Advisory panel on healthcare innovation - Terms of reference

Context

Canadians benefit from a healthcare system that provides access to high quality care, supports good health outcomes, and contributes to a healthy and productive workforce. But it needs to adapt to remain sustainable in the face of changing economic, demographic and technological pressures^{Footnote 1}.

Canada's total spending on healthcare (public and private) currently stands at 11.2% of GDP, the fifth highest among Organization of Economic Co-operation and Development (OECD) countries.  At the same time, Canada continues to lag other leading industrialized countries on key health system performance metrics of access and quality.^{Footnote 2}

There is an emerging consensus that more money is not the solution. As noted in a 2013 article published by the Institute for Research on Public Policy, problems related to access, quality and equity of healthcare in Canada remain, despite the doubling of real healthcare spending between 1997 and 2011^{Footnote 3}. And with most provinces and territories already devoting upwards of 40% of their budget to healthcare, there is little room to increase healthcare funding without compromising other important public services.

Innovation is critical if the healthcare system is to continue delivering the high quality care Canadians expect at a cost that is affordable to society. This means breaking down barriers, tapping into creative minds, and working collaboratively to make better use of existing resources to improve services and outcomes for patients.

All jurisdictions have taken action to slow the growth in health spending and have started to focus and align their innovation efforts. Provinces and territories are implementing innovations in healthcare both individually and collectively. For its part, the Government of Canada is providing significant support for healthcare innovation through the Canada Health Transfer, research funding and other targeted health initiatives (see Annex 1). Federal health transfers are now on a long-term growth track that is fiscally responsible and provides financial certainty for provinces and territories to plan around their health needs.

As jurisdictions accelerate their efforts to transform their healthcare systems to achieve the "triple aim" of improving patient care and health outcomes while reducing costs, it is time to take stock of where progress has been made in Canada and around the world. This is essential if we are to accelerate the pace of healthcare innovation and ensure the long-term sustainability of Canada's healthcare system.

Key elements

Mandate

• The Minister of Health will strike a time-limited Advisory Panel on Healthcare Innovation.
• The Panel will:
  1. Identify the five most promising areas of innovation in Canada and internationally that have the potential to sustainably reduce growth in health spending while leading to improvements in the quality and accessibility of care.
  2. Recommend the five ways the federal government could support innovation in the areas identified above.

2. Guiding Principles

• In carrying out its mandate, the Panel will be guided by the following principles:
  • Respect for jurisdictional roles: The Panel will be mindful of and respect federal and provincial/territorial jurisdictions in health and will focus its recommendations on areas of federal responsibility.
  • Evidence-based: The Panel's work should be guided by the best evidence on what works.
  • Support for healthcare values: Innovation should not compromise core healthcare principles as set out in the Canada Health Act.
  • Avoiding duplication of effort: The Panel will not duplicate the work of other bodies in related fields of inquiry, such as the Council of the Federation's Health Care Innovation Working Group and the work of the Independent Panel on Federal Support to Research and Development (the "Jenkins Panel", 2010).
  • Fiscal responsibility: The Panel's recommendations must not imply either an increase or a decrease in the overall level of federal funding for current initiatives supporting innovation in healthcare. The recommendations must also not result in increasing spending pressure on provincial and territorial budgets.

3. Panel Governance, Term and Composition

• The Panel is established as an ad-hoc Advisory Body, pursuant to Health Canada's Policy on External Advisory Bodies, 2011 with a limited term of one year.
• The Panel is headed by David Naylor as Chair, who is responsible for ensuring the Panel mandate is fulfilled and reporting back to the Minister throughout the Panel's review, as needed, and at its conclusion.
• The other members of the Panel are:
  • Cyril Frank
  • Neil Fraser
  • Francine Girard
  • Toby Jenkins
  • Jack Mintz
  • Chris Power
• The Panel Chair may select a Vice-Chair from the Panel members to help him with the Chair's duties.

4. External engagement

• To ensure that the work of the Panel is informed by provincial and territorial perspectives, the Panel should meet as required and as requested with provincial and territorial representatives throughout the process, i.e., Ministers; Deputy Minister Steering Committee on Healthcare Innovation (Alberta, PEI, Yukon, Health Canada); Strategy for Patient-Oriented Research (SPOR) National Steering Committee.
• Given the importance of international perspectives in its work, the Panel may travel abroad to meet with international experts and learn from best practices in healthcare innovation.  The Panel may also invite international experts to travel to Canada to engage in its deliberations.
• The Panel should also meet with representatives of healthcare professionals for their perspectives.
• Panel outreach and engagement should additionally draw upon a wide range of perspectives including:
  • Patients and consumers
  • Businesses and industry representatives
  • Innovators and entrepreneurs
  • Representatives of key health system stakeholders
  • First Nations leaders
  • Experts across a range of relevant specialities
  • Other relevant federal advisory bodies (e.g. Jenkins Panel; Science, Technology and Innovation Council)

5. Panel Process

Deliverables

• The Panel will provide an interim report in January 2015 and a final report at the Panel's conclusion, no later than by May 31, 2015.  

Panel Activities

• In order to advance its work, the Panel could undertake a range of activities including:
  • In camera discussions to exchange perspectives, establish a shared understanding of issues, identify key themes, and develop advice
  • Meetings with the Minister at key milestones to receive direction and exchange views on key topics for further exploration (e.g. at launch, once outreach and information gathering is completed, and, upon completion of report)
  • Commission papers synthesising knowledge and providing analysis of selected themes and issues
  • Participate in site visits in Canada and internationally and host small group meetings to explore leading practices and facilitate dynamic engagement with a mix of experts
  • Invite guests with experience and expertise in key areas and issues to make presentations to, and engage in dialogue with, them
  • Prepare interim reports to the Minister on emerging findings and/or specific themes, as well as a final report with conclusions and advice in accordance with its mandate.

6. Funding and Administrative Support

• Funding and administrative support will be provided by Health Canada.

Annex 1

Federal Support for Healthcare Innovation

The Government of Canada's significant support for healthcare has laid a strong foundation for innovation upon which further efforts can build.

1. With the renewal of the Canada Health Transfer (CHT), the federal government has put funding for healthcare on a predictable and stable growth track. The CHT will continue to increase by 6% per year through 2016-17, and will grow at the rate of GDP growth (with a 3% floor) starting in 2017-18. The federal contribution through the CHT continues to rise annually, and by the end of the decade will surpass $40 billion.
2. The Government of Canada also invests $1 billion a year in research, which serves as an important catalyst for innovation. In particular, the Strategy for Patient-Oriented Research (SPOR) is helping to align research, innovation and health system needs through collaborations with provinces and territories. Other CIHR initiatives such as its Community-Based Primary Healthcare Initiative and Evidence-Informed Healthcare Renewal are also helping to provide evidence to support healthcare policy decision-making.
3. The federal government also provides other important support for healthcare innovation through organizations such as Canada Health Infoway, the Canadian Foundation for Healthcare Improvement (CFHI), the Canadian Agency for Drugs and Technologies in Health (CADTH), the Canadian Institute for Health Information (CIHI), and various Health Canada initiatives and programs. Healthcare innovation is also supported more widely through the Canada Foundation for Innovation, the National Research Council, Genome Canada, other granting councils and economic development agencies.
4. In addition, the Government of Canada provides important support for innovation in healthcare for First Nations communities. Budget 2013 provided predictable funding to maintain existing investments in connectivity and expand electronic health services in remote and isolated First Nations communities, as well as increasing the number of accredited health facilities.