HEALTH WORKFORCE PLANNING: CHANELLING YOUR INNER PLANNER

HealthAchieve

November 7, 2017

Denise Cole, Assistant Deputy Minister

Health Workforce Planning & Regulatory Affairs Division

Ontario Ministry of Health and Long-Term Care

No planning process, just processes for making plans

Disparate strategies based on incomplete picture of population health needs

Short-sighted and narrowly focused

Planning is not collaborative and takes place in isolation

Evidence and data not aligned to planning needs

PLANNING TODAY 2

CHALLENGES TO PLANNING (1/2) 3

• Challenges underpinning health workforce planning efforts

• Shifting patient needs, preferences and technological advances create uncertainty

• The mix, supply and distribution of health professionals is constantly evolving

• New types of professionals are being introduced with the roles of existing professionals under pressure to expand

• Health professionals are not employees of the government (they either bill the government or work under contract)

• Organization of care delivery constantly needs to evolve to improve patient experience and health outcomes, keeping costs manageable (triple aim)

Workforce planning in the province mostly utilization-based, rather than needs-based (and little consideration of effective demand)

CHALLENGES TO PLANNING (2/2) 4

• What are the major problems with respect to workforce planning in Ontario?

Planning efforts have not reflected realities of the health system

• Don’t account for patient needs, new/emerging models of care

• Mostly focus on physicians and nurses

• Haven’t considered (lack of) economic growth

Health system arrangements

• Governance (e.g., fragmented professional regulatory structure)

• Financial (e.g., policy levers limited to remuneration)

• Delivery (e.g., labour supply and distribution out of control of government)

5THE JOURNEY AHEAD

shift the planning paradigm

Workforce planning is about ‘getting the right number of

people with the right skills in the right jobs at the right time’.*

*State Government of Victoria, Australia

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Interprofessional

Patient Centred

Right Mix

Right size

Right time

Right place

Right Care

WORKFORCE PLANNING BINGO – FROM RHETORIC TO ACTION

8RN PRESCRIBING

We think:• Enhanced access to care• Better patient experience• Improved access to

medication• More efficient use of the

workforce

• To many, a scope change…

• Actually a TRANSFORMATIVE INNOVATION that requires careful health workforce planning

But we SHOULD be thinking…

1) How does this change our projected future workforce needs?

2) Model of care we need to make this work?

3) How does it impact the scope of practice of others?

4) Education required for RNs AND for others?

9LHIN RENEWAL

We think:• Better access to care• More equitable access• Better patient experience• Higher-quality care• Improved efficiency

LHIN Renewal

• To many, better access to integrated care closer to home…

• Actually, an INNOVATION requiring careful health workforce planning to enable success…

But we SHOULD be thinking…

1) How does this change our projected future workforce needs?

2) Evidence and data needs?3) Models of care we need to make this

work?4) Compensation Models?5) Provider education needs?

10OTHER INNOVATIONS

Virtual Health Networks….

Personal Health Care Apps….

Virtual diagnostic Imaging…

AND,NOW…

PIGEONS????

11THINKING OUTSIDE THE BOX

Pigeon Vision:trainable observers of pathology and radiology breast cancer images

“Overall, our results suggest that pigeons can be used as suitable surrogates for human observers in certain medical image perception studies…”

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What we think…

Transformative innovation Better access to diagnostic

imaging Fewer highly paid

radiologists/pathologists Recruitment centre in Trafalgar

Square?

PIGEON

Technological Advancement

What we think…

Transformative innovation Better access to diagnostic

imaging Fewer highly paid radiologists/

pathologists Recruitment centre in Trafalgar

Square!

BUT!

Transformative Innovation does NOT become reality without a carefully planned health workforce to support it

We SHOULD be thinking…

• What type of skills are needed to support this innovation?

• Existing or new providers?

ALSO…• Training for new providers?• Continuing professional development

to transform our EXISTING workforce?• Impact on labour market?• Regulatory framework for safe delivery

of care?

13RE-CAP

Our approach to health workforce planning is evolving away from supply and demand planning

But still not responsive to changing patient need

We do not (and perhaps cannot yet) plan a health workforce to support transformative innovation

We need to shift the planning paradigm

The journey will be a long one, but it has begun

14PAN-CANADIAN HEALTH WORKFORCE PLANNING

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Health Workforce Planning

Scope of Practice

EducationModels of

Care

Labour Market

Understanding “Need”

Equitable Accessto Care:

DistributionRecruitment Retention

Integration

LegislativeBarriers

KEY COMPONENTS OF HEALTH WORKFORCE PLANNING

Health Workforce Planning Advisory Table

MOHLTC

Policy and Priorities Working Group

Evidence and Data Working Group

Measurement andEvaluation Working

Group

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Sector Engagement Key Internal and External Resources (may be individuals or organizations)

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Thank You!