Solution One: Become a magnet for health providers
Our government will make Nova Scotia a sought-after place for health providers by offering a simple, streamlined recruitment experience that leads directly to jobs in healthy workplaces and a home in welcoming communities. In our vision, health providers from all communities are respected, valued, and heard.
Our progress on what we will do
Work Ongoing: Started and continues through 2022-26
Complete: The action is complete
Work Underway: The action has been initiated
Not Started: The action has not been initiated yet
- Invest in education and training opportunities to ensure the health needs of communities are met
Actions will include Progress Update Status - Develop a provincial health workforce strategy to ensure community health needs are met in the short and long term
- A health workforce strategy is in development, while work is actively underway on recruitment, retention, onboarding and orientation, workforce expansion, and service redesign.
- Physician recruitment remains strong in Nova Scotia. 168 doctors started practicing in Nova Scotia from April 1, 2022, to March 31, 2023. The net gain is 86 physicians.
- Open more nursing seats to increase the number of registered and practical nurses graduating in the province, including those from underrepresented groups
- Investments have been made to add 200 new nursing seats across the province.
- Eligibility criteria expanded to allow more LPNs to qualify for Bachelor of Science, Nursing (BScN) programs at Cape Breton University (CBU) and St. Francis Xavier University.
- Pathways for underrepresented groups have been developed by each school.
- In Fall 2023, a new nursing program will start at Acadia University, in partnership with Cape Breton University, expanding the Nova Scotia Community College (NSCC) Practical Nursing Program.
- Nova Scotia is now offering a free, practical nursing diploma program for Continuing Care Assistants (CCAs) working in Nova Scotia. The pilot CCA–Practical Nursing Bridging Program will provide free tuition and support to 25 currently certified CCAs who have worked in the continuing care sector for at least two years to become licensed practical nurses. They will sign a 2-year return of service agreement to work in continuing care as an LPN.
- Work with Cape Breton University to research and explore new ways to recruit, train, and retain more healthcare workers in rural areas
- A new medical school campus will be opening at Cape Breton University by Fall 2025. Students will have access to special training in rural health needs as well as Indigenous health and African Nova Scotian health.
- Cape Breton University and Dalhousie University have partnered to create five medical school seats for the training of rural doctors.
- Work with Dalhousie Medical School’s Family Medicine Clinics to take 3,500 more people from the Need a Family Practice Registry
- A proof of concept has been implemented with key positions, and process changes to practice in place, supporting enhanced care in chronic disease management, efficiencies in administrative processes and enhancements to scopes to practice for all team members. . A rapid onboarding team is in place, with over 2,664 patients onboarded. This initiative has scaled to Truro, Antigonish, Bridgewater and Yarmouth.
- 124 patients completed the Onboarding Patient Experience Survey, with 87% reporting being satisfied or very satisfied with the experience.
- 11 focus groups were conducted with providers, staff, and stakeholders.
- $6.3 million is being invested over the next four years to help new graduates and new doctors to the province establish practices, starting at Dalhousie family medicine clinics.
- Incubator clinic work is underway.
- Increase residency seats, targeted to areas of specialty and need across the province, such as child psychologists
- Created 10 new residency seats in family medicine across the province for 2023.
- Increased the number of seats from 6 to 16 for international medical graduates interested in a Nova Scotia residency, with priority given to those with a connection to Nova Scotia.
- Five undergraduate medicine seats have been added to Cape Breton University and four psychology residency positions have been added between NS Health and the IWK.
- There are now 11 Clinical Psychology Residents in NS.
- The new clinical psychology residents who started with NS Health in September 2022 will complete their residency in August 2023, with six new residents secured for September 2023.
- IWK Health increased their placements for residency students, with five new residents in September 2023 and six for September 2024.
- Train more specialized healthcare professionals, including laboratory technologists, through a partnership with the Michener Institute of Education
- An agreement was signed with the Michener Institute of Education to create a program for internationally educated Medical Laboratory Assistants. This has been expanded to include a traditional Medical Lab Technology program, and the admission process is underway. The goal is to enroll 40 Nova Scotians in the new Michener program.
- The first pilot class of five students began January 4, 2023. Planning is underway for the next cohort.
- The first pilot class of the Bridging program will be complete in May 2023, with the second group being recruited for September 2023.
- Another program from the Michener partnerships is a new, flexible online learning option will be available to Nova Scotians who want to become medical laboratory technologists. Up to 40 people will be accepted to the program, starting in September, and offered through Nova Scotia Community College (NSCC).
