Canadian Heart Health Strategy and Action Plan CHHSAP

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Canadian Heart Health Strategy and Action Plan
(CHHS-AP)

• Stakeholder Consultation
• May 28 29, 2007
• Toronto
• Eldon R. Smith

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GO FLAMES SENS GO
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Context International

• Prevention Strategies
• Six International Heart Health Conferences and
  Declarations (1992 2004)
• WHO Global Strategy for the Prevention of
  Non-Communicable Diseases (2000)
• WHO Global Strategy on Diet, Physical Activity
  and Health (2002)
• North Karelia Project in Finland
• A Strategy to Prevent Chronic Disease in Europe
  (WHO)
• PAHO Integrated Approach to the Prevention and
  Control of Chronic Disease
• CDC Prevention Action Plan

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Context for a Canadian Strategy

• CVD is Canadas number one public health problem.
• Risk factors, particularly obesity, diabetes and
  hypertension are increasing.
• Gaps between what we know and what we do exist in
  primary and secondary prevention as well as in
  treatment.
• The health care system lacks integration access
  is limited with significant disparities.
• Health human resources are deficient.
• Care delivery models have been relatively
  stagnant.
• Canada lacks a surveillance system for CVD.

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Context Political

• Public concern about access
• Health accord
• Stephen Fletcher, MP, introduced a private
  members bill calling for chronic disease
  strategies cancer, heart and mental health (May
  2005)
• 2005 federal budget included CVD specific
  resources
• Representatives from CV community met in the fall
  of 2005 and with Stephen Fletcher (April 2006)
• Presentation at health caucus meeting (June 2006)
• Verbal commitment for funding

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CHHS-AP Chronology of Events

• Management Group formed (Summer 2006)
• Developed TOR for Strategy Development Process, a
  Governance Model and a Thought Leader Survey
• Announcement by Minister of Health (Oct 22 2006)
• Press conference (Oct 23 2006)
• Steering Committee membership confirmed (Nov
  2006)
• Secretariat established and staffed (Nov 2006)
• Steering Committee selected Themes (Jan Feb,
  2007)
• Theme Working Group Co-Chairs selected (Mar 2007)
• Working Group Members selected (Mar Apr 2007)
• First Working Group Retreats (Apr May, 2007)
• Stakeholder Consultation (May 28 29 2007)

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CHHS-AP Purpose and Description

• Purpose
• To reduce the growing burden and loss due to CV
  disease in Canada
• Description
• Independent, stakeholder driven
• Comprehensive, integrated strategy
• Continuum of the health system health
  policy/prevention to end-of-life care
• Continuum of life preconception to death
• Address disparities
• Evidence-based/best practices

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Framework for a Comprehensive Canadian Heart
Health Strategy and Action Plan
The Vision
HEALTH PROMOTION
PRIMARY
SECONDARY
Interventions Required
Policy and environmental change
TREATMENT
Behaviour change strategies
Prevention, detection management of risk factors
Timely access to quality (acute) care
Timely access to quality chronic disease
manage-ment/rehab
PREVENTION
Timely access to end oflife care
OUTCOMES

• Decreased burden of cardiovascular disease

• Healthier population

• Added quality life years

• Sustainable health system

• Reducedinequities

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CHHS-AP Leadership

• Leadership partners
• Heart and Stroke Foundation of Canada
• Canadian Cardiovascular Society
• Canadian Institutes of Health Research
• (Institute for Circulatory and Respiratory
  Health)
• Funder
• Public Health Agency of Canada

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CHHS-AP Steering Committee

• Primary policy decision-making body
• 29 thought leaders and experts
• Balance of expertise, knowledge, skills, regions,
  gender, research pillars, continuum of CV health

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CHHS-AP Management Group

• Executive Committee of Steering Committee
• Administrative body of CHHS-AP
• Operational responsibilities

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CHHS-AP Secretariat

• Housed at the offices of the Heart and Stroke
  Foundation and Canadian Cardiovascular Society
• Provides management services and operational
  support
• Director, Program Manager, Administrative
  Coordinator

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CHHS-AP Theme Working Groups

• Co-chairs (1 member of SC)
• 11 15 members per group selected on basis of
  expertise
• 80 members total
• Two face-to-face retreats (Apr May, Fall 07)
• Provide theme specific advice and expertise
• Commission synthesis research
• Develop reports with 5 6 key recommendations
  and priorities for action (associated costs,
  evaluation, surveillance etc.)
• Innovative, implementable and practical
• Based on evidence and best practices
• Integration with existing strategies
• Input from stakeholders

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CHHS-AP Theme Working Groups

• Strengthening information systems for monitoring,
  management, evaluation and policy development
• Creating environments conducive to cardiovascular
  health
• Preventing, detecting and controlling major risk
  factors
• Addressing and enhancing Aboriginal / indigenous
  cardiovascular health
• Timely access to quality (acute) care and
  diagnostics
• Timely access to quality chronic disease
  management, rehabilitation services and
  end-of-life care

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CHHS-AP TWG Co-Chairs

• TWG 1
• Anne McFarlane (SC)
• Andy Wielgosz
• TWG 2
• John Millar (SC)
• Roy Cameron
• TWG 3
• Norm Campbell (SC)
• Jean-Pierre Després

