Integrated needs-based HHR planning for pandemics: Matching provider competencies to service requirements

An analytical framework was developed to integrate health services planning with health workforce planning using a population needs based approach and provider competencies.  Building on lessons learned from applications to planning for a variety of health care contexts in multiple countries, the framework was applied to planning surge capacity for an influenza pandemic in Canada at the provincial (Nova Scotia) and sub-provincial (health authority) levels. Data were gathered from administrative sources, health care provider surveys and interdisciplinary clinician panels, and analyzed using professions and services as the unit of analysis to identify potential gaps between service supply and requirements. Analyses suggest that both jurisdictions have health workforces with sufficient training and numbers overall to meet the service requirements of  their populations under various potential pandemic scenarios. This is contingent on the ability to redeploy providers from serving other needs  during the pandemic and using health care providers to the full scope of practice. Largest potential service gaps pertained to making diagnoses, providing a range of pharmacy services, and recommending appropriate in-home supports for patients.  Strengths of the approach identified by decision-makers were the explicit incorporation of measures of population health needs and its capacity to accommodate a wide range of supply and requirement scenarios. This approach offers a flexible tool to guide the alignment of scarce resources across sectors and professions, including the legislated competencies of different provider groups as closely as possible with population health needs. The availability of such tools is particularly important during ‘surges’ in health care needs, such as pandemics.