perhaps incorrect, initially, was that it was clear that there was going to be reporting mechanisms being put in place, being forced upon us from the ministry, and that AFHTO wanted to try to get in on the ground floor to try to see … basically to influence the ministry. What’s feasible, what’s reasonable, what’s important to primary care, and to get clinicians involved in trying to influence those decisions. I think from that respect, D2D is important. (ID = 001)

• The other part of it was we wanted to be able to work with AFHTO to start being able to direct where Health Quality Ontario was asking us to go on our quality improvement by using data that was more accurate or more up to date, to create those conversations between AFHTO and HQO. (ID = 015)

• Well, I think it puts us in a good position if indicators that we report on D2D are ones expected of us, say from the Ministry. I think that puts us in a great position because we’re already able to report on them. (ID = 006)

• Knowing that we were in a climate where primary care, just in general, was being scrutinized around performance and whether or not it was actually making an impact, patient-centred and outcomes and things like that. It was always, from the get-go, probably, the underlying reason why we wanted to participate in the day-to-day because we wanted to tell the story. Yes, don’t believe everything you are hearing out there. At the local level, we are making a lot of really good progress around patient outcomes. (ID = 003)

• So sometimes perhaps the Ministry will be looking for information that doesn’t paint the true picture of what primary care, the members of AFHTO are doing. So by having the association work with us to generate these measurement reports, we can actually give them to the Ministry at different levels of how that goes and share the information and say this is where we’re doing very well, this is where we’re making a difference. You may not be aware of that based on what you’re looking to collect yourselves. So that’s my thought on it. (ID = 019)

• I know there’s been a lot of question regarding the impact the family health teams have had. It was a rather expensive rollout for the government to establish all the teams, and they’ve obviously put a pause on the expansion of those teams over the last year or so, they’ve slowed down quite a bit, actually. (ID = 021)

• I would argue that people didn’t view this so much as a policy climate as they viewed it as a political climate where the Ministry was trying to justify the huge price tag of family health teams. And being able to demonstrate a high level of performance impact on the health care system, which I understand, I think that was fine. I think, initially, people viewed this is an overwhelming experience. (ID = 005)