Renewing Public Health Systems: Public Health
Human Resources Planning Processes
Co-authors:
Sandra Regan, Western University
Marjorie MacDonald, University of Victoria
Cheryl Martin, BC Ministry of Health
Nancy Peroff-Johnston, ON Ministry of Health and Long-Term Care
Sabrina Wong, University of British Columbia
Canadian Public Health Association Conference
May 28, 2014
Study Background
• CIHR-funded study - Renewal of Public Health Systems
(RePHS) 2009-2015
• Principal Investigators: Marjorie MacDonald, Trevor
Hancock, Bernie Pauly, & Ruta Valaitis
• Purpose of the study is to compare the implementation
and impact of the BC Core Public Health Functions and
Ontario Public Health Standards
• Focus on two public health programs in BC and ON –
• Chronic disease prevention (CDP)
• Sexually transmitted infection prevention (STIP)
Research Questions
Question 1: What factors and contexts influence or affect
the implementation of the BC Core Public Health
Functions and Ontario Public Health Standards ?
Question 2: What have been the impacts and effects of BC
Core Public Health Functions and Ontario Public Health
Standards on: staff, the organization, the populations
served, other organizations, & communities?
Cross-cutting themes: Equity, Health Human Resources,
Primary Care/Public Health Collaboration
Study Participants
• Interviews with BC & ON Directors, Associate/Medical
Officers of Health, Government Staff (N= 29)
– 6 Ontario public health units
– 4 BC regional health authorities
– Both provincial governments
• Data collection in Phase 2 – 2011-2012
– Focused questions regarding their approach to public
health workforce planning
• Data Analysis - Inductive thematic analysis
Background –
Public Health BC & ON
• Certain public health events highlighted system weaknesses,
e.g.: Walkerton (2000); SARS (2003); and H1N1 (2009).
• Led to reviews, reports, recommendations about public health
system:
– Learning from SARS: Renewal of Public Health in Canada. (2003)
– Development of a Draft Set of Public Health Workforce Core
Competencies. Summary Report (2005)
– Building the Public Health Workforce for the 21st Century: A
Pan-Canadian Framework for Public Health Human Resources
Planning. (2005)
– Local Public Health Capacity Review Committee Interim Report
(2005) and Final Report (2006).
PH Workforce Issues
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Shortages/supply
Profile of public health
Job instability
Compensation
Professional development
Career paths, opportunities for advancement
Workplace culture and conditions
Professional support
Leadership
PHHR data and information
Alignment of academic and practice fields
Access to support services
Context:
PH Workforce Planning
British Columbia
Ontario
• Provincial government
• Provincial government
– Ministry of Health
• Provincial agencies
– BC Centre for Disease Control
• Regional Health Authorities
– 5 geographic/1 provincial
• Provincial association
– Public Health Association of BC
– Ministry of Health & Long-Term Care
• Provincial agencies
– Public Health Ontario
• Local public health units
– 36 units
• Provincial associations
– Ontario Public Health Association
– Association of Local Public Health
Agencies (alPHa)
B.C.’s Guiding
Framework
• In 2013, BC’s Guiding Framework for
Public Health was released.
• Broad public health functions identified:
Provincial-Level Functions and
Infrastructure: The set of organizational
resources and services that support the
development and application of public
health programs (e.g., public health
human resources)
• The document identifies areas of focus
including: Public health human resources,
training and development.
Ontario Public Health
Organizational Standards
• In 2011, the Ontario Public
Health Organizational
Standards were released
• Establish management and
governance standards for
boards of health
• Include organizational
requirements for public
health human resource
planning and development
Interviews: Workforce
Planning Activities
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Retirement projections
Succession planning
Predicting types of skills needed in the future
Recruitment and retention
Identifying trends and issues
Workforce/staff development planning
Interviews:
Workforce Planning
• Some degree of Workforce Planning was discussed by all participants.
• Typically, participants mentioned aspects of Workforce Planning but no
one identified that their organization had a comprehensive plan.
• In BC, public health workforce planning is integrated into each regional
health authority’s planning processes; PH may or may not be a priority
within broader health care system planning
• In ON, public health workforce planning occurs both in the local public
health unit and with the municipality; PH may compete with multiple
demands on the municipality.
• Both BC and ON discussed the public health core functions/standards in
relation to Workforce Planning – but this was more evident in BC
interviews.
Interviews:
Workforce Planning
• No comprehensive workforce “plan” was obtained from
any regional health authority/public health unit.
• Most discussed having a “human resources” person in
their regional health authority/ public health unit.
• Many discussed the need for a more formal plan that
would combine key activities – projections, demand,
education, recruitment and retention.
• References were made to provincial government level
planning of the public health workforce
• “…So they have some estimates [of the public
health human resources ] but I think there’s some
issue around defining public health professionals
and the training that’s required and the different
areas, etcetera. So I’m sure they would say that
they do have [a plan] but from my perspective
they aren’t able to accurately measure the public
health workforce so they are not able to properly
plan for their development.”
• “We have somebody that’s working with
[municipal] HR on looking at workforce
development.”
• …there’s a process that’s going on right now
and which will eventually, I think, yield a
human resource plan for us for the next few
years.”
Conclusions
• Public health renewal has led to the development of numerous
documents calling for attention to and addressing aspects of
PHHR planning such as competency development, enumeration
of the workforce, recommendations for future PHHR-related
work.
• However, participants were not able to point to a specific plan for
the PH Workforce either at the regional/local or provincial levels.
• Data were collected in Phase 2 – 2011-2012. Phase 4, just
completed, asks about progress on Workforce Planning.
• In order to achieve the recommendations of the numerous public
health recommendations of the 2000s, a comprehensive public
health workforce plan is a necessity.
Acknowledgements
• Canadian Institutes of Health Research
Emerging Team Grant
• CIHR/PHAC Applied Public Health Chair
(Dr. Marjorie MacDonald)
• RePHS BC and ON Research Team –
Investigators – Academic and
PHU/government Decision-Makers
Thank you!
Questions?
Presenters:
Sandra Regan sregan4@uwo.ca
Nancy Peroff-Johnston Nancy.Peroffjohnston@ontario.ca
RePHS Project Contact: Diane Allan, RePHS Project
Coordinator dallan@uvic.ca
http://www.uvic.ca/research/groups/cphfri/projects/curre
ntprojects/rephs/