In order to establish an understanding and definition of what encompasses ‘program management’ the evaluation team conducted a document review and interviews.
3.1 Definition
Based on a review of numerous sources, including Government of Canada policies, the Project Management Institute (PMI), the International Organization for Standardization (ISO), and various industry articles the evaluation team established the following definition of program management:
Program management is the management of several interrelated projects, or program components, managed together to achieve an organizational or operational objective(s) and outcome(s). Program management is about keeping all the components on track to deliver the expected results. Unlike project management, which focuses on completing specific project plan tasks on time, program management requires more emphasis on strategic thinking, analysis and relationship building.
The evaluation’s document review highlighted the following key concepts/characteristics of program managementFootnote 18:
- Program components are interdependent/interrelated (with opportunities for synergies/efficiencies by co-managing components);
- Program management plan/framework is in place (including governance structure, alignment to organizational/strategic objectives, benefits to be realized by managing the program, roles and responsibilities, and necessary resources);
- Resources are coordinated and prioritized across program components;
- Costs, scope, quality and risks are managed;
- Deliverables are aligned to program outcomes;
- Program is managed to achieve objectives and outcomes;
- Organizational capability and capacity are optimized; and
- Stakeholder interests are identified and managed.
Potential differences of program management in the public sector versus the private sector to consider include:
- Many government programs are permanent ongoing programs/funded long-term (versus project oriented programs that are shorter in time); and
- Government programs are designed to provide benefits to program recipients and meet their needs but must also adhere to federal government regulations and legislation, and potential budgetary limitations (versus specific requirements and costs being provided by clients in requests for proposals in the private sector).
Additional information regarding typical roles and responsibilities surrounding program management can be found in Appendix D.
3.2 Structure of Program Management at VAC
The Treatment Benefits Program Management Unit (herein referred to as the Treatment Benefits Unit) is responsible for the management and operations of the Program. During the scope of the evaluation, the Treatment Benefits Unit was part of VAC’s Health Care and Rehabilitation Programs DirectorateFootnote 19.
As of September 2017, the Treatment Benefits Unit consisted of one Program Manager (who is also responsible for the Veterans Independence Program), three senior analysts, two junior analysts, two administrative positions, and one student for a total of nine staff.
There have been some internal and external changes related to the delivery of the Program in the past number of years:
- Head Office organizational re-structuring occurred in 2011 (amalgamating the program management and service delivery functions into one division);
- Department led initiatives seeking improved efficiencies and streamlined processes occurred from 2011 through 2013;
- New FHCPS contract was awarded in 2015 to a third-party health claims processor which included additional components of administering the Program being transferred from VAC over to the contractor;
- Changes to Canadian legislation around cannabis for medical purposes in 2014–15;
- Treatment Benefits Unit experienced a significant turnover in staff between 2013 and 2017;
- Office of the Auditor General’s (OAG) office released their report titled Drug Benefits—Veterans Affairs Canada in April 2016 with findings and recommendations linked to the drug benefits portion of the Program which resulted in updates to VAC’s drug formulary and its governance structure; and
- VAC cannabis for medical purposes policy established in November 2016 and a separate unit was created to manage this area using some staff from Treatment Benefits Unit.
Appendix E, Timeline of Events further highlights key program milestones.