Results at a glance: Evaluation of the Health Care Policy and Strategies Program

Office of Audit and Evaluation

January 2024

Program context

The Health Care Policy and Strategies Program (HCPSP), formerly the Health Care Policy Contribution Program (HCPCP, was launched in 2002. The HCPSP provides contribution funding to address health care system priorities, through funding for projects in four priority areas:

• Mental health care
• Home and community care
• Palliative and end-of-life care
• Other federal, provincial, territorial, and emerging priorities.

Funding

The HCPSP's core budget provides up to $25.7 million per fiscal year in contribution funding. Projects funded by HCPSP core program funds were evaluated. The evaluation did not cover funds that were transferred to other Health Canada groups for projects under different program authorities, or projects that used the HCPSP's authorities but received funding from Treasury Board decisions related to Budget initiatives.

Evaluation approach

This evaluation covers activities from 2018-19 to 2022-23. It was conducted to satisfy Financial Administration Act requirements and to inform program management.

Methods

• Literature review
• Key informant interviews
• Survey of recipient funding
• Document and performance data review
• Financial analysis

What the evaluation found

The HCPSP continues to address key needs within the Canadian health care system. The HCPSP's priority areas are consistent with Government of Canada priorities, including those related to the health care system and supporting groups experiencing health inequalities. The HCPSP is generally complementary to the work of other programs, and there are both formal and informal processes in place to help prevent or limit duplication of other programs' activities.

HCPSP-funded projects were largely effective in generating, accessing, and sharing knowledge products. The evaluation found some evidence that target audiences were applying these products and that this had led to health care system changes, including changes to guidelines and policies, and improvements in treatment and care for patients. Organizational readiness and project leadership within funded organizations, as well as Health Canada direction and support to funding recipients, were key factors for project success, while capacity limitations within some funded organizations created impediments for some projects. The COVID-19 pandemic created some delays and challenges for projects but also led to innovation.

At the program level, the HCPSP has established some of the necessary oversight and accountability elements for projects managed in part by other groups within Health Canada and where other groups use the HCPSP's authorities to flow funding for budget-related initiatives. This includes governance committees and informal understandings on respective roles and responsibilities with other groups. However, it is lacking a formalized description of roles and responsibilities for other groups using the HCPSP's authorities.

Overall, the support from Health Canada to funding recipients throughout the project cycle, including the application, implementation, performance measurement, and reporting processes, is a strength of the Program. The Program has made extensive improvements to the HCPSP's performance measurement approach and has introduced various enhancements for reporting results. However, Health Canada does not share information on projects or lessons learned with funding recipients or internally. Sharing this information could allow projects to learn from one another, avoid working in silos, prevent duplication, and identify gaps. Internally, program efficiency could be improved by better understanding and sharing the lessons learned from projects.

The flexibility of the HCPSP was important for its success. The priority area of other federal, provincial, territorial, and emerging priorities allowed the Program to respond to a variety of unanticipated priorities, fund innovative projects and was particularly useful in light of the COVID-19 pandemic. In addition, the expanded use of the Program's authorities for budget-related initiatives allowed for a wider variety of issues, activities, and organizations to be funded, and for the Department to more easily respond to Ministerial and government-wide priorities and initiatives. However, human resource capacity issues within the HCPSP Unit contributed to feelings of burnout and limited the Program's ability to complete some planned work. Work areas affected included the sharing of lessons learned and the finalization of a roles and responsibilities document.

Recommendations

1. Increase the sharing of information both externally and internally, including project information and lessons learned.
2. Clarify program accountabilities, which could include formal articulation of key process steps and associated roles and responsibilities for projects managed by those outside of the HCPSP Unit.