Health workforce planning should be priority with system in flux, say Alberta doctors, nurses

The Alberta Medical Association president says it's unclear how much health-care workforce planning is underway as the provincial government pushes ahead with its sweeping restructuring plan, so he's calling for urgent action.

The provincial government announced last year its intention to overhaul health-care provision and create four new organizations: acute care, primary care, continuing care, and mental health and addictions.

The controversial changes come at a time when staffing shortages are plaguing many corners of Alberta's health system, from operating rooms to family doctors' offices.

"With this restructuring, reorganizing, it's absolutely not clear who's leading the big provincial workforce planning," said Dr. Paul Parks, president of the Alberta Medical Association.

The provincial government said it is committed to this work.

But, according to Parks, Alberta Health Services (AHS) used to take on this role. And while he has asked at high level meetings who is now responsible and what is being done, he hasn't received what he considers an adequate answer.

"It's very fragmented and not very well co-ordinated."

Ideally, he said, groups including the AMA, post-secondary institutions and other organizations such as nursing associations should be involved.

"Part of workforce planning is knowing what you have now, knowing what your needs are for the coming years and actually finding what the universities and the places that are training and recruiting for the future are doing," said Parks.

"This co-ordinated, provincial-wide workforce planning has definitely been falling off, or not happening at all."

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Jennifer Jackson said she's also concerned about a lack of "concrete plans" from the provincial government for its health system overhaul.

"Without more staff, restructuring won't work," said Jackson, an RN and assistant professor in the faculty of nursing at the University of Calgary.

"We're putting the cart before the horse.… We need to use our workforce planning and our efforts there to inform system restructuring. We can't do it the other way around because we'll have great ideas and shiny new buildings but nobody to staff them."

She argues health-care unions should also be at the table.

Staffing woes continue

According to Parks, staffing shortages continue to impact a number of key areas of the health system.

For example, he said, patients can wait for days in Calgary and Edmonton emergency rooms when they need surgery.

"[Patients with] fractured ankles that need to be operated on can sit in hospitals for days because of OR capacity issues, workforce issues, access to anesthetists.… And that adds to the ER overcrowding," he said, noting this is just one example of the workforce troubles.

"All of these pieces impact each other, and if we're not addressing this in a co-ordinated manner, it's really just going to keep getting worse."

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The province recently announced plans to improve surgical access. But, Parks said, this will only succeed with comprehensive workforce planning.

"If you don't have the workforce and the skilled people to man those spaces and buildings and ORs, it's not going to be helpful at all."

During a news conference last Tuesday, an AHS spokesperson said the health authority is focused on addressing staffing shortages.

"Workforce is always something that we're concerned about, and we continue to work hard at recruitment and retention.… A major focus of ours is on Canadian and international recruitment," said Sean Chilton, interim vice-president and chief operating officer, clinical operations, with AHS.

"We're starting to see some gains, but there's still some work to be done."

Previous plans

A 2023 Alberta government workforce strategy — written under former health minister Jason Copping and before the government announced its restructuring plans — included a number of key long-term commitments.

"Workforce forecasting and reporting will be a core ongoing component of future workforce planning approaches and will be integrated into the overall provincial workforce planning model and structures," the report said, noting this would be done collaboratively between Alberta Health Services and Alberta Health.

The document also committed to the development of a three- to five-year workforce plan. And it outlined plans for a provincial workforce planning committee, including AHS, Covenant Health, unions and post-secondary institutions.

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Parks wants to know what has been done since. 

And he worries any progress that had been made has been paralyzed by the restructuring.

In response to questions from CBC News, the provincial government said it is committed to health workforce planning and is working to update the 2023 health workforce strategy to ensure it aligns with changes, including the system overhaul.

"We continue to work with health system stakeholders to identify strategies to attract and retain health-care workers in Alberta," Andrea Smith, press secretary to Health Minister Adriana LaGrange, said in an email.

"This work will continue throughout the refocusing initiative and beyond. Our ministry is working to establish a health workforce oversight committee, which will enable co-ordinated workforce consultation across initiatives."

Smith said health-care workers, employers, post-secondary institutions and regulated colleges are considered "key partners" in this process.

"Alberta has the best front-line health-care workers in the world, and our government is committed to ensuring Albertans get the care they need when and where they need it."