# Recruiting and Retaining the Staff You Need
Many organizations experience challenges in recruiting and retaining the staff they need to maintain and increase their organization's capacity. In this chapter, you will find tools from Ontario Health and OH - Toronto Region that can help you plan your health workforce, recruit new graduates, and support internationally trained professionals.
Job Boards
- The Alliance for Healthier Communities has a page for job postings in our sector and related sectors. Alliance members may post jobs for free; other organizations may post for a small fee, subject to approval. If you would like to list job posting on this page, please reach out to communications@allianceon.org for more information.
- HFO Jobs is the Job Board for HealthForceOntario. Register here (for free) to submit a posting or search postings.
Health Workforce (Ontario Health)
Health Workforce (formerly HealthForceOntario) is operated by Ontario Health. On this website, yhou can find:
- Basic information and links to resources for/about each of 30+ health care professions, such as their regulatory bodies, accredited educational programs, and resources for internationally trained professionals (see also these pages on Ontario Health's website).
- Links for employers to sites where they can post jobs, find locum physicians, get help from an HR specialist, or learn about strategies for effective recruitment on campus.
- Physician Recruitment toolkit (Practice Ontario now redirects here)
- Attracting new PSW graduates to your team.
- Temporary reimbursement of registration fees for internationally educated and inactive nurses, to help address financial barriers that may be preventing them from getting their license to resume or begin practicing nursing.
HFOJobs is HealthForceOntario's Job Board. It has been moved to Ontario Health. Find it here.
Other Health Human Resources Tools from Ontario Health and the Ministry of Health
- Health Human Resources (HHR): Recruitment and Retention Programs Available to the Primary Care Sector (Ontario Health, 2024). Ontario Health's Health Workforce Strategy & Implementation team put together this guide to their HHR programs. It contains information on programs to recruit and retain physicians (especially in rural and northern communities), nurses, and physician assistants, as well as travel reimbursement programs to support community assessment visits. A brief description is included for each program, as well as eligibility criteria, key contact information and online resources where additional details are available.
- This page from the Ministry of Health contains links to many more resources to support recruitment and retention of staff for the roles listed above. It is specifically focused on education as well as developing new graduates and supporting internationally educated and repatriated clinical and nursing staff.
- This page inks to information about other regulated professions within the health system. It includes links to the regulatory acts that define scope of practice for many professional roles frequently found in comprehensive primary health care teams.
Workforce Planning Toolkit (OH — Toronto Region)
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The Toronto Region Primary Care Workforce Planning Toolkit (Ontario Health — Toronto Region). This collection of resources was developed by Ontario Health — Toronto Region to support integrated primary health care workforce planning. It includes:
- An interactive dashboard that provides an overview of the primary care landscape at a neighbourhood level, including demographic data, information about attachment, health system usage, projected service requirements, workforce capacity, and guidance to help you see the "big picture" in all this data (Note: this dashboard currently only contains information for Toronto and its suburbs. If you are outside of this area, consider using these Primary Care Data reports from INSPIRE-PHC for information about your community).
- A primer on health workforce planning
- A how-to playbook for planning
# Supporting Staff Wellness
Staff wellness is a key enabler of long-term staff retention. High turnover and burnout can deplete your organization's capacity and reduce its efficiency. Resources and stories in this section from Healthcare Excellence Canada (HEC) can help you develop strategies for staff wellness. The case example from the Essex County NPLC describes how they used HEC's workforce resources to to develop and implement staff wellness initiatives that reduced burnout, increased joy in work, and advanced operational efficiency.
Health Workforce Resources & Case Examples from Healthcare Excellence Canada
Supporting the Health workforce is one of Healthcare Excellence Canada's (HEC) focus areas. This page contains many resources that can support your efforts to recruit, support, and retain staff in your organization, including:
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Six strategies for strengthening the Workforce. This one-page guide outlines and describes six key strategies health systems in Canada can use to better support and retain the health workforce. These were identified by a roundtable of more than 50 health system leaders and a review of over 40 documents and 270 activities. They are listed below:
- Fostering physically safe work environments.
- Enhancing sustainable staffing.
- Building flexible work structures.
- Provide equitable and appropriate compensation.
- Ensuring supportive and inclusive workplaces.
- Supporting career advancement.
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Health Workforce Innovation Challenge Awards. Offered by Healthcare Excellence Canada in 2023 to 2024, the Health Workforce Innovation Challenge (“the Challenge”) provided financial awards, coaching, resources and a peer network to nearly 150 healthcare teams interested in taking steps to retain and support their staff. Teams came all sectors and from a diverse mix of communities in every province. The following Alliance members were among the winners.
- Country Roads Community Health Centre
- Langs
- Gateway Community Health Centre
- Essex County Nurse Practitioner-Led Clinic. See their case example in this chapter.
