Management Response and Action Plan - Audit of Surveillance - September 2020

Recommendation 1

The Vice President of the Infectious Disease Prevention and Control Branch, the Vice President of the Health Promotion and Chronic Disease Prevention Branch, and the Vice President of the Health Security Infrastructure Branch should:

• Ensure that corporate leadership responsibilities for surveillance are assigned, including responsibility for overseeing development and implementation of the Agency's surveillance strategic plan, and for championing a regular review of surveillance systems and activities for corporate decision making; and
• Clarify the information requirements of senior management and formalize the reporting obligations and processes of supporting committees.

Surveillance is a core function of public health that supports evidence-based action and recommendation to promote the health and well-being of Canadians.

Recognizing that data is the key driver, there will be two positions in the Agency dedicated to the management and oversight of data - the Chief Data Officer (CDO) and a new position of Director General (DG) of Surveillance. Both of these positions will report to the Associate Vice President, Infectious Disease Prevention and Control Branch (IDPCB), ensuring that corporate oversight rests within one Branch.

The CDO will continue to play a leadership role in data custodianship, data management, and the Data Hub.

The DG, Surveillance will assume a set of responsibilities similar to, but expanded on, those assigned to the previous Chief Health Surveillance Officer (CHSO) role, including oversight of strategic corporate surveillance plans, reporting on surveillance activities to Executive Committee, providing technical expertise on surveillance priorities, and championing a regular review of surveillance systems and activities for corporate decision making, including data sources external to the Agency's surveillance systems. Surveillance programs will remain within their respective Branches, and the DG, Surveillance will be responsible for the horizontal surveillance function.

As such, this position will work closely with surveillance leads in the various program areas across the Agency.

Recommendation 2

The Vice President of the Infectious Disease Prevention and Control Branch, the Vice President of the Health Promotion and Chronic Disease Prevention Branch, and the Vice President of the Health Security Infrastructure Branch should:

• Establish and implement an Agency-wide process for the corporate review of surveillance activities to support decision-making. The former Corporate Process for Surveillance Decision Making would provide a strong basis for this purpose.

Recommendation 3

The Vice President of the Infectious Disease Prevention and Control Branch should ensure that negotiations with provincial and territorial partners support the timely development of the Multi-lateral Information Sharing Agreement annexes, including by ensuring that the Multi-lateral Information Sharing Agreement team continues to incorporate project management principles and continues to receive adequate support and resourcing.

Multi-lateral Information Sharing Agreement (MLISA) is a federal/provincial territorial (FPT) initiative that is implemented with project management provided by PHAC. Note that MLISA activities have been put on hold due to the COVID-19 epidemic.

The MLISA team is currently located within the Vice-President Office, IDPCB, and will be repositioned under the new DG, Surveillance to ensure corporate oversight of the surveillance function.

PHAC will ensure appropriate support for MLISA and will develop a workplan and critical path that is informed by lessons learned through the COVID-19 epidemic. It will engage relevant governance structures within the Public Health Network Council (PHNC) to ensure awareness of progress, gaps and provincial/territorial responsibilities.

A revised timeline will be established for the development of the MLISA annexes, with the goal being that this high-profile information sharing agreement will be realized.

Recommendation 4

The Vice President of the Infectious Disease Prevention and Control Branch, the Vice President of the Health Promotion and Chronic Disease Prevention Branch, and the Vice President of the Health Security and Infrastructure Branch should ensure that centres systematically assess and document users' needs and report on the usefulness and timeliness of surveillance outputs. Consideration should be given to the Surveillance Knowledge Translation Standard developed for this purpose.

Best practices exist across PHAC's surveillance programs to assess user needs and monitor surveillance outputs. However these practices are not systematically assembled and shared by surveillance programs to support scale up and standardization across the Agency.

Under the new surveillance structure (deliverable under recommendation 1), leadership will be in place to guide the development of annual plans for the corporate release of horizontal surveillance information, as well as corporate knowledge translation standards and guidance. Together, these will improve consistency in approach across all surveillance programs and will aim to improve the uptake and use of the resulting intelligence.

Surveillance programs will serve a critical role in this process, and will continue to deliver surveillance information products targeted to their specific stakeholder audiences.

Recommendation 5

Recognizing the Agency's current development of a Data Strategy, the Vice President of the Infectious Disease Prevention and Control Branch, the Vice President of the Health Promotion and Chronic Disease Prevention Branch, and the Vice President of the Health Security Infrastructure Branch should assign a senior manager to work with the Chief Information Officer to ensure that the Agency's technical infrastructure facilitates achievement of surveillance objectives, and that effective corporate processes exist for communicating, prioritizing and resolving surveillance-related IT issues.

In developing the Data Strategy, strong collaboration has been established with the Chief Information Officer (CIO) recognizing the fundamental importance of IT infrastructure in supporting surveillance and other data collection systems.

The CDO will be the senior official assigned to bring the IT requirements forward to the CIO for resolution. This accountability will ensure PHAC's Executive Committee approves IT priorities and receives progress reports on planning, milestones, and barriers to resolutions of issues.
Consideration will be given to unique needs of program areas, including those that operate outside of the Shared Services Canada model.

Recommendation 6

The Vice President of the Infectious Disease Prevention and Control Branch, the Vice President of the Health Promotion and Chronic Disease Prevention Branch, and the Vice President of the Health Security and Infrastructure Branch should ensure that:

• Comprehensive Human resources strategies are developed and implemented to address surveillance related competency needs; including those critical to innovation;
• Specialists who perform activities outside of their typical duties receive adequate support for these activities.

Secondary to the COVID-19 epidemic, the Agency is revisiting the infrastructure and human resource (HR) capacity required to successfully deliver on its mandate.

With the goal of ensuring effective surveillance operations now and into the future, PHAC will develop an HR strategy outlining retention and recruitment strategies for surveillance expertise. This strategy will also address issues of workforce capacity and resources.

Appropriate learning and support tools will be implemented to support individuals in surveillance roles.

Recommendation 7

The Vice President of the Infectious Disease Prevention and Control Branch, the Vice President of the Health Promotion and Chronic Disease Prevention Branch, and the Vice President of the Health Security and Infrastructure Branch should ensure that the recommendations of the March 2018 review related to Sex- and Gender-Based Analysis+ in surveillance products are considered and addressed.

Update data management tools to enact common approach to capturing sex, gender (including non-binary), age, race / ethnicity, socioeconomic status and other priority identity factors as relevant, where available and feasible and expand options for disaggregator data collection where appropriate, including adding SGBA+ as a review criteria as part of the corporate review of surveillance