Provincial premiers will be meeting as the Council of the Federation at the end of July in Halifax and health care is almost certain to be on the agenda.

The first report from the first ministers health care innovation working group will be presented at the meeting, and was promised to address health human resource and service delivery issues with a national lens.

The meeting will also present the opportunity to identify the next set of priorities for the working group.

The front-runner on the priority list should be home and community care. Heres why.

Home and community care is the collection of services that people receive outside of hospitals and doctors offices. This includes nursing homes, as well as home health care, personal support services (like help with bathing or housekeeping), other community care services and, of course, care from family and friends.

Ideally, all care providers will work together to create a comprehensive approach to home and community care. When they do not, it is costly, both to the health of individual Canadians, and to the public health system at large.

When home and community care fails, patients end up in hospital emergency rooms, often long past the point at which preventive care measures may have provided a solution. Many then get admitted as in-patients the most expensive form of health provision. They may then stay far too long in the hospital, awaiting a spot in a nursing home or for other appropriate community-based services to be arranged. One in every nine hospital beds is occupied by a person over age 65 who could receive appropriate care elsewhere.

When emergency rooms and hospital beds are full, patients receive care in hallways. Care and work conditions are jeopardized, which increases the likelihood of infections, medical errors and readmissions.

The interconnectedness of different parts of the health care system is not lost on Mike de Jong, British Columbias Minister of Health. De Jong recently told the Fraser Health Authority that they have 150 days to improve hospital care in several key areas including less hallway care; quicker movement from the emergency room to an actual bed if in-patient care is needed; and a lower average length of stay.

Fraser Health is not unique in B.C., and B.C. is not unique in the country. Health ministries across Canada are all trying to address overcrowding in acute care. In many cases, they are employing similar initiatives to improve care and reduce the need for emergency rooms, acute in-patient care and nursing homes.

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Home, community health care services should top premiers’ list