- Guelph Community Health Centre
- Promising practices to strengthen primary care in northern, rural and remote communities.
Case Example: Better Clinician and Staff Wellness Leads to More Efficiency in Care at Essex County NPLC
In 2022, the Essex County Nurse Practitioner—Led Clinic (NPLC) was facing challenges related to staff morale, job satisfaction, and employee retention issues. In response their board and leadership made a commitment to enhanving staff and clinician wellness by providing a safe, inclusive, and respectful workplace; fostering opportunities for learning and teaching; developing positive and collaborative relationships; and promoting work-life balance.
To help them meet this commitment, they joined Health Care Excellence Canada's Health Workforce Innovation Challenge, which helps organizations experiment with innovations to enhance workforce retention and support.
Through in-depth collaboration with staff, they implemented several innovations, including:
- Introducing flexible work schedules
- Implementing remote work options, taking advantage of virtual care and related tools
- Reducing administrative burden with AI tools and other technology tools
- Empowering interprofessional staff to work at their full scope of practice
- Establishing a wellness committee with designated Wellness Champions at each of their sites
- Group activities such as themed lunches, staff walks, and participation in community events.
To evaluate the impact of these changes, they quantified staff satisfaction at baseline and at the end of the challenge, using proxy measures such as sick leave utilization and retention rates as well as staff wellness survey scores. After completion of the challenge, sick time utilization was down; retention rates were up and survey scores were up. The results are showcased in this infographic.
Testimonials from staff and clients have provided further evidence of improved staff engagement, efficiency, and access to care.
# Optimizing Scope of Practice
Expanding the scope of practice for healthcare providers enhances access to care and allows teams to fully utilize their education and training. This approach ensures that patients receive the highest quality care from the most appropriate professional in the right setting and at the right time, tailored to their individual needs.
With the growing prevalence of chronic diseases and multimorbidity, the demand for healthcare services often exceeds what physicians can handle alone. As healthcare professionals take on additional responsibilities, patients often feel more supported and engaged in their care, leading to higher satisfaction with their overall healthcare experience. When organizations empower other members of the interprofessional team to take on such responsibilities as prescribing medications, administering vaccines, and managing therapies, patients benefit from improved access to timely and essential care. Delegating tasks across a diverse team of healthcare providers increases system efficiency, alleviates the workload on physicians, and facilitates more effective care delivery.
The resources on this page can help your organization expand the contributions made by different members of your interprofessional health care team.
You may also find the sample MOUs under "Partnership Agreements" in Chapter 5 to be helpful as you develop the scope of work for staff from partnering organizations.
Link Workers
Often associated with social prescribing, link workers support clients to improve their health and wellbeing by connecting them to nonmedical, community-based supports and services. Working closely with primary care providers, allied health professionals, and community partners, this role provides person-centred, strengths-based support to address the social determinants of health, with a focus on reducing social isolation and barriers to access.
A link worker builds trusting relationships with clients, listens to what matters most to them, and co-designs personalized social prescriptions or support plans aligned with client goals, values, and priorities.
- The Alliance has created a Link Worker Job Description Template to help you recruit a link worker to your team.
- This short report created by the Alliance outlines the evidence for the impact of link workers on community and individual health.
- A link worker is a key part of the Neighbourhood Health Home. They can help coordinate care among partner organizations in diverse health and social care organizations, allowing physicians, nurse practitioners, and their teams to focus on medical care while ensuring their clients get support for social and practical issues affecting their health. Consider drawing from this position statement in advocating for link worker funding for your team.
Nursing Staff
The tools linked below can help your organization identify and address gaps between the current and full scope of practice for registered nurses and registered practical nurses (RNs and RPNs) in your primary health care setting.
# Gap Analysis
Gap analysis is a process of finding gaps between the full scope of practice for a profession and the current functions being fulfilled by that profession in your organization. If your RNs and RPNs are not practicing to full scope, a gap analysis can help you figure out what's missing from their role and find opportunities to make the most of their expertise.
These two tools from the Registered Practical Nurses Association of Ontario (RPNAO) can guide you in doing a gap analysis.
- Primary Solutions for Primary Care outlines the full RN and RPN scope of practice.
- The Gap Analysis Tool will lead you through a process of comparing the current roles of RNs and RPNs in your organization to the full scope of practice. For each of the 30+ role description recommendations in the Primary Solutions document, you can flag whether your RNs and RPNs are performing the task consistently, inconsistently, or not at all, and then record change strategies for incorporating those tasks into their roles.
# Barriers and Enablers of Full-Scope Practice
To expand the scope of practice for nurses, it is crucial to address both the enablers and barriers to implementation. This article, How Do We Achieve Full scope? is part of a Primary Care Nurse Toolkit produced by the Registered Practical Nurses Association of Ontario (RPNAO). It identifies some of the key enablers for your organization to enhance and barriers to address in order to reach the improvement goals identified in your gap analysis.