- Continue implementation of free tuition and books for Continuing Care Assistant students
- As of June 30, 2023, 1,326 students had enrolled in free tuition CCA training programs. This exceeded the target of 1,000 free Continuing Care Assistant spaces and is on track to meet overall goal of 2,000 spaces by March 31, 2024. All students sign a return of service agreement to work in continuing care in NS.
- Increase supports for local recruitment efforts, showcasing Nova Scotia’s warm and welcoming culture
Actions will include Progress Update Status - Give communities the tools they need for successful recruitment, including establishing a $2 million fund for local recruitment efforts, and developing recruitment and retention plans to meet community health needs
- A Community Fund was launched in November 2022, community groups and municipalities have applied for up to $100,000 each for projects to help recruit and retain healthcare professionals. 28 groups have been awarded funding so far.
- Recruitment and retention planning is currently underway and recruitment trips are occurring.
- NS Health has launched a digital recruitment approach.
- NS Health celebrated Rural Week in May 2023 to attract physicians to rural areas of NS.
- Continue to implement new physician incentive programs to recruit doctors and retain graduates, primarily in rural communities
- New incentive programs were introduced in March 2022, with implementation ongoing.
- Provide new and graduating family physicians and nurse practitioners the tools they need, such as office space, mentorship, and onboarding supports, to establish new practices
- Work to support new practitioners is ongoing and supported through strategic initiatives and innovative models of care.
- $6.3 million is being invested over the next four years to help new graduates and new doctors to the province establish practices, starting at Dalhousie family medicine clinics where they will gain experience working alongside other care providers, including licensed practical nurses, family practice nurses, social workers, pharmacists, occupational therapists, and physiotherapists.
- The funding will also provide new doctors with valuable mentorship opportunities, as well as administrative support when bringing on new patients so they can focus on responding to patient needs. Mentorship clinics and incubator clinics are being implemented to enhance key supports for new providers and physicians.
- Interprofessional Practice & Learning offers transition to practice support and ongoing mentorship for nurse practitioners. More than 15 nurse practitioners are working in innovative models of care and many of them are new grads. Nurse practitioners are also being supported in rural and remote models of care.
- Work with the Health Association of Nova Scotia to support clinical placements and rural hiring of continuing care assistants
- As of July 2023, 215 individuals have been hired to work in Continuing Care in Nova Scotia through igility/Health Association Nova Scotia (HANS). 85 are domestic hires who have already started working in NS and 130 are international recruits in the immigration process.
- Over the course of three recruitment missions internationally, igility/HANS made contact with over 600 potential candidates and made conditional offers to 164 candidates. New Work and Learn Continuing Care Assistant training options allow students to be hired into rural areas from the start of their program. As of June 30, 2023, 725 individuals have enrolled in work and learn CCA programs since the start of free tuition.
- At NS Health, the Early Immersion Program has hired 228 Undergraduate Student Nurse Employees, with the next intake being processed.
- There have been over 7,500 total clinical placements in NS Health from all levels of health professional learners.
- Streamline the recruitment experience to attract qualified health providers, including those from underrepresented groups
Actions will include Progress Update Status - Establish clear and effective processes and timelines for hiring
- Targeted strategic initiatives are being implemented to enhance recruitment and retention.
- Between January and September 2022, more than 350 nurses have started working or have accepted offers to work with NS Health and IWK Health.
- Physician recruitment remains strong in Nova Scotia. 168 doctors started practicing in Nova Scotian from April 1, 2022, to March 31, 2023. The net gain is 86 physicians.
- “Come Home to Nova Scotia” Physician Recruitment Website & Campaign has been launched.
- IWK has completed a recruitment and onboarding continuous improvement initiative which has resulted in streamlined processes and improved timelines for hiring.
- The NICHE Program: Nova Scotia’s International Community of Healthcare Workers Engagement Program is providing comprehensive supports for international professionals and their families. The program aims to implement and test a sustainable recruitment strategy for qualified internationally trained health professionals as a means of improving access to care in rural Nova Scotia.
- Three cohorts of international nurses have started the NS Bridging program at the Learning Institute, totalling 76 learners.
- Memorandums of Understanding have been signed with three colleges of nursing in India.
- The NS College of Nursing announced changes to regulation of international nurses in NS starting May 1, 2023.
- Work is underway to rapidly onboard more than 600 international nurses through innovative pathways into NS Health and another 120 nurses from India starting September 2023.