• TWG 4
• Jeff Reading (SC)
• Richard Jock
• TWG 5
• Peter Glynn (SC)
• William Ghali
• TWG 6
• Heather Arthur (SC)
• Richard Lewanczuk

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CHHS-AP Cross-Cutting Issues

• Reducing the impact on cardiovascular outcomes
  that result from disparities.
• Expanding the knowledge base.
• Translating knowledge into action.
• Addressing impact/outcomes of interventions.
• Addressing and enhancing Aboriginal/indigenous
  cardiovascular health.
• All groups will also consider workforce/education
  system needs

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CHHS-AP Advisory Committee(s)

• 1. Integration and Partnerships

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CHHS-AP

• Outcomes and Deliverables
• A Strategy and Action Plan using a collaborative
  approach
• A Business Plan to support implementation
• A plan for a system of CV surveillance
• Evaluation and monitoring protocol

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CHHS-AP Timelines

• Throughout
• Engagement and partnership building with
  provinces/territories
• Engagement and consultation with stakeholders
• Timely and transparent communications, e.g.,
  interactive website, communiqués

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CHHS-AP Timelines cont

• January July 2007
• Steering Committee meeting ( Jan 10- 11 in
  Montreal)
• Established Theme Working Groups (March)
• 6 Theme Working Groups Retreats (1 1 ½ days -
  May)
• Launch web site www.chhs--scsc.ca (public
  private sides)
• Commission work for 6 Theme Working Groups and SC
• Develop and implement a consultation strategy
• Stakeholders (175 people) meeting (May 28 - 29
  Toronto)
• Ongoing consultation with p/ts and stakeholders
  (meetings, surveys, workshops etc.)
• Commission writer

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CHHS-AP Timelines cont

• Aug 2007 March 2008
• Analysis and synthesis of evidence by 6 Theme
  Working Groups
• Second Theme Working Groups Retreats (late Fall
  2007)
• Draft Reports from Theme Working Groups (mid Dec
  07)
• Review of draft reports by SC
• Co-Chairs present to SC (late Jan 08)
• TWG Final Reports (end of March 08)

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CHHS-AP Timelines cont

• April 2008 October 2008
• Integration of TWG reports by Steering Committee
• Dialogue with stakeholders
• Prepare Strategy Report and Business Plan
• November 2008
• CHHS-AP Chair submits final report to Minister of
  Health

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CHHS-AP

• Success factors
• Engage stakeholders
• Engage provincial/territorial governments
• Maintain timelines
• Innovative and practical strategies
• Sound implementation plan
• Successful integration with other strategies

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Related Initiatives

• F/P/T
• Cardiovascular Disease Surveillance Issue Group
  (reports to the Chronic Disease and Injury
  Prevention and Control Expert Group of the Public
  Health Network)
• Pan Canadian
• Canadian Stroke Strategy
• Diabetes Strategy, Cancer Strategy
• Pan-Canadian Healthy Living Strategy
• P/T Strategies
• Ontario, Nova Scotia
• Regional Strategies
• Champlain CV Disease Prevention Strategy

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CHHS-AP

• What it is
• Independent, stakeholder driven
• Comprehensive, integrated
• The continuum of the health system
• Healthy policy/prevention to palliation
• The continuum of life
• Preconception to death
• Evidence-based/best practices

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CHHS-AP

• Contact
• 613. 569.4361 ext 254
• info_at_chhs-scsc.ca
• www.chhs-scsc.ca

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GO - SENS - GO
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CHHS-AP Steering Committee
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CHHS-AP Steering Committee
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CHHS-AP Steering Committee
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CHHS-AP Themes

• Theme 1 Strengthening information systems for
  monitoring, management, evaluation and policy
  development
• Build capacity (access to data, infrastructure)
• Identify CV components of info systems
• Address barriers around data use (technology)
• Link policy and decisions to best practices
• Create a system that allows effectiveness
  evaluation

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CHHS-AP Themes

• Theme 2 Creating environments conducive to
  cardiovascular health
• Identify CV specific determinants of health
• Develop heart healthy public policy recs
• Influence sectors outside health that impact
  heart health
• Explore best practices (international)
• Explore science of health promotion

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CHHS-AP Themes

• Theme 3 Preventing, detecting and controlling
  major risk factors (RF)
• Empower individuals to change behaviour
  (education, tax breaks)
• Enhance understanding of impact of RF on health
• Address nutrition, physical activity, tobacco
• Improve screening and detection inside/outside
  health sector
• Ensure systems exist to address RF once
  identified
• Ensure health profs play advocacy role in health
  promotion

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CHHS-AP Themes

• Theme 4 Addressing and enhancing Aboriginal /
  indigenous cardiovascular health
• Disparities in health services
• Complex co-morbidities
• Research and surveillance
• Supportive environments (food, tobacco)
• Vulnerable youth

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CHHS-AP Themes

• Theme 5 Timely access to quality (acute) care
  and diagnostics
• Evidence-based framework
• HHR issues
• Evidence-based standards of care
• System change, integrated models of care
• Timely access to care, wait times

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CHHS-AP Themes

• Theme 6 Timely access to quality chronic
  disease management, rehabilitation services and
  end-of-life care
• Evidence-based framework
• HHR issues
• Evidence-based standards of care
• System change, integrated models of care
• Timely access to care, wait times