Nova Scotia Department of Health and Wellness
10-37494_public_health_6stakes_REV1.indd 1
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...............................................................................................
Nova Scotia Public Health
2010
Renewal of
Public Health
in Canada
Strategic
Planning
Commenced
2010
Public Health’s Fut
ure
A Commitment to
Moving Forward
Nova Scotia Public Health
ies
Stake 6 – Core
Competenc
Stake 4 – Core
Public Healt
h Functions
Stake 5 – Areas
of Focus
Walkerton
9/11
S A R S
L e a r n i n gfrom
e
- Purpos
Stake 1
ership
tory Lead
- Participa
Stake 2
Roles for
ships and
- Relation
Stake 3
Health
lic
Pub
Six Stakes
.................................................................................................
The
Context
It is about concretely addressing the determinants of
health to foster an environment that contributes to
the optimal health of the population.
In 2006, “Renewal of Public
Health – Building a Public Health
System to meet the needs of
Nova Scotians” was accepted
by government as the path for
the renewal of public health.
It has 21 actions for system renewal. The first identifies the need and
importance of a collective vision for public health.
The third process supports all the other processes and involves the
recognition of the Core Competencies for Public Health Release 1.0.
A work plan to embed these competencies into the work of all Public
Health practitioners in Nova Scotia is being developed by a working group
on core competencies.
2008
2010
Also of significance for the public health system this year was our collective
experience during the H1N1 pandemic, which contributed many insights
into roles, capacities and competencies for public health.*
It is plainly obvious from indicators such as our high obesity, chronic disease
and food insecurity rates as well as our demand for mental health services
that Nova Scotians need to improve our collective health. Nova Scotians
need this not only for the economic viability of the health care system,
but for all to be able to live to their full potential in a healthy society. It is
the right thing to work toward. It is bigger than anyone’s individual health
effort. It is about concretely addressing the determinants of health to foster
an environment that contributes to the optimal health of the population.
2007
2011
Based on that, the public health system has been on a 14-month strategic
planning journey of listening and understanding what the people of Nova
Scotia want from us and our services. This journey involved 60 dialogue
interviews, seven learning journeys (site visits with innovative groups), and
five stakeholder gatherings involving over 450 people. This culminated in
a clear purpose statement for public health and four strategic areas for
innovative work and initiatives to grow.
2006
2012
Over a similar time period, three other processes were underway. The
first process was the review of the public health system’s organizational
capacity. This involved interviews and several meetings with vice presidents
of community health and leaders in public health. Subsequently, some DHA/
shared service areas have reviewed and re-oriented their capacity to provide
local management/leadership as well as other public health core work.
Others are continuing to work toward their capacity and re-orientation.
2005
The second process was the work toward the development of a core
program framework for public health in Nova Scotia. The work of this group
has informed this communication.
2003
The following is an articulation of what public health now understands to
be our work. This communication is stating our stakes as leaders – what
we are now committed to do to improve the health of Nova Scotians.
We understand we are not there yet and we must develop the knowledge,
skills and abilities over time. However, these are the stakes that we will be
working towards – together.
*None of the above noted events/processes can be viewed in isolation of each other
and all contribute to the following commitment stakes by leaders in public health.
10-36945_ public_health_REV.indd 1
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i
Release 1.0
Nova Scotia Public Health Standards 2011-2016
i
2011–2012
i
FC
Tainted
North
Blood Battleford
A Journey
SARS
Nova Scotia Public Health
External
Review
Initiated
Chief Public
Health
Officer
Appointed
2011-2016
Protocols
Commenced
ENTER
Standards
Nova Scotia Public Health
2011
2008–2010
2007
The Path of
Public Heal�’s Future
2005–2006
1990s–2003
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1990s–2003
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Following a decade of crumbling public health infrastructure and subsequent inquiries (Tainted Blood, Walkerton, North
Battleford, and 9/11), Severe Acute Respiratory Syndrome (SARS) challenged the public health system of Canada in 2003.
SARS demonstrated that the public health system was extremely fragile. Learning from SARS by Dr. David Naylor from
the University of Toronto (known as the ‘Naylor Report’) identified the fragility of public health in Canada and highlighted
many areas that needed strengthening, investment, and leadership.
1990s–2003
2005–2006
2007
Tainted
Blood
Walkerton
North
Battleford
9/11
SARS
2008–2010
.................................................................................................
