Held in Ottawa in June 2007, the National Roundtable on Frontline Health set the stage for what would become a series of regional dialogues about frontline health held in cities across Canada.

Download full report: The Frontline Health Dialogues: Report from the Ottawa Roundtable

The roundtable consisted of doctors, nurses, allied health professionals, policy makers, nonprofit leaders and academics from across the country who together explored the question: What will it take to make Canada the best in the world at meeting the healthcare needs of unserved and under-served populations?

Throughout the discussion there arose a number of key ideas:

(a) Frontline populations are richly diverse. Research, policy work and service delivery must take this diversity into consideration.

(b) The field of frontline health should be framed by a common definition of terms, issues and opportunities to enhance awareness and collaboration efforts, and validate its status within the healthcare system.

(c) A community of frontline practitioners should be created to encourage the sharing of ideas, innovations and opportunities.

Participants offered many diverse perspectives, creating a dialogue that was rich in ideas and insight. The discussion centred around three main themes: communities of practice ; future orientation; and influencing public policy and perception.

View list of Ottawa Roundtable Steering Committee members
View list of Ottawa Roundtable participants

Communities of Practice

The health of marginalized populations is often overlooked. This makes the frontlines a very lonely place for practitioners and patients alike. Many practitioners work in isolation and have no network or association to draw on for support.

Building a community of practice can help practitioners overcome that sense of isolation. The dialogue explored a number of different ways to strengthen communities of practice including:

• Defining the reality and culture of the frontlines;
• Articulating a shared set of values;
• Sharing stories of innovation and best practices;
• Building networks to continue the dialogue;
• Taking care of the caregivers; and,
• Clarifying language.

Future Orientation

Frontline Healthcare is beginning to emerge as a recognized field of practice. But its future is uncertain. There is a critical shortage of doctors, nurses, healthcare providers and specialists trained to care for marginalized populations. There is a lack of culturally or linguistically appropriate services. There are incredible transportation challenges for rural and remote populations. And there is still great discrimination and/or stigmatization based on race, gender and/or sexuality.

The dialogue explored a number of different ways to support the growth and development of a field of practice in frontline healthcare in the decades to come:

• Attracting, recruiting and retaining the next generation of frontline practitioners;
• Consulting and collaborating with others;
• Rethinking the current approach to healthcare delivery in Canada; and,
• Understanding future challenges: what will Canada’s frontlines of health look like in 5, 10, 20 years?

Influencing Public Policy and Perception

Influencing public policy must be on the agenda if Canada wants to become the best country in the world at meeting the needs of its vulnerable populations. However, the overall isolation of this field of work removes it from the general public and from the portfolios of most policy makers. Specific to influencing public perception and policy, the dialogue explored the following ideas:

• Clarifying the goal of policy work;
• Clarifying the focus of policy work;
• Implementing a proactive, problem solving approach; and,
• Understanding the capacity of the current healthcare system.

Conclusion

What will it take to make Canada the best country in the world at meeting the healthcare needs of vulnerable populations? It will take all of us. Not just the frontline practitioners and thought-leaders around the table in Ottawa but the greater network of people who will join this dialogue in the months and years to come.

There was a consensus that future dialogue participants would need something to build on, something to show that they are not starting at ground zero. Providing some specific actions and ideas will maintain the momentum and take the energy of this first roundtable into future dialogues. Here are some ideas to keep moving the agenda forward:

(a) Continue the dialogue of June 2007 through annual dialogues that engage practitioners and thought-leaders from across the country;

(b) Establish a community of practice, a network of networks, that can speak with a “collective voice” to promote and support cohesive efforts to improve the state of frontline healthcare;

(c) Tell the story of the frontlines, the patients, the practitioners, and the issues to build understanding and awareness of frontline healthcare.

(d) Empower the next generation by encouraging cross-sector collaboration, sharing information and best practices and developing long-term, effective training and education opportunities.

Download full report: The Frontline Health Dialogues: Report from the Ottawa Roundtable