CANADA: BACKGROUND PAPER 15 th IHWC CONFERENCE 2015 COUNTRY ROUNDTABLE 13 May 2015

Transcription

1 CANADA: BACKGROUND PAPER 15 th IHWC CONFERENCE 2015 COUNTRY ROUNDTABLE 13 Intrductin Canada is made up f 10 prvinces and 3 territries with a ppulatin f ver 35 millin. 1 Canada has a publicly funded health care system that is largely administered by its prvinces and territries. As health care is delivered by the prvinces and territries, health human resurces planning had histrically been cnducted by each jurisdictin individually. Hwever, since 2003 effrts have been made at the federal/prvincial/territrial level t develp a cllabrative strategy that will enable better evidence based pan-canadian health human resurces planning. The Cmmittee n Health Wrkfrce is a natinal frum fr strategic discussin, infrmatin sharing, and actin n pririty federal/prvincial/territrial health wrkfrce issues. The Cmmittee n Health Wrkfrce prvides plicy and strategic advice t the Cnference f Deputy Ministers f Health n health wrkfrce issues including the planning, rganizatin, and delivery f health services. Members f the Cmmittee n Health Wrkfrce cnsist f Assistant Deputy Ministers r equivalents respnsible fr health wrkfrce f their respective prvince/territry. The remaining sectin f this paper will address the rundtable questins as it pertains t the Cmmittee n Health Wrkfrce s wrk. Rundtable Questins 1. Transitins frm the last cnference: What changes, if any, have happened in the natinal health wrkfrce planning landscape in yur cuntry since the last meeting? 1 Statistics Canada, Canada s ppulatin estimates, furth quarter 2014: Accessed n May 6, Prepared by Ontari Ministry f Health & Lng-Term Care Page 1 f 7

2 Since the 2013 Internatinal Health Wrkfrce Cllabrative meeting, tw new task frces were created under the Cmmittee n Health Wrkfrce regarding team-based mdels and health human resurces management. In January 2015 the Cmmittee n Health Wrkfrce hsted Frm Innvatin t Uptake: A Team-Based Mdels Summit. This multi-stakehlder meeting was designed t prmte the uptake f team-based mdels; explre the ptential f team-based mdels t psitively impact the patient and prvider experience; and build strng learning-centered relatinships amng the Canadian health prvider cmmunity. 2. The Basics: What is the scpe f this wrk? When did it start? Hw many full-time equivalents are allcated t this wrk? What are the key skill sets needed t set up/maintain a natinal health wrkfrce planning effrt? The Cmmittee n Health Wrkfrce was established in The Cmmittee n Health Wrkfrce is c-chaired by the Assistant Deputy Minister f Health Canada s Strategic Plicy Branch and a prvincial Assistant Deputy Minister that rtates annually amng the prvincial/territrial members. The administratin f the Cmmittee n Health Wrkfrce is supprted by a secretariat frm Health Canada s Health Human Resurces Plicy Divisin Wrk t address varius health wrkfrce issues are undertaken by the Cmmittee n Health Wrkfrce s task frces and wrking grups. This wrk reflects t sme degree the health wrkfrce pririties at a pan-canadian level. As f April 2015, the fllwing task frces and wrking grups have been set t address varius health wrkfrce pririties: Task Frce r Wrking Grup Internatinally Educated Health Prfessinals Task Frce Principal Nursing Advisrs Task Frce Physician Resurce Planning Task Frce Fcus f Wrk Prvides the Cmmittee n Health Wrkfrce, the Freign Qualificatin Recgnitin Wrking Grup, and federal departments such as Citizenship and Immigratin Canada with leadership, analysis and advice n the issues and trends impacting internatinally educated health prfessinals. This includes infrmed recmmendatins and guidance n ptential plicy directins within the larger health human resurces cntext. Prvides advice n plicy, prgrams, and initiatives in supprt f effective and ptimal utilizatin f nursing knwledge, skills and expertise. Pan-Canadian nursing human resurce planning and nursing educatin are the current pririties f this task frce. Wrk is fcused n advancing a recmmendatin frm the Future f Medical Educatin in Canada Pstgraduate Prject Reprt t ensure the right mix, distributin and number f physicians t meet scietal needs. Prepared by Ontari Ministry f Health & Lng-Term Care Page 2 f 7