2011
L e a r n i n gfrom
S A R S
2011–2012
Renewal of
Public Health
in Canada
...............................................................................................
Nova Scotia Department of Health and Wellness
i
1
2
2005–2006
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PAGE NUMBERS BELOW.
Following the release of the Naylor report, Nova Scotia wanted to assess current capacity, strengths, limitations, and opportunities
to ensure the system was responsive, integrated, coordinated, efficient, and effective, and prepared for new, existing, and
emerging public health issues. In 2005, Nova Scotia undertook an external review of its system resulting in the release of The
Renewal of Public Health in Nova Scotia: Building a system to meet the needs of Nova Scotians (Renewal report).
1990s–2003
2005–2006
The Renewal report outlined 21 actions for system renewal. These 21 actions clustered into five main groupings:
• Improve the structure and function of the provincial level of the system
• Improve the structure and function of the local level of the system
• Improve how these two system levels work together
• Improve how public health at both levels worked with the broader health system; and
• Improve the infrastructure supports in terms of organization, people and information
2007
The Renewal report recognized the enormity of the work ahead, and outlined a ten-year plan. It recognized that all the
actions were interrelated, that they could not be “cherry-picked”, and that most of the actions were major initiatives unto
themselves. This is the plan for the renewal of our public health system.
2011–2012
2008–2010
2011
External
Review
Initiated
Nova Scotia Department of Health and Wellness
1
2
3
2007
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THE YEARS, BUTTONS, OR
PAGE NUMBERS BELOW.
Upon the approval of the Renewal report, and building on the success of the Office of Health Promotion, the Department
of Health Promotion and Protection was established which comprised all of public health, addictions and physical activity,
sport and recreation. Dr. Rob Strang was appointed Nova Scotia’s first Chief Public Health Officer in 2007 (Action for System
Renewal #2). Action for System Renewal #3 recommended an integrated public health organization at the provincial level of
the system consisting of responsibility centres. Responsibility centres were created as follows:
• Communicable Disease Prevention Centre
• Environmental Health
• Healthy Communities
• Healthy Development
• Population Health Assessment and Surveillance
1990s–2003
2005–2006
2007
2008–2010
2011
Public Health Renewal Team (Action for System Renewal #21) was established to manage the implementation of the Actions
for System Renewal.
2011–2012
Chief Public
Health Officer
Appointed
Nova Scotia Department of Health and Wellness
2
3
4
Nova Scotia Department of Health and Wellness
10-37494_public_health_6stakes_REV1.indd 1
Nova Scotia Public Health
2010
10-36945_ public_health_REV.indd 1
25/08/10 5:09 PM
3
4
5
21/09/10 3:53 PM
2010
Public Health’s Fut
ure
Moving Forward
A Commitment to
Nova Scotia Public Health
ies
A Journey
Stake 6 – Cor
e Competenc
Stake 4 – Cor
e Pub
lic Health
Nova Scotia
Public
Health
Functions
Stake 5 – Are
as of Focus
e
- Purpos
ip
Stake 1
Leadersh
patory
- Partici
for
Stake 2
and Roles
ips
sh
ion
- Relat
Stake 3
Health
c
bli
Pu
Strategic
Planning
Commenced
Six Stakes
The
Context
This purpose statement brought clarity to our vision which was that our work needed greater emphasis on populations,
needed to be focused further upstream and that our work needed to be entrenched in the determinants of health. To
understand this better, Moving Forward—The Six Stakes was developed which highlighted and further articulated the work
that public health is committed to, to improve the health of Nova Scotians. The Six Stakes are:
• Our purpose statement guides our work
• We are committed to participatory leadership
• Our roles as practitioners needs to expand to be advocate, coach, supporter, facilitator and collaborator
• Our commitment to all five functions of public heath, the four areas of focus of our work—healthy development,
healthy communities, environmental health, communicable disease prevention and control—all have a foundation
and a fundamental connection to understanding and social justice
• Our stake related to the core competencies for public health.
It is about concretely addressing the determinants of
health to foster an environment that contributes to
the optimal health of the population.
In 2006, “Renewal of Public
Health – Building a Public Health
System to meet the needs of
Nova Scotians” was accepted
by government as the path for
the renewal of public health.
It has 21 actions for system renewal. The first identifies the need and
importance of a collective vision for public health.
