Public Health Sector Strategic Plan

Update to alPHa board

April, 2013

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Purpose

• To provide an update on the Public Health Sector Strategic Plan since it was presented at the alPHa Winter Forum in February, and released at TOPHC

• To share preliminary thinking on implementation and next steps

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Context• Significant strides have been made to renew Ontario’s public health system in the after-

math of key events including Walkerton and SARS:• Operation Health Protection, released in 2004, articulated the government’s strategic

approach to renewal of public health and included key commitments related to: Emergency management; infection control and communicable disease capacity, including the creation of Public Health Ontario, and public health sector health human resources

• The final report of the Capacity Review Committee also made recommendations related to sector renewal and capacity development

• Key achievements have included: Establishment of Public Health Ontario (PHO); new Ontario Public Health Standards; new public health organizational standards; first ever accountability agreements and performance indicators with boards of health, and initiation of a review of provincial funding for public health

• The issues and policy environment has continued to change and evolve• A Strategic Plan is required to leverage gains made and to continue to move the yard-stick

in collective areas of focus• The Plan was released on April 4, 2013 as a Chief Medical Officer of Health (CMOH)

Special Report, at the Ontario Public Health Convention (TOPHC)

Strategic Plan for the Public Health Sector

The Plan:• Articulates a long term vision with short term, renewable, collective areas of

focus• Addresses gaps in sector infrastructure and capacity• Addresses complex/emerging issues • Will transform current activities related to the established “core” business of

public health, coalesce resources across the sector, and engage others outside of the sector, as needed

• Makes the “case” for public health and links public health more clearly to broader health care sector reform, and activities of the non‐health sectors, to improve the health of the population

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Strategic Plan for the Public Health Sector (cont’d)

• The plan is intended to articulate a long-term vision but to also identify collective areas of focus over the next 3-5 years.

• The Plan is framed within context of what we are already doing; including gaps in current efforts, emerging issues, and what the evidence is telling us:

• We have made considerable progress in renewing the public health sector in Ontario, and considerable gains in health which must be maintained.

• We need a plan to (1) address gaps in sector infrastructure and capacity; (2) make an impact on wicked/emerging issues; and, (3)

transform current activities related to the established, “core” business of public health (i.e., coalesce resources of the sector and outside of it).

• The Plan is intended to be relevant and appropriate within the current statutory, policy, fiscal, accountability, and programmatic landscape.

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A Plan Built on Partnerships: The Unique Position of the Sector

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Determinants of health – social, economic, environmental

Please note that the Venn diagram is not meant to list all partners/organizations. Those included are identified as examples.

Non-Health Sector Partners

Local governmentProvincial ministriesFederal departments

Broader public sector

Private sectorEducation sector,

including Colleges and Universities

First NationsAboriginal Groups

Health Sector Partners

Primary careCommunity care

Acute careLong-term care

Professional, and other, associationsNon-governmental

organizationsHealth Canada,

Public Health Agency of Canada

First NationsAboriginal Groups

Public Health Sector

Engagement of Aboriginal and First Nations Organizations

• The unique needs of Aboriginal and First Nations communities are recognized in the Plan approach and we intend to invite representatives to be involved in the implementation planning phase of the work

• The Ministry has committed to a separate but parallel process for First Nations communities under the Public Health Working Group of TFNHSOC, that is articulated in its Project Charter. Now that the report has been released it will be taken back to the Public Health Working Group of TFNHSOC and to the Health Coordination Unit at COO for further discussion, and to seek advice on how to engage First Nations communities throughout implementation.

• Further discussions will be held with the off-reserve organizations to seek advice on how to engage the off-reserve Aboriginal communities in the next phase of work.

• This includes proposed implementation tables, and other mechanisms, which are currently under discussion.