- The Atlantic Physicians Registry was launched in May 2023, which will eliminate barriers for physicians to work seamlessly throughout the Atlantic region and assist all four provinces in providing better access to care, closer to home. The Registry marks the first multi-jurisdiction licencing model in Canada.
- By May 2023, more than 140 nurses had signed on to return to Nova Scotia’s healthcare system. The government offered nurses who left the system $10,000 to come back.
- Expand opportunities for physicians and/or other health professionals to participate in recruitment efforts
- Six physicians now serve as MD recruitment leads. Their role is to participate in site visits and meet with potential candidates to share their experiences of living and working in NS.
- Multiple streamlined pathways are being implemented, including a pilot program for international professionals.
- Internationally educated nurses and health care providers are being successfully recruited and matched to positions within NS Health.
- Physicians and other health professionals actively participate in recruitment efforts, including attraction missions.
- Establish a retirement fund for full time physicians who practise patient-facing services
- Options for a retirement fund are currently being finalized.
- Understand and address systemic racism, oppression, and discrimination in recruitment and retention strategies
Actions will include Progress Update Status - Ensure reporting mechanisms are in place for staff experiencing racism and discrimination in the workplace
- Work is underway to determine whether current organizational processes are working, accountable, trusted, and culturally appropriate; the new provincial Health Equity Framework (HEF) will add further support the development of a reporting mechanism for the health care system.
- The Department of Health and Wellness has begun discussions on a larger anti-racism policy for the department that is aligned with health system partners.
- IWK has formed a Respectful Workplace Action Group that is updating the policies and is looking into creating educational material and preventative channels before the formal investigation route.
- IWK is in the process of implementing a new inclusive case management system for a respectful workplace, racism, discrimination, disclosure of wrongdoing, and all other workplace concerns. This system will support proper data collection, improve response time, and add transparency to the reporter.
- Identify and address internal barriers to equity in employment and advancement
- Work on employment and advancement actions from the Department of Health and Wellness Staff Equity Strategy and Action Plan has begun. The Leadership Equity Achievement Program (LEAP) will be launched in September 2023.
- IWK has received the full diversity census report with recommendations. IWK has worked with community partners in the design of questions, the development of the full report, and the recommendations. The next step is to dive deep into the data as well as the recommendations and develop an employee-led action plan.
- IWK is recruiting for Manager, Equity & Belonging to oversee the EDIRA programs and initiatives. A team will be built once the manager is hired.
- The Anti-Racism Action Plan is wrapped up at IWK with a great knowledge transfer ceremony and a report of recommendations which will be used in the upcoming EDRA strategic plan.
- Review and update employment equity policies to address the concerns of equity- seeking and racially visible groups
- A review of the 1995 Employment Equity Legislation is taking place, with the NS Black Business Initiative (BBI) leading local consultation.
- Engagement and discussions are occurring to better understand employment inequities and solutions, including an Employment Equity Action Group at the IWK. Findings will be used to support corporate employment equity policies.
- The Department of Health and Wellness is supporting efforts to update employment equity policies, especially at the IWK around training of managers on employment equity during the hiring process.
- Review and implement diversity and equity training to support the continued development of the workforce
- Two diversity and equity training programs have been finalised at the Department of Heath and Wellness. Inclusion Circles, and a training module on cliches and stereotypes, will be implemented in fall 2023.
- Cultural awareness and safety module has been implemented by NS Health.
- An Indigenous cultural safety program is being tested with clinicians at NS Health and IWK, and an Anti-Racism Action Program (ARAP) at the IWK is supporting the diversity census, employment equity plan, and developing an organization wide educational module.
- IWK is exploring opportunities to work with a consultant and facilitator from representative communities, African Nova Scotian and Indigenous, to bring education to Equity, Diversity, Inclusion, Reconciliation and Accessibility (EDIRA) steering committee and leadership.
- IWK has partnered with Impact Organizations of Nova Scotia to provide self-paced e-learning opportunities.
- Accelerate and support the integration of qualified internationally educated and trained health providers
Actions will include Progress Update Status - Explore opportunities to increase the number of Clinical Assistants practising in the province
- Collaboration has begun between Government and the Health Authorities on including a Physician Assistant pilot in Emergency Departments. Positions are in place at South Shore Regional Hospital and Dartmouth General Hospital; and positions posted for Cumberland Health Centre and Cape Breton Regional Health Centre.
- IWK Health has added several Clinical Assistant positions.
- Physician Assistants will be added to 20 primary care practices.
