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Health Human Resources: Effects and Challenges for Seniors Care

In November 2018, the Canadian Medical Association (CMA), along with other stakeholders, attended a roundtable meeting hosted by the Canadian Association for Long Term Care (CALTC). The purpose of the meeting was to discuss the widespread effects of shortages in the health care workforce (known as health human resources or HHR) on seniors care and to brainstorm next steps to more effectively address these challenges.

Seniors care is facing three main challenges: a shrinking supply of traditional full-time workers, devaluing of employment in seniors care and a lack of concentrated and coordinated federal and provincial/territorial planning support.

A combination of cultural, economic and societal shifts has affected the number of people entering the traditional full-time workforce in recent years, including tighter regulations, English language standards for immigrants and the high cost of training new workers. The absence of incoming full-time workers is causing higher burnout and injury rates among existing workers, many of whom are approaching retirement age.

There is an ongoing negative perception of work within the seniors care sector. Media portrayals of work in this sector tend to focus on isolated incidents within long-term care homes, which, on top of the burnout and high turnover rate of current workers, contributes to the perception that the seniors care sector is an undesirable work environment.

The previous HHR strategy from 2003/04 focused largely on the supply of physicians and lowering surgical wait times. The most recent annual report came out in 2009/10, and it indicated that no level of government has yet engaged in meaningful HHR planning. It can be difficult for the federal government to implement a pan-Canadian strategy because long-term care homes typically fall under provincial/territorial jurisdiction, but as staffing shortages reach critical levels across the country, collaboration between the various levels of government is needed to ensure that provinces and territories are able to meet the demand for seniors care.

A renewed HHR strategy needs to focus on creating a transient workforce, wherein movement among sectors and skill sets is the norm. Some provinces are implementing small changes to this effect, but the federal government can also help by creating a national standard that encourages these movements.

Revaluing work in the seniors care sector requires building a positive perception of the work environment that invigorates job seekers to explore opportunities within the sector. While employment incentives need to be addressed, the federal government can help such efforts by subsidizing education and standardizing training across the country. Seniors care is a very fast growing industry, and if efforts are made to revalue work in this sector, it should become very desirable for job seekers.

A renewed HHR strategy is not just about funding; it must also include a federal strategy of accountability between levels of government for spending targets, while making clear links to existing strategies (like the national dementia strategy). Evidence collection should focus on the identification of current and future needs, to help the federal government invest in priority areas.

The aging population and sustained challenges in the recruitment and retention of workers present a unique opportunity to engage in the discussion of a renewed HHR strategy. All health care organizations stand to benefit from a renewed strategy as it provides an opportunity to influence policy development in seniors care and as well as in other sectors of the health care system.