For many people, particularly in Vancouver’s Downtown Eastside (DTES), who face complex health, mental-health and addiction challenges, access to primary care can be difficult and require low-barrier services. Designed to provide a broad range of accessible psychosocial and primary care services, the Primary Care Clinic (PCC) at H2H is interdisciplinary, focusing on a client’s needs and offering a coordinated and proactive care approach. Serving clients with complex health care needs, unattached to primary care, the PCC provides essential care for those living or receiving most of their services in the DTES of Vancouver.

With the goal of enrolling, engaging and empowering these clients to improve their clinical outcomes, the services are akin to “ambulatory critical care” for a priority population. Close monitoring of the clients served by H2H with real-time analytics and a solid quality improvement approach, has been key to its success.

Home to over 1,800 clients, recent funding announced by the provincial government will provide resources to expand this capacity to 2,800 total clients over the next year. Taking a holistic approach to healthcare delivery, teams of specialists work together to provide comprehensive, patient-centred care to help these clients meet their healthcare goals.