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Spotlight on Public Health Core Competencies:
Today’s Health Human Resource Development Issue


The public health landscape in Canada is being influenced by an increased focus on a critical need—the need to ensure an effective, responsive and sustainable approach to health human resource planning.

The concept of properly planning, producing and managing a country’s health human resources is not new. For decades, numerous reports from various provinces, countries and the World Health Organization stressed the need to undertake country-wide and health system-wide reviews of how health human resources are selected, trained and managed to ensure that health goals can be achieved. Since our definition of health itself and our understanding of what determines health has evolved conceptually, many jurisdictions find themselves behind in strategically thinking through and implementing health human resource plans to keep pace. Bureaucracies are large, political winds shift and change – by nature often threatening - can be difficult to implement in all sectors.

As is often the case, however, the lightning rod for Canada’s high-profile shift toward focusing on public health human resource planning in this country can be traced to the compound effect of several significant crises in confidence about our public health infrastructure, ranging from the tainted blood scandal and the Walkerton (Ontario) and North Battleford (Saskatchewan) cases, to the threats of West Nile virus, avian flu and SARS.

In fact, the seminal report Learning from SARS: Renewal of Public Health in Canada (A report of the National Advisory Committee on SARS and Public Health October 2003) crystallized the link between public health status for Canadians and human resource planning in stating: “No attempt to improve public health will succeed that does not recognize the fundamental importance of providing and maintaining in every local health agency across Canada an adequate staff of highly skilled and motivated public health professionals. Our national aim should be to produce a cadre of outstanding public health professionals who are adequately qualified and compensated, and who have clear roles, responsibilities and career paths.”

In the wake of SARS, there was a widespread public and political recognition of the sobering reality that Canada’s public health system was only as strong as its weakest link. This led to a 2004 Ministers of Health commitment to support a 10-year action plan to strengthen the public health system. The establishment of the Public Health Agency of Canada, with a significant mandate in the area of health human resource planning, was yet another signal of the momentum for public health workforce planning. The Agency is working on providing support to the Pan-Canadian Framework for Public Health Human Resources Planning. The focus is on fostering a collaborative approach to public health human resource planning. Confirmed by international best practices in countries such as the United States, the United Kingdom and Australia, there is recognition that effective workforce planning must be designed to respect and enhance the interprofessional nature of public health work.

The challenge of shifting toward this collaborative model is significant. While the practice of public health is highly inter-professional, planning and training in this area has historically been discipline specific. To introduce this approach successfully will require a careful communication and change management plan that focuses on the benefits of a collaborative system for public health human resource planning—benefits for practitioners, for citizens and for policy makers.

The evolution toward a collaborative approach to public health human resource planning has fuelled the move toward a core competency model. This client-centered approach stems from realizing that positive health outcomes often result from effective collaboration among and between practitioners in Canada’s public health professional communities. As such, focusing on the skills, knowledge and abilities required to maintain and promote public health, irrespective of professional designation, is essential to ensuring that Canada is equipped with a strong workforce of public health professionals.

The case for core competency becomes even more compelling because of the significant challenges associated with recruiting and retaining public health talent, particularly in under-serviced areas. A pan-Canadian approach makes sense, not only for citizens but also for practitioners, who benefit from more opportunity and career mobility.
In a very real way, this is a new beginning in health systems planning in this country. We are finally beginning to recognize the role played by a now much broader range of workers in promoting and protecting the health of Canadians. The formal core competency work that the more traditionally recognized health disciplines are carrying out is critical in helping to guide the work of others. Throughout, strategic and clear communications planning will remain the key to limiting any duplication of efforts.

As a consulting firm with both conceptual knowledge and practical experience that can be leveraged to help disciplines work toward strategically planning and, just as importantly, communicating their work on core competencies, The Alder Group is proud and excited to be able to build on past successes and continue to contribute to ongoing work in the area of health human resource development.

The Alder Group's depth of expertise was acknowledged last October as Brian Hyndman’s informative paper Towards the Development of Canadian Health Promotion Competencies: Where we’ve been, where we are, and where we’re going was published in the Ontario Health Promotion E-Bulletin.

Assignments carried out by The Alder Group relevant to health human resource core competencies include the following:
 

Strategic Communications Plan for the Canadian Institute of Public Health Inspectors

In partnership with Ingenium Communications, carried out the development of a high impact, results-based strategic communications strategy on Core Competencies for the Canadian Institute of Public Health Inspectors (CIPHI). This collaborative project included extensive research on core competency best practices, key informant interviews, international benchmarking, a facilitated workshop based on Ingenium's Results Map methodology, and strategy report writing.
 

Competencies for Health Promotion Practitioners in Canada

Health Promotion Ontario (HPO), the association representing the collective interests of health promoters working at Ontario public health units, hired The Alder Group to develop a set of competencies for health promotion practitioners in Canada. This is one of seven discipline-specific competency development initiatives funded by the Public Health Agency of Canada.

A proposed set of competencies was presented at the HPO conference in May 2007. The competencies were also presented at a workshop held at the International Union for Health Promotion and Education (IUHPE) conference in Vancouver in June 2007. In addition, an e-survey has been developed to gather feedback on the competencies from health promoters across Canada.
 

Pan-Canadian Core Competencies Consultation Plan

The Alder Group developed a national consultation work plan on public health core competencies for the Public Health Agency of Canada. This work plan was instrumental in guiding the management of a pan-Canadian strategy and has been used to guide a range of initiatives over the last two years. The Alder Group also planned a website to serve as a communications hub for a broad consultation process, developed a list of references and background materials, and researched and wrote a glossary of terms and a list of frequently asked questions.
 

Public Health Core Competency Literature Review

The Alder Group conducted a literature review of existing core competency work, developed a communications strategy and planned, facilitated and provided a detailed meeting report of the proceedings of a meeting for the Core Competencies Task Group—Ontario Public Health Association, the Public Health Research, Education and Development Division (PHRED) at the Sudbury and District Health Unit and other key stakeholders.
 

Planning and Facilitation Services for Core Competency Meetings

The Alder Group provided facilitation, rapporteur services and logistics services for two core competency meetings for the Ontario Public Health Association. The first meeting, hosted by the Association in 2005, was intended to provide guidance and direction for the Public Health Research, Education and Development Division in the creation of the companion document to the technical document The Development of a Draft Set of Public Health Workforce Core Competencies. The Alder Group wrote the final meeting report that helped guide the direction of the companion document. In 2006, the participants reconvened to review the companion document discussion paper.
 

Facilitation and Rapporteur Services for Core Competency Meeting

The Alder Group facilitated and provided rapporteur services for a meeting of the Core Competencies Task Group in Toronto in January 2007, the purpose of which was to provide the Public Health Agency of Canada, Core Competencies and Skills Enhancement Programs, and the Ontario Public Health Association with a refined and prioritized set of recommendations for the training and continuing education of public health professionals.