3 Team-Based Mdels Task Frce Health Human Resurce Management Task Frce Health Labur Relatins Wrking Grup Health Prfessins Credentials Wrking Grup Explre innvative mdels f team-based care which have demnstrated imprved patient-centered care and value thrugh enhanced access, integratin and ptimizing the skills and scpes f practice f the health care prfessinals. Supprt prvincial/territrial and pan-canadian health human resurces planning effrts. Plan a jint meeting f the Cmmittee n Health Wrkfrce members and fficials respnsible fr physician negtiatins t discuss areas f cmmn interest and areas f ptential federal/prvincial/territrial cllabratin. Wrk cllabratively t review, assess and prvide recmmendatins n frmal requests fr changes in entry-tpractice credentials as well t serve as a natinal frum fr infrmatin exchange and knwledge transfer n matters related t scpes f practice, initial regulatin f a health prfessin within any jurisdictin and ther matters f cmmn interest related t changes in credential fr regulated health prfessins. 3. Sustainability: What is the length f current funding cycle fr this (these) health human resurces bdy (bdies)? T what degree is existence tied t plitical will? Are there ther sustainability issues besides funding/plitics? The Cmmittee n Health Wrkfrce s wrk plan and budgets fr its task frces and wrking grups are reviewed and apprved by the Cnference f Deputy Ministers n an annual basis Missin/Current Tpics: Wh decides what health wrkfrce issues will be the fcus f wrk? What are the current issues f mst interest t the health human resurces bdy (bdies)? What are the challenges fr wrkfrce planning in a rapidly changing health system in each cuntry? The Cmmittee n Health Wrkfrce s primary mandate is t prvide plicy and strategic advice t the Cnference f Deputy Ministers. As such, the Cmmittee n Health Wrkfrce s wrk will be influenced by requests frm the prvincial Deputy Ministers f Health. Fr example, the Physician Resurce Planning Task Frce was established t supprt a Deputy Ministers f Health/Deans f Medicine Wrking Grup. This wrk fcuses n advancing a recmmendatin frm the Future f Medical Educatin in Canada Pstgraduate reprt, t ensure the right mix, distributin and number f physicians t meet scietal needs. 2 The Cnference f Deputy Ministers f Health is an in-persn meeting f federal/prvincial/territrial deputy ministers. This meeting is usually held twice per year. These meetings allw deputy ministers frm acrss the cuntry t gather t discuss issues f natinal imprtance. Their discussins help t infrm the annual federal/prvincial/territrial Health Ministers Meeting. Prepared by Ontari Ministry f Health & Lng-Term Care Page 3 f 7