- Expand existing pathways for foreign-trained physicians to gain full licensing in Nova Scotia by increasing the number of seats in the Practice Ready Assessment Program
- Assessors are currently being recruited to allow more candidates to be accommodated through the Practice Ready Assessment Program.
- Support internationally educated health providers to work in the province, including supporting their transition and integration into communities
- A new orientation program is being developed to bring 140 doctors to the province over the next three years. The College of Physicians and Surgeons of Nova Scotia has developed the program, called the Welcome Collaborative, to be delivered with physician leaders, NS Health, Immigrant Services Association of Nova Scotia, and Doctors Nova Scotia. It will bring community partners together to offer support, mentorship, and a sense of community as new doctors begin to practise in the province.
- 15 Internationally Educated Nurses (IENs) were enrolled in a new Full-Time RN Bridging Program launched this fall at the Nova Scotia Health Learning Institute for Health Care Providers. This program will prepare IENs faster than the current part-time 14-month program that offers 90 seats per year.
- More than 90 IENs enrolled in January 2023 cohorts offered in partnership with NSCC and STFX through the Learning Institute for Healthcare Professionals.
- The English Language Policy Exam was amended for Internationally Educated Nurses, creating new options to demonstrate proficiency in English.
- Work is underway to support recruitment and integration of displaced Ukraine healthcare workers.
- Funding was provided to the Nova Scotia College of Nursing to support the ongoing and comprehensive review of the registration and licensing process for internationally educated nurses.
- Memorandums of Understanding have been signed with three colleges of nursing in India.
- Work is underway at Department of Health and Wellness to support three equity organizations under the Office of Professional Healthcare Recruitment’s community fund to recruit, welcome and retain healthcare professionals from equity groups.
- Advance a targeted immigration strategy to support recruitment efforts in continuing care
- Over the course of 3 recruitment missions internationally, Health Association Nova Scotia (HANS) contacted over 600 potential candidates and made conditional offers to 164 candidates.
- The Department of Seniors and Long-Term Care is working closely with the Department of Labour, Skills and Immigration and the Office of Healthcare Professionals Recruitment regarding international recruitment in 2023-2024. An initial calendar has been developed for continuing care recruitment. The recruitment plan is based on a multi-stream approach for domestic and international students, and multiple international recruitment streams.
- Work with the Nova Scotia Community College (NSCC) to position the Nursing Re-entry Program to meet the needs of internationally educated licensed practical nurses
- The Practical Nursing Stream Re-entry Program at NSCC resumed in Fall 2022 (20 seats).
- NS Health’s Learning Institute for Healthcare Professionals has implemented an Orientation to the Canadian Healthcare System program to support internationally educated health care providers.
- Identifying pathways for internationally trained Nurse Practitioners and Licensed Practical Nurses through an Express Entry Pathway initiative.
- Accelerate investments in technology and digitization to ensure care teams are able to provide quality, people- centred care that is culturally specific
Actions will include Progress Update Status - Implement One Person, One Record (OPOR)
- The contract for the solution (Oracle Cerner) was signed in February 2023.
- Front-line clinicians, staff, and leaders are currently actively engaged in design of the Clinical Information System (CIS) and will participate in workshops to configure evidenced-based content from other Canadian sites to the Nova Scotia context in fall 2023.
- Community-based providers including family doctors will have better access to clinical information through a Provider Portal launching in fall 2023.
- The CIS will go live at Dartmouth General Hospital, Cobequid Community Health Centre, and the Community Outpatient Centre in early 2025 followed by the rest of the province by zones so that it will be used in every hospital across Nova Scotia by end of 2026.
- Once completed, patients will also have access to their own clinical information including lab results as part of the OPOR program.
- Use resident assessment technology in long-term care homes to better understand people’s care needs
- Nursing homes have adopted the InterRAI tool for resident assessment and care planning. Data is reported to the Canadian Institute for Health Information (CIHI) for cross jurisdictional comparisons.
Solution One Results
We said we would streamline the recruitment experience.
We will monitor how many health providers we recruit, and the number of family physicians available for Nova Scotians. Future updates will include targets for net increases in health providers. The type of providers included in this count may also expand in future updates.
Family Physicians - New Inflow
Family Physicians - Annual Net Increase
Nurse Practitioners - New Inflow
Nurse Practitioners - Annual Net Increase
Registered Nurses - New Inflow
Registered Nurses - Annual Net Increase
Continuing Care Assistants
8,214
Total Registered 2022-2023