Appendix 1. Strategic Context

Vision, Mission and Values

Vision:

A health system that ensures high quality public health care services that meet patients' needs where they live and when they need them.

Mission:

To guide and enhance the province's health services to ensure British Columbians are supported in their efforts to maintain and improve their health.

The top priorities are renewing public health care while providing high quality public health care services that meet patients' most essential needs.

Values:

A set of beliefs, consistent with the principles of the Canada Health Act, defines our organizational behaviour:

• patient and consumer focus which respects the needs and diversity of all British Columbians.
• equity of access and in the quality of services delivered by government.
• access for all to required health services.
• effectiveness of delivery and treatment leading to appropriate outcomes.
• efficiency, providing lowest cost consistent with quality services.
• appropriateness, providing the right service at the right time in the right place.
• safety in the delivery of health services to minimize the risks to the health and safety of British Columbians.

Planning Context

Environmental Scan

Numerous challenges continue to face the creation of a patient-centered, coordinated and well-managed system that best meets the evolving and diverse health services needs of British Columbians.

Fiscal Challenges — Annual growth in provincial health care costs continue to put pressure on available health budgets, even after receipt of new federal funding.

Increases in health care costs come from:

• A growing and ageing population, rising use of pharmaceuticals, higher service expectations, and rapid technological innovations.
• Increased incidence of preventable illness/disease such as diabetes and heart disease resulting from unhealthy lifestyle choices.
• New diseases result in new tests, drugs and treatments.
• Increasing pressure from both health care providers and the public for government to fund new technologies, pharmaceuticals and clinical interventions regardless of established effectiveness or value for money.
• Investments to update or expand health care facilities and equipment.
• Increasing labour wage and benefit costs.

Demographic Trends

• B.C.'s population is forecast to increase by 45,200 persons in 2004, 49,300 in 2005 and 50,200 in 2006.
• B.C.'s population is ageing. Relative to 2000, by 2010, there will be 26 per cent more people over 65, 30 per cent more over 75, and 63 per cent more over 85. The median age in B.C. is forecast to reach 40.0 by 2006. This is up from 35.4 years in 1995.
• Life expectancy is increasing. By 2007, the median age at death will be 80 years.
• The health system's workforce is ageing.

Other Challenges and Risks

• Health care planning is complicated by shifts in patterns of disease. For example, a more intense flu epidemic or intensification of the Severe Acute Respiratory Syndrome (SARS) in B.C. would alter immediate patient needs. Also, changing health human resource demographics, clinical practices and technologies make planning challenging.
• Attracting and retaining high quality staff in the health sector is difficult at a time of global shortages in health care professionals.
• The focus on "patients first" requires a shift in management and provider culture.
• Managing the restructuring of health care service delivery during a period of modest increases in health funding.

Opportunities to Meet the Challenges

The ministry has expertise in planning, monitoring and evaluation and is building stronger relationships with its health system partners. Through last year's redefinition of core businesses, the ministry has also more clearly defined its role and responsibilities, and those of its health authority partners.

The ministry will capitalize on these opportunities to create a system capable of meeting our challenges, by:

• Moving to evidence-based decision making.
• Making the public aware of how unhealthy lifestyle choices can affect health.
• Streamlining to focus on core businesses and priority issues.
• Developing and implementing standards of care and accountability to improve the delivery of health services and patient outcomes.
• Using formal planning and projection tools to forecast the services that will be required to meet the health care needs of British Columbians.
• Fostering cooperative working relations with health system partners.
• Building relationships with other provincial ministries to facilitate the coordination of services.
• Directing, supporting, monitoring and reporting on system performance and accountability.
• Involving experienced staff and external experts with extensive knowledge of the issues facing the system.

Highlights of Strategic Shifts and Changes from the Previous Service Plan

The ministry made significant shifts in its service plans from 2001/02 to 2003/04. It redefined its own role and that of its health authority partners, established new core businesses, and introduced new measures of accountability. In the 2003/04 service plan, the ministry articulated key objectives and priority strategies to focus and guide health system redesign.

This year's service plan continues to focus on the objectives and priority strategies introduced in last year's plan. It also incorporates the key functions of the former Ministry of Health Planning, which was merged with the Ministry of Health Services in January 2004. Strategies and performance measures for health system planning, public health protection, legislative and policy development, and reporting on the health of the population are now incorporated under the ministry's core business of Stewardship.

In additon to the changes to the Stewardship section referenced above, this service plan also has three new performance measures. The first, PS-PM11 (page 25), strengthens the ministry's ability to monitor performance and results in the area of chronic disease management. The second, PS-PM17 (page 29), signals the ministry's intent to create a performance measure for patient safety based on the work of the Patient Safety Task Force. The third, MOHS-PM14 (page 41), supports and sets targets for the adoption of enterprise-wide risk management.

Two performance measures have been discontinued. The first, Commitments articulated in 2003 Accord met (03/04 MOHS-PM2) was intended to include compliance targets for initiatives under the Federal/Provincial/Territorial Health Accord of 2003. The measure has been dropped because the ministry does not have sufficient control over the timing of target setting, and because the ministry will be reporting the use of Accord funding in its Annual Service Plan Report. The second, Number of redundant or unnecessary policies eliminated from policy manuals (03/04 MOHS-PM6), was eliminated because other, more effective measures are in place to monitor the ministry's success in providing clear direction and guidance to its health authority partners.

Consistency with Government Strategic Plan

Health is a top priority of the government as outlined in the Government Strategic Plan. The service plan supports the government strategic plan as follows:

Government's Priorities Related to the Ministry • British Columbians will be healthy. • B.C. will have a healthy physical environment. • Government will be affordable and fiscally responsible.

Ministry Goals • High Quality Patient Care. • Improved Health and Wellness for British Columbians. • A Sustainable, Affordable Health Care System.

Ministry Objectives • Provide care at the appropriate level in the appropriate setting. • Provide tailored care for key segments of the population to better address their specific health care needs and improve their quality of life. • Keep people as healthy as possible by preventing disease, illness and disability and slowing the progression of chronic illness. • Manage within the available budget while meeting the priority needs of the population. • Improve the services the ministry delivers directly to the public.