Richmond Primary Care Networks Logo

PCN for Richmond Family Physicians

You don’t have to manage complex patient needs alone.

Richmond’s Primary Care Network expands your care team with MSP-funded clinicians who can support your patients’ physical, mental, and social health needs. Refer eligible patients to PCN services to improve access, enhance outcomes, and free up valuable physician time for the care only you can provide.

Why Make a PCN Referral?

  • Earlier intervention
  • Better chronic disease management
  • Improved mental health support
  • Increased patient self-management
  • Reduced social barriers to care

Living Well with Chronic Conditions: Vickie’s Story

Discover how Richmond PCN’s team-based care helped Vickie improve diabetes management, stay active, and continue the creative activities she loves.

Benefits of PCN for Richmond Patients

  • MSP-funded services
  • Easier access to the right services
  • Personalized team-based care
  • Ongoing health support
  • Support in multiple languages, where available
  • Better health outcomes

George’s Return to Community and Connection

With support for both his own wellbeing and his wife’s recovery, George found renewed confidence, stronger social connections, and the tools to live more independently.

Available PCN Clinician Services

Chronic Disease Management Nurse

  • provides support to manage chronic diseases (diabetes, heart failure, high blood pressure, more)
  • teaches patients how to understand and develop self-management strategies

Mental Health Counsellor

  • provides support for anxiety, depression, relationship issues, grief/loss
  • helps patients to gain new perspectives
  • introduces tools to cope with personal issues

Clinical Pharmacist

  • conducts medication assessments
  • ensures prescriptions are suitable for each condition
  • provides advice on dosage and adverse reactions

Dietitian

  • provides nutrition assessment/consultation
  • improves patient eating habits
  • prevents/delays chronic conditions
  • teaches about nutrition needs
  • helps patients make sustainable lifestyle changes

Seniors Team

  • provides timely, appropriate senior care
  • improves overall senior patient health
  • increases patient independence
  • enhances safety

Occupational Therapist

  • helps patients maintain skills for daily activities (personal care/meals)
  • teaches adaptive energy conservation skills
  • provides stress management strategies

Physiotherapist

  • treats musculoskeletal/neurological conditions (arthritis/MSK injuries/stroke/MS/Parkinson’s)
  • develops personalized home exercise programs
  • helps patients to prevent falls
  • provides advice on gait aids

Social Worker

  • addresses factors that impact patient health (finances, housing, social supports)
  • develops advanced care plans
  • provides referrals to community programs

Community Link Worker & Community Navigator

  • supports patient health and wellness goals
  • connects patients with social and physical activities
  • improves patient physical and emotional wellness
  • informs patients about local community services and opportunities for connection

Chronic Disease Group Education

  • small, in-person group education
  • taught by interdisciplinary Primary Care Network clinicians
  • teaches patients and caregivers self-management skills
  • classes:
    • Type 2 Diabetes
    • Pre-Diabetes
    • Cholesterol/Dyslipidemia/Heart Health
    • Cognition/Brain Health
    • Depression/Anxiety

Before You Refer: Care Team Eligibility

To ensure patients are connected with the right services, referrals to the Richmond PCN Care Team must meet the following eligibility criteria. Please review these requirements before submitting a referral.

Make a PCN Referral with Confidence

Make informed referral decisions with the PCN Wait Times Dashboard. View current wait times across a range of Richmond PCN services to help connect your patients with the right care, at the right time.

Contact the Primary Care Network (PCN)

The Richmond Primary Care Network uses a team-based, coordinated care model to support Richmond family physicians, nurse practitioners, and their patients through seamless healthcare collaboration.

Have questions about your referrals? Get in touch:

  • Call 604-233-5686
  • Fax 604-244-8599
  • Email rmdpcn@vch.ca