HSA Constituency Liaison Lobby Kit: Health Care
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HSA Constituency Liaison Lobby Kit: Health Care EFFECTIVE NOVEMBER 2020 Address the shortage of Health Science Professionals in public health care For years, British Columbia has struggled with shortages of Health Science Profes- sionals in the public sector, including (but not limited to) rehab therapists, diagnostic medical sonographers, medical laboratory technologists, and medical imaging tech- nologists. The specific reasons for these shortages vary by profession, but generally arise from recruitment and retention challenges, including lack of provincial post-sec- ondary training capacity, competition with the private sector, heavy workload, and professional burnout. Health Science Professionals represent the majority of shortage professions in health care The BC Ministry of Health’s Provincial Health Workforce Strategy 2018/19 – 2020/21 indicates that the majority of current and future priority professions with labour market challenges are health science professions. These professions are critical to the success of our public health care system, and ensuring robust and reliable care for patients across British Columbia. Because of unfilled vacancies and low staffing levels, many departments rely on over- time to deliver necessary services. One therapy department in an acute care hospi- tal, for example, can only manage demand using upwards of 1,800 to 2,000 hours of overtime each month – and yet that department has vacancies that have remained unfilled for a year. This is not a sustainable strategy in the immediate, medium, or long term – either economically or in terms of human resources. It is expensive and causes burnout of the limited professionals we have. The Select Standing Committee on Finance and Government Services, Budget 2021 consultation report commented on the challenge facing our health care system stemming from the shortage of professionals. Recommendation 72 from their report states: “Provide targeted, increased funding for training health care professionals in areas facing shortages with a focus on expanding capacity and resources within exist- ing programs in smaller communities and ensuring opportunities for British Columbi- ans in rural, remote and Indigenous communities to train locally.” Strategic Priority Areas Priority Professions for Future Priority Professions 2018/2019 I. Primary Care Services Nurse Practitioner Registered Nurse Family Physician Psychologist Licensed Practical Nurse (LPN) Social Worker Occupational Therapist (OT) Physiotherapist II. Adults with Complex Medical Health Care Assistant (HCA) Registered Nurse Conditions and/or Frailty Licensed Practical Nurse (LPN) Rehabilitation Assistant Occupational Therapist (OT) Dietitian Physiotherapist Social Worker Medical Specialist III. Surgical and Diagnostic Ser- Nurse (LPN and RN) Anesthesiologist and GP Anes- vices thesiologist Nurse Practitioner Anesthesia Assistant Physiotherapist Case Manager Perfusionist Surgeon & GP with enhanced surgical skills Dietitian Counsellor Home Nursing Support Surgical Services Team Clinical Surgical Subspecialists IV. Mental Health and Substance Psychiatrist Psychologist Use Registered Psychiatric Nurse Social Worker Occupational Therapist (OT) Clinical Counsellor Family Physician Trained Peer Support Nurse Practitioner Pharmacist Physiotherapist Dietitian Naturopathic Medicine Recreation Therapist Music and Art Therapists Spiritual Services Traditional Chinese Medicine and Acupuncturist Cross-Cultural Liaison Vocational Expert Expert in Public Health Expert in Psychosocial Rehabil- itation Heavy workloads causing professionals to leave the public system, making short- ages worse The current shortages in these fields are already taking a toll. In a recent survey of HSA members, 65% reported shortages in their professions, and 53% said their de- partment already has a patient waitlist. Most concerning, over 42% said they are con- sidering leaving public practice due to unmanageable workload. If our public health care system is to be successful in fighting COVID-19 and working down the surgical and diagnostic backlog, it will depend on immediate action to ad- dress these professional shortages. Recent government action is welcome, and much more is needed In 2019 the BC government committed to workforce planning with the creation of the new Director of Allied Health Workforce Development role in the Ministry of Health. Further, over the last three years, the BC government has taken encouraging steps towards growing training opportunities for health science professionals, including 40 new first-year physiotherapy and 24 occupational therapy training seats across the 1 province; and new diagnostic medical sonography training programs at College