4 The mandate f this task frce is t advance: A prcess fr addressing physician imbalances acrss identified specialties. A pan-canadian physician planning tl t better understand the cmplexities f physician supply. Accurate infrmatin t supprt decisin-making by thse cnsidering and currently pursuing medical educatin, bth in Canada and abrad. The challenges that Canada faced with wrkfrce planning are largely gegraphical and structural. With a land mass that is equivalent t the Eurpean cntinent; there is a challenge t ensure a balanced supply f the health wrkfrce thrughut varius regins f the cuntry. As well, since health care is delivered by prvinces and territries, jurisdictins have their wn unique wrkfrce planning challenges t address. A frum such as the Cmmittee n Health Wrkfrce and the creatin f the Physician Resurce Planning Task Frce is imprtant t help fster a cllabrative apprach t planning. 5. Data: What wrkfrce data are cllected fr health human resurces planning purpses? What health prfessins are represented in this data? Wh cllects this infrmatin and where is it hused? What data use/data cnfidentiality/integrity issues are mst salient? The Canadian Institute fr Health Infrmatin s Health Wrkfrce Database huses the mst cmprehensive data n the Canadian health wrk frce. This database has infrmatin n 31 grups f health care prfessinals, including practice setting, regulatry envirnment, supply, and demgraphic, educatin and emplyment characteristics. Individual jurisdictins may als have prvincial health wrkfrce data. Fr example, Ontari has the Ontari Physician Human Resurces Data Centre which cllects infrmatin n Ontari physicians in practice and in training, and Ontari s Health Prfessins Database which cllects standard, cnsistent and cmparable data fr 24 regulated health prfessins in Ontari. 6. Analysis: What types f analyses and mdeling are dne? Hw d the natinal health wrkfrce centers apprach health human resurces analysis and planning beynd the traditinal quantitative appraches (e.g. dctr t ppulatin ratis) t factr in ther cmpnents such as verlapping scpes f practice, flexible use f wrkfrce etc.? At present, Canada des nt have natinal health wrkfrce mdelling tls. This is ne f the reasns fr establishing the Physician Resurce Planning Task Frce. Several prvincial gvernments have develped physician health wrkfrce mdels, which are used fr planning and analytical purpses. Sme prvinces are als develping mdels fr ther health care prviders. Fr example, Ontari is develping a nurse frecasting tl that will incrprate supply, demand, and need. The Canadian Institute fr Health Infrmatin maintains databases and publishes aggregate supply statistics fr several health care prvider grups. They use their databases t Prepared by Ontari Ministry f Health & Lng-Term Care Page 4 f 7

5 develp special tpic reprts and als serve as a data surce fr health wrkfrce studies cnducted by researchers utside f The Canadian Institute fr Health Infrmatin. Ntwithstanding Canada s relatively limited natinal level utputs, prvincial research centers, like Ontari s Institute fr Clinical Evaluative Sciences, have prduced numerus indepth health wrkfrce studies. Mrever, the Canadian Academy f Health Sciences new reprt entitled Optimizing Scpes f Practice may be an early signal f increased research n verlapping and cmplimentary scpes f practice. 7. Audience/Authrity t Implement: Wh is the primary audience fr wrkfrce data/analysis/reprts? Hw d they use the infrmatin? Is the natinal planning bdy purely advisry r d ther agencies have t fllw its recmmendatins? Given sub-natinal (i.e. state/prvincial) respnsibility fr the delivery f care in certain Internatinal Health Wrkfrce Cllabrative cuntries, hw des the natinal entity address gvernance and what authrity, if any, d they have? The infrmatin and deliverables prduced by the Cmmittee n Health Wrkfrce s varius task frces and wrking grups are infrmatinal t infrm discussins n pan-canadian health human resurces issues. They are nt intended t be prescriptive and jurisdictins are nt bund t act upn the infrmatin. 8. Disseminatin: Hw is the wrk f the wrkfrce planning bdy disseminated? In what types f frmats is the infrmatin presented s that it is mst useful fr the intended audience? What has wrked well and nt s well fr disseminating findings and recmmendatins? The Cmmittee n Health Wrkfrce s task frces and wrking grup prvide updates t the Cnference f Deputy Ministers. This may be in the frm f reprts, presentatins, r in sme cases a prduct related t a deliverable. Fr example, in regards t the Physician Resurce Planning Task Frce s wrk t prduce infrmatin that can supprt decisin making f thse cnsidering a career in medicine, an nline resurce called FutureMD is being develped. 9. Gegraphy: What are the wrkfrce plicy levers that require a natinal-level health wrkfrce planning entity? What are sub-natinal (prvincial, state, reginal) wrkfrce plicy questins that require health wrkfrce planning? Hw d subnatinal health wrkfrce planning entities, if they exist, relate t the natinal WFP bdy? T what degree are reginal cncerns taken int accunt (e.g. prvincial planning in Canada and trauma centers in the United States.)? Prvincial/territrial gvernments hld primary respnsibility fr health care delivery and wrkfrce planning in Canada. The apprach t planning varies acrss jurisdictins. The Cmmittee n Health Wrkfrce is the main frum in which federal/prvincial/territrial gvernments interact n health wrkfrce matters. The Physician Resurce Planning Task Frce was created t help bring medical educatrs and natinal rganizatins int federal/prvincial/territrial discussins fr physician wrkfrce planning. Prepared by Ontari Ministry f Health & Lng-Term Care Page 5 f 7