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Public Health Sector Strategic Plan Framework

Our VisionOntarians are the healthiest people in the world supported by the best public health system in the world

Our MissionTo protect and promote the health of all people in Ontario through the delivery of quality public health

programs and services, effective partnerships and a focus on health equity

Improve the preventionand control of

infectious diseases

Strengthen the public health sector’s

capacity, infrastructure, and emergencypreparedness

Improve health by reducing preventablediseases and injuries

Optimize healthy human development

Promote healthy environments – both

natural and built

Our Strategic Goals

Immunization Information and knowledge systems;

collaborative mechanisms; a highly competent workforce

Physical activity and healthy eating;

tobacco and alcohol

Early childhood development, including

mental wellness and resiliency

Built environment

Our Collective Areas of Focus

Our ApproachA population health and life course approach that addresses the determinants of health and health inequity,

and the needs of vulnerable populations, including Aboriginal populations.

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OUR PROPOSED ACTIONS

OUR STRATEGIC GOALS

OUR COLLECTIVE AREAS OF FOCUS

Promote healthy environments, both natural

and built

Built Environment

Scope Definition;Capacity Building, and Evidence Generation.

Optimize healthy human

development

Early ChildhoodDevelopment,

including mental wellness

and resiliency

Build on current initiativesincluding HBHC and other government strategies;

Integrate evidence to supportearly childhood development

and maternal/child/youth health, and mental wellness

and resiliency.

Improve health through reducing

preventable diseases and injuries

Physical Activity & Healthy Eating

Tobacco & Alcohol

Preventive strategies to attain healthy weights;Reduce tobacco use;

Reduce alcohol misuse; Including accessing

priority populations.

Improve the prevention

and control of infectious diseases

Immunization

Implement Immunization Review findings;

Evaluate and renew Universal Influenza Immunization

Program (UIIP); Consider and

prioritize new vaccines forpublic funding.

Strengthen the public health sector’s capacity, infrastructure, and

emergency preparedness

Information & Knowledge Systems

Sector CollaborativeMechanisms

HighlyCompetent Workforce

Implement Panorama; Develop I&IT Strategy; Develop Surveillance

Strategy; Partnerships with Health sector; Enhance partnerships with other

Sectors; Create formal mechanism for Public

Health evidence to policy; Public Health HR

and workforce development strategy.

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Identifying Outcomes and Indicators

• We will review current metrics• We will identify desired population outcomes, and develop metrics for the Plan• Work will be informed by existing Accountability Agreements and indicators, and will also

consider the 2011 CMOH Annual Report

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t Current metrics (e.g. Accountability Indicators, PHO balanced score card, health status indicators etc.)

Current metrics (e.g. Accountability Indicators, PHO balanced score card, health status indicators etc.)

Current metrics (e.g. Accountability Indicators, PHO balanced score card, health status indicators etc.)

Current metrics (e.g. Accountability Indicators, PHO balanced score card, health status indicators etc.)

Current metrics (e.g. Accountability Indicators, PHO balanced score card, health status indicators etc.)

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rs 3-5 year metrics (established as sector)

3-5 year metrics (established as sector)

3-5 year metrics (established as sector)

3-5 year metrics (established as sector)

3-5 year metrics (established as sector)

OUR STRATEGIC GOALS

OUR COLLECTIVE AREAS OF FOCUS

OUR PROPOSED ACTIONS

15-20 year metrics – population outcomes

15-20 year metrics – population outcomes

15-20 year metrics – population outcomes

15-20 year metrics – population outcomes

15-20 year metrics – population outcomes

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Evidence Informed through continuous research, evaluation, best practices and quality improvement processes

Implementation

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• Since the Plan’s release we have sought advice and direction from PHLC regarding next steps

• We are considering key milestones and processes, going forward• This will include:

• Continued engagement of government and local-level partners to further socialize the plan and to build broader buy-in

• Work to comprehensively inventory existing initiatives at the provincial and local levels that can be leveraged to support implementation [e.g. the Healthy Kids’ Panel Report, Open Minds, Healthy Minds]

• Regional sessions - We will be asking Public Health Units if they will consider hosting these sessions which may also include other local partners

• The establishment of implementation tables with provincial and local-level membership

• A detailed implementation plan/strategy – to be completed by December 2013

• Do you have any advice regarding implementation approaches? • What is your advice regarding optimal engagement of alPHa, boards of health,

and PHUs?• Do you have advice regarding prioritization of implementation approaches?

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Discussion & Questions