- Key enablers include effective team communication, trust, role clarity, access to education, and a supportive organizational culture.
- Barriers identified include staff readiness, time constraints, lack of resources, and heavy workloads.
Social Workers for Mental Health and Chronic Disease Management
A pressing need in primary health care is mental health. Social workers have an essential role to play in addressing this need.
Social Work and Primary Care: A Vision for the Path Forward (link is external)is a report as well as a vision document that emphasizes the importance of integrating social workers more fully into primary care as a way to meet rising demand for mental health and chronic disease management. Social workers in primary care provide a range of services, including assessments, crisis management, counseling, and support for patients with complex health needs.
The report also discusses several barriers to fully utilizing social workers, including underrepresentation in primary care teams as well as pay disparities. It calls for increased access to social workers in primary care across Canada, ensuring they can practice to their full scope and are better represented in leadership roles.
# #Social Work in Primary Care e-Learning Modules
Team Primary Care(link is external) is a federally-funded initiative that is building capacity for effective interprofessional collaboration in primary care settings. The program funded researchers and leaders from 25 professions to develop learning resources in support of this. In addition to the Social Work and Primary Care report linked above, Team Primary Care funded the development of a free, public curriculum about the role of Social Work in Primary Care(link is external). It consists of six e-learning modules that take about 30 minutes each to complete. Each also contains additional, optional resources to explore. They are intended for new or practiced social workers who wish to work in primary care settings, as well as for other health professionals who want to learn more about social workers' roles in primary care.
Physiotherapists and Occupational Therapists
Physiotherapists (PTs) and occupational therapists (OTs) working to their full scope of practice within interprofessional primary healthcare teams can be an effective way to increase capacity for patient attachment and ease the workload for primary care providers.
In a primary care setting, patients can directly access PTs and OTs, without first seeing a physician or nurse practitioner. Within their scopes of practice, these rehab professionals can address a wide range of conditions including, but not limited to, neuromusculoskeletal injuries and diseases, heart and lung disease, stroke, brain injury, spinal cord injury, cancer related sequelae, incontinence and pelvic dysfunction, chronic pain/conditions and pre- and post-surgical recovery.
This letter from the Ontario Physiotherapy Association (OPA) outlines the benefits of including PTs working to full scope in primary health care teams. It notes that between 20% and 30% of primary care visits are for musculoskeletal conditions and asserts that the addition of a physiotherapist can increase attachment rates by an average of 450 rostered patients.
This document(link is external) from the Rehabilitative Care Alliance (RCA) was developed for OHTs. It describes the value of Community-based rehabilitation in outpatient, at-home, and primary care settings, and can be useful for population health planning. It includes several case studies demonstrating how community-based rehabilitative care supports the Quintuple Aim.
To support the development of Interprofessional Primary Care Teams and local health networks that are inclusive of these occupations, these organizations are also available to support proposals and help make the case for having their members join the team. This support will continue through future cycles of expansion funding.
# #PT and OT Learning Modules from Team Primary Care
Team Primary Care(link is external) is a federally-funded initiative that is building capacity for effective interprofessional collaboration in primary care settings. The program funded researchers and leaders from 25 professions to develop learning resources in support of this.
- Preparing Physiotherapists for Team-Based Primary Care(link is external) is a series of eight e-learning modules which aim to help physiotherapists develop competencies for physiotherapy practice in team-based primary care settings.
- Occupational Therapy and Primary Care(link is external) is a free, two-part course designed to enhance the capacity of OTs to participate in collaborative primary care teams. It is available to members of the Canadian Association of Occupational Therapists.
# #Additional PT Resources for Primary Care Teams
Physiotherapists in Primary Care Teams: Optimizing Attachment, Access, and Outcomes(link is external) (2025) is a new guide from the OPA for integrating physiotherapists in a primary care team. It includes information about the role of PTs in a primary health care team, from first contact to care across the lifespan, as well as guidance to support HR decisions, such as information about scope of practice, service contracts, and considerations for implementation of PT services. It is a companion to this primary care "hub," (link is external)which the OPA developed for physiotherapists who want to develop their readiness for working in primary care.
This suite of resources(link is external) from the UK supports implementation of First Contact Physiotherapy, a model where people with musculoskeletal conditions can access PT care at the start of their pathway.