6 10. Cllabratrs: Wh are the key partners and what is the value/nature f partnership t federal wrkfrce planning entity? T what degree des the health wrkfrce planning prcess include the prfessinal assciatins, Funders (e.g. gvernment, insurance cmpanies)? The membership t the Cmmittee n Health Wrkfrce s task frces/wrking grups generally included prvincial/territrial ministry and federal Health Canada representatives. Sme grups include representatives frm ther natinal rganizatins r ther gvernment agencies. Fr example: The Physician Resurce Planning Task Frce is a multi-stakehlder grup with representatives frm federal, prvincial and territrial gvernments, natinal stakehlders, medical educatrs and learner rganizatins. The Principal Nursing Advisrs Task Frce has representatives frm principal nursing advisrs in each prvincial/territrial ministry, Health Canada, Canadian Frces, Crrectin Services Canada, Public Health Agency f Canada and Veterans Affairs Canada. Team-Based Mdels Task Frce has representatives frm varius prvincial/territrial ministries, Health Canada, Canadian Medical Assciatin, Canadian Nurses Assciatin, Health Actin Lbby, Canadian Pharmacists Assciatin, and the Paramedic Assciatin f Canada. 11. Cmpetitin: Are there ther rganizatins with WFP missins in the cuntry? Hw d they cllabrate r cmpete with natinal WFP bdy? There are n natinal level rganizatins with mandates that cmpete with the Cmmittee n Health Wrkfrce s mandate. Hwever, there are rganizatins that prduce reprts which help infrm emerging health wrkfrce issues. The fllwing sectin prvides sme examples f reprts and activities that have emerged since the last Internatinal Health Wrkfrce Cllabrative meeting. In 2013, the Ryal Cllege f Physicians and Surgens f Canada released the results f a cmprehensive, natinal wrkfrce study fcusing n the grwing number f newly certified specialist physicians wh have truble finding wrk in their specialties. A Natinal Physician Emplyment Summit was cnvened in February 2014, mbilizing effrts t imprve health wrkfrce planning and t address physician emplyment challenges. The summit was pan-canadian in scpe and drew in mre than 100 attendees, including representatives frm gvernment and all f Canada s majr medical rganizatins. A secnd Summit will take place in the fall f 2015 t exchange best practices and prgress reprts, as well as t develp an actin plan that will streamline and crdinate effrts t address physician un- and under-emplyment. In 2012, the Canadian Academy f Health Sciences cmmissined the Canadian Health Human Resurces Research Netwrk t study scpes f practice that will be mst effective in supprting innvative mdels and transfrming the health care system. In Octber 2014, study results were published in a reprt entitled, Optimizing Scpes f Practice: New Mdels f Care fr a Transfrmed Health System. The study s c-chairs summarized the reprt as fllws: Prepared by Ontari Ministry f Health & Lng-Term Care Page 6 f 7

7 ..the reprt calls fr a new apprach twards determining scpes f practice based upn cmmunity need. This apprach wuld empwer the cllabrative practice team t determine the relative respnsibilities f the different practitiners and the team wuld be held accuntable thrugh an accreditatin prcess within a prfessinal regulatry envirnment. In Octber 2014, the Canadian Health Human Resurces Netwrk hsted the Canadian Health Wrkfrce Cnference. This was the first pan-canadian health human resurces-fcused cnference Canada has had since Participatin was crsscutting, with representatives frm gvernment, the health prfessins and academia. The cnference highlighted health human resurces research thrughut Canada and featured prgramming targeted t graduate students. The Canadian Institute fr Health Infrmatin cntributed financial and planning supprt, alng with almst a dzen ther agencies. The Canadian Health Human Resurces Netwrk is planning a secnd Canadian Health Wrkfrce Cnference fr the fall f Prepared by Ontari Ministry f Health & Lng-Term Care Page 7 f 7