of New Caledonia in Prince George and at Camosun College on Vancouver Island.2 These are important steps forward, but now is the time for bold action to address the critical shortages. We need to increase training seats, especially outside the Lower Mainland, for those professions experiencing shortages and develop incentives for graduates to bring their skills into the public health sector. Responding to COVID-19 and the surgery backlog requires investment in Health Science Professionals COVID-19 has created the largest surgery and diagnostic testing backlog in BC his- tory. As BC resumes scheduled procedures with an ambitious plan to ramp up public sector volumes of diagnostic testing and surgeries,3 it will be critical that our public system has the health science professionals in place necessary to support patients throw each step of the pre-and-post surgical needs. It is not just doctors and nurses who support patients, but the whole team of health care professionals. Jobs in the health science professions are key to our economic recovery. Investing in the health care and social services workforce makes solid economic sense. These are good jobs that support families and communities. And, most importantly, they serve an urgent need in our province as we manage through a global pandemic. Recommendations 1. Implement targeted recruitment and retention measures to address the pub- lic-sector shortage of health science professionals, including more clinical leadership opportunities, increased post-secondary training opportunities, and incentives to attract recent graduates and professionals working in private practice into public practice. 2. Continue to expand and support the activities of the Director of Allied Health Workforce Development in the Ministry of Health. 3. Increase Ministry of Advanced Education funding to train more health science professionals that face public-sector shortages. 1. Ministry of Advanced Education, Skills and Training, Occupational and physical therapy seats coming to Northern BC, May 24, 2019. There are currently 80 first-year physiotherapy seats in BC. This will increase to 120 first-year spaces, with full expansion expected by September 2022. The First 20 seats will be at UBC Vancouver, followed by Fraser Valley. The most recent increase was in 2008. In occupational therapy, there are 48 first-year seats in BC. This will increase to 72 first-year seats with the first eight at UBC Vancouver (Sep. 2020) and 16 through a joint UBC/UNBC initiative (Sep. 2022). The most-recent increase was in 2009. 2. Ministry of Advanced Education, Skills and Training, Northern B.C.’s First Sonography Program Gets Underway, Jan. 28, 2019; Minis try of Advanced Education, Skills and Training, First sonography program coming to Vancouver Island, October 17, 2019. 3. Ministry of Health, Province launches renewal plan for surgeries, May 7, 2020. Invest in health workforce to tackle surgery backlog and support economic recovery (This opinion piece was published in the Vancouver Sun on July 23, 2020) Health science professionals have been on the frontlines of the effort to flatten the COVID-19 curve. The work of these professionals is often invisible, but this pandem- ic has shone a bright light on their important contributions. Respiratory therapists, medical laboratory and imaging technologists, dietitians, pharmacists, physiothera- pists, occupational therapists, social workers, biomedical engineers, and many, many others are critical to our health care system. This pandemic has made it abundantly clear that people are the heart of health care. There is no doubt that COVID-19 has challenged our public health care system, high- lighting its strengths and exposing its vulnerabilities. The pandemic has shown us all the fundamental importance of a responsive, integrated, and well-coordinated public health care system. Because of the BC government’s commitment to public health care, BC is meeting the challenge of this pandemic head on. The response from the provincial govern- ment, Provincial Health Officer Dr. Bonnie Henry, and Health Minister Adrian Dix has been swift and effective. It is my hope that this experience shows us that we must commit to even deeper investment in public health care, and that this be a priority for the $1.5 billion economic recovery fund. This is the moment to ensure our system is as robust and resilient as possible – able to recover from this pandemic, successfully manage a possible second wave, and has the resources to work through the largest surgical and diagnostic testing backlog in BC’s history. The BC government is on the right track by increasing hospital operating room hours and ramping up diagnostic procedures, but these efforts must also be accompanied by system-wide improvements. Increasing surgical volumes, without