# #Additional OT Resources for Primary Care Teams
The Canadian Association of Occupational Therapists(link is external) also has a variety of resources on their website to support integration of OTs into primary health care teams:
- What Do Occupational Therapists Do?(link is external) (fact sheet on OT in general - spring 2025)
- OT Practice Document: Primary Care (link is external)
- Occupational Therapy and Primary Health Care(link is external) (fact sheet)
- Occupational Therapy and Primary Care: A Vision for The Path Forward(link is external) describes the current role of occupational therapists in primary care throughout the client lifespan, as well as opportunities to enhance it by emphasizing health promotion. It defines key characteristics of occupational therapy in primary care such as describing ways in which occupational therapy has been traditionally practiced in primary care, as well as presenting a vision for the future of occupational therapy in interprofessional primary care teams.
Kinesiologists
Kinesiologists are regulated experts in the science of human movement and exercise, applying their knowledge to health care. Kinesiology covers prevention and management of chronic diseases and physical injury, rehabilitation of physical injury, and improvement of overall performance.
Since 2013, Kinesiologists have been regulated professionals in Ontario. The Kinesiology Act defines the practice of Kinesiology as “the assessment of human movement and performance and its rehabilitation and management to maintain, rehabilitate or enhance movement and performance.” Kinesiologists and their standards of practice are governed by the College of Kinesiologists of Ontario.
# Case Example: Kinesiologists Supporting Diabetes Management
Kinesiologists at Guelph Family Health Team (GFHT) are Certified Diabetes Educators who help clients who have or are at risk of developing diabetes to look after their health and wellbeing. They work under physician supervision through signed medical directives, supporting people with diabetes through pharmacological, lifestyle, and psychosocial interventions. They help clients choose and follow exercise plans that first address diabetes and chronic pain, then work outward to improve outcomes for as many comorbidities as possible.
Community Health Workers and Community Ambassadors
For decades, Alliance members have embraced the roles of Community Health Workers and Community Ambassadors. This report, published in Healthcare Policy(link is external), describes the vital ways community health workers contribute to advancing health equity in Canada. They assist clients in accessing necessary care, deliver health education, and offer guidance and counseling to those in need.
The report argues that formally recognizing and supporting these roles, alongside integrating Community Health Workers and Multicultural Health Brokers/Multicultural Liaison Workers into health systems, can significantly enhance care delivery and address barriers faced by marginalized communities.
For more about the potential of how these roles help to make primary care more accessible to people in your community, especially those clients who experience systemic barriers to care, check out the case example of the Thorncliffe Community Hub in Chapter 8 of this toolkit.
Certified Chronic Disease Educators
Certified Chronic Disease Educators work with clients to support self-efficacy, monitor their health outcomes, and provide support for the clinical team managing their condition.
Staff in numerous different roles can be trained as Certified Educators for a variety of conditions. For example, Kinesiologists at the Guelph Family Health Team work in their Diabetes Care Program(link is external) and have been trained as Certified Diabetes Educators (CDE). They work under physician supervision through signed medical directives(link is external). This enables them to work to their full scope of practice, addressing diabetes patients through pharmacological, lifestyle, and psychosocial interventions.
Below are links where you can access training and certification for Chronic Disease Educators:
- Certification for Asthma, Respiratory, COPD and Tobacco Educators(link is external) (Canadian Network for Respiratory Care)
- Diabetes Educator Certificate Program(link is external) (Michener Institute at the University Health Network): This training can help learners prepare for the certification exam(link is external) from The Canadian Diabetes Educator Certification Board
- International Heart Failure Certification(link is external) (American Heart Association)
- Mental Health Nursing Certificate Program(link is external) (Michener Institute at the University Health Network).
BestCare(link is external) is a service delivery model and program of KT/practice facilitation supports for optimizing the role of Certified Chronic Disease Educators in interprofessional teams. BestCare equips Certified Educators to support management of:
- Asthma
- Chronic Obstructive Pulmonary Disease (COPD)
- Chronic Heart Failure (CHF)
- Atrial Fibrillation
Certified Educators participating in BestCare work under medical directives to confirm diagnoses and optimize medication, und
Other Interprofessional Roles in Primary Care
Team Primary Care (link is external)is a federally-funded initiative that aims to build a strong interprofessional primary care workforce across the country, as a key step in addressing the crisis in access to care. They are building capacity for effective interprofessional collaboration in primary care settings by sharing innovations that are ready for spread, developing learning and QI tools for better collaboration, helping organizations integrate new staff, and supporting people to work to the full scope of their professional practice.
To support this last goal, Team Primary Care convened an Interprofessional Collaborative Table with representatives from 30 professions within primary care. Researchers and leaders from 25 of these professions were funded to develop learning resources that would empower richer integration of their professions into interprofessional primary care. Resources include pre- and post-licensure training, tools to support workflow and role integration, and detailed role descriptions to support decision-makers. This page contains links to all of these resources(link is external).
Ready to get started? Email QI@AllianceON.org for guidance and coaching support.
2 | Optimizing your workflow to improve access and attachment
4 | Technology tools that can support operational efficiency and improve access to care
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