Transition of Care Program

Transition of Care Program

The MUHC's Cedars Cancer Centre  is a tertiary-care centre, dedicated to providing comprehensive, specialized cancer care to patients with complex needs. 

In February 2020, the MUHC launched the  Cancer Care Transition of Care Program (CCTCP). This initiative is in line with national best practices and follows the recommendation from Choosing Wisely Canada to avoid following patients in a tertiary-care setting when they can be followed with the same results in a primary-care setting in the community.

The goal of the CCTCP is to provide seamless, shared care between the MUHC and community healthcare professionals from the moment a patient enters the cancer care system.

When appropriate, patients may transition from hospital-based cancer care teams to their family doctors or other community healthcare providers, ensuring they continue to receive high-quality care closer to home.

This program brings together a wide range of partners, including:

  • MUHC specialists and leadership
  • McGill Family Medicine
  • community physicians and health care providers
  • patient partners

Together, we are building a more collaborative patient-centered model of cancer care—one that improves access and supports both patients and healthcare providers during the care journey. 

Transition of care documents

These documents are meant for a select group of cancer patients who have received treatment and are now eligible to be part of the CCTCP. 

Follow-up visits will be shared between the MUHC and a family doctor or a community health practitioner, and will eventually be transferred completely to a community practitioner.

How to contact the CCTCP