2011–2012
2011
Based on that, the public health system has been on a 14-month strategic
planning journey of listening and understanding what the people of Nova
Scotia want from us and our services. This journey involved 60 dialogue
interviews, seven learning journeys (site visits with innovative groups), and
five stakeholder gatherings involving over 450 people. This culminated in
a clear purpose statement for public health and four strategic areas for
innovative work and initiatives to grow.
2008–2010
Over a similar time period, three other processes were underway. The
first process was the review of the public health system’s organizational
capacity. This involved interviews and several meetings with vice presidents
of community health and leaders in public health. Subsequently, some DHA/
shared service areas have reviewed and re-oriented their capacity to provide
local management/leadership as well as other public health core work.
Others are continuing to work toward their capacity and re-orientation.
2007
The second process was the work toward the development of a core
program framework for public health in Nova Scotia. The work of this group
has informed this communication.
The third process supports all the other processes and involves the
recognition of the Core Competencies for Public Health Release 1.0.
A work plan to embed these competencies into the work of all Public
Health practitioners in Nova Scotia is being developed by a working group
on core competencies.
Also of significance for the public health system this year was our collective
experience during the H1N1 pandemic, which contributed many insights
into roles, capacities and competencies for public health.*
It is plainly obvious from indicators such as our high obesity, chronic disease
and food insecurity rates as well as our demand for mental health services
that Nova Scotians need to improve our collective health. Nova Scotians
need this not only for the economic viability of the health care system,
but for all to be able to live to their full potential in a healthy society. It is
the right thing to work toward. It is bigger than anyone’s individual health
effort. It is about concretely addressing the determinants of health to foster
an environment that contributes to the optimal health of the population.
The following is an articulation of what public health now understands to
be our work. This communication is stating our stakes as leaders – what
we are now committed to do to improve the health of Nova Scotians.
We understand we are not there yet and we must develop the knowledge,
skills and abilities over time. However, these are the stakes that we will be
working towards – together.
*None of the above noted events/processes can be viewed in isolation of each other
and all contribute to the following commitment stakes by leaders in public health.
Action for System Renewal #1 in the Renewal report identified the importance of articulating and being guided by a collective
vision. Strategic planning ensued over the next two years. The process and outcome of strategic planning is described in The
FC
Journey to Renewal. Strategic planning identified a purpose statement for public health: ‘Public Health works with others
to understand the health of our communities and acts together to improve health’.
2005–2006
1990s–2003
2008–2010
NAVIGATE THROUGH THIS
DOCUMENT BY SELECTING
AN ITEM IN THE TIME LINE,
THE YEARS, BUTTONS, OR
PAGE NUMBERS BELOW.
2011
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DOCUMENT BY SELECTING
AN ITEM IN THE TIME LINE,
THE YEARS, BUTTONS, OR
PAGE NUMBERS BELOW.
In 2011, public health proceeded with the development of Public Health Standards that further articulated the expectations
around the areas of focus of our work (Action for System Renewal #11). Five standards emerged—a Foundational Standard
along with standards for Healthy Communities, Communicable Disease Prevention and Control, Healthy Development and
Environmental Health. Societal and public health outcomes were articulated and requirements were identified.
1990s–2003
2005–2006
2007
2008–2010
Nova Scotia Public Health
Standards
2011-2016
2011
ENTER
2011–2012
Release 1.0
Nova Scotia Public Health Standards 2011-2016
i
Nova Scotia Department of Health and Wellness
i
i
4
5
6
2011–2012
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DOCUMENT BY SELECTING
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THE YEARS, BUTTONS, OR
PAGE NUMBERS BELOW.
In 2011–2012, we also took stock on where we were in terms of the implementation of the Renewal report. It was a 10
year plan and five years into the plan, the Mid-Course Review was undertaken and released in 2012. Using an appreciative
inquiry approach, we found that indeed all 21 actions for system renewal are all still applicable and there are 5 areas
requiring sustained attention. These are environmental health, model of public health, information systems, surveillance
capacity, and workforce development. As well, there are areas that require attention and discussion such as working as
a system, Public Health System Leadership Team, primary care-public health interface, translating theory into practice and
integrating public health infrastructure into the broader health system.
1990s–2003
2005–2006
2007
2008–2010
In Spring 2012, the process to develop the Protocols commenced. The Protocols will provide the next level of detail in relation
to the Public Health Standards.
2011
Protocols
Commenced
Nova Scotia Department of Health and Wellness
2011–2012
5
6