Engagement a key focus in reform progress

Stephen McKernan
Director – Health & Disability Review Transition Unit (TU)

It has been a busy period for the Transition Unit, since the Minister's announcements in late April about the reform in the health and disability sector. Our principle focus has been on engagement – both to discuss the shape of the reforms and how the future system will work in practice, and just as importantly, to listen, and to hear from the sector. We've undertaken more than 100 meetings, including with Māori, sector groups and government agencies, and we have many more planned.

From these engagements, we are gathering information about progressing the reforms to meet New Zealand's future health care needs.

Based on our conversations, the need for change and response to the planned reforms from the sector has been positive. There is broad consensus that the system review presents a significant opportunity to address some of the key shortcomings of the current model – equity being a good example.

At the same time, these same conversations have highlighted for us the numerous examples of good practice currently out there. We will capture this and ensure it informs our future thinking.

Group photos from Hui Whakaoranga, regional hui

Photos from Hui Whakaoranga, regional hui hosted by the Māori Health Directorate. These are part of four regional hui with a focus on how the Māori health sector looks at development of Māori health in the future. This was hosted by John Whaanga, DDG Māori for the Ministry of Health and facilitated by Herewini Te Koha as an independent facilitator. We have attended the two previous hui in Wellington and Dunedin and will attend the last one in Rotorua this week.

We have an ambitious work programme, and as well as engagement, our priorities include progressing critical health reform deliverables including legislation to establish the interim and new entities, developing the NZ Health Plan and preparing for interim Boards to be in place from September 2021.

From September, the Transition Unit and the interim entities will increasingly be engaging the Ministry of Health and DHBs around planning and organisational design work.

We are also working with the sector to agree next steps and planning for Health Charter engagement later this year.

I know everyone is keen to understand key features of our work programme. In this update, we focus on plans for progressing the development of our locality prototypes and the Charter. I look forward to sharing more detail in future updates.

Of course, it's important to remember that the day to day work of providing health care to New Zealanders continues. DHBs and the Ministry of Health retain their roles and accountabilities until new legislation comes into effect in July 2022, and we continue to work with the Ministry to advise and support DHBs to provide certainty and clarity where required.

Progressing locality prototypes

In the future system operating model, primary and community services will be commissioned closer to communities – through 'localities'. Health systems will be delivered through networks of providers with a focus on shared outcomes, specific to their community.

Infographic outlining how the population health approach can be used to address the wider lifestyle, environmental and socioeconomic factors that impact on people's health and wellbeing.

Population health approach

The 'locality approach' creates an opportunity to drive integration of care models and service delivery around local people. It also offers a platform to implement a population health approach to address the wider lifestyle, environmental and socioeconomic factors that impact on people's health and wellbeing.

Health NZ, in partnership with the Māori Health Authority, will ultimately be responsible for implementing the locality approach that will be rolled out in phased tranches, starting with early adopter 'prototypes'. These prototypes will provide an opportunity to create exemplars of leading practice and innovation and gather knowledge to inform future national roll out.

Budget 2021 set aside $45.98m over four years to develop these prototypes and test the locality approach. $9.6m was allocated for FY21/22 for the first five to six localities, which will cover around 5% of the New Zealand population.

To inform the establishment of locality prototypes, the Transition Unit will undertake a 'discovery phase' to capture current or planned integration initiatives across the country. The discovery phase will seek to develop a better understanding of current practice and identify potential early adopters of the locality approach.

An indicative timeline for selecting prototypes is provided below – it will be finalised based on the timing of setting up the interim Health NZ and Māori Health Authority.

Image of indicative timeline for selecting prototypes

Indicative timeline for selecting prototypes – it will be finalised based on the timing of setting up the interim Health NZ and Māori Health Authority.

Developing the New Zealand Health Charter

The New Zealand Health Charter provides an opportunity to shape the expected culture and behaviours of our nationwide health workforce. It will be one of the key areas of engagement with our health workforce and the sector in the coming months.

The Charter is a way to embed shared values and ways of working across regions and professions, set shared expectations for workforce collaboration, and create a vision for a unified 'New Zealand health workforce' – which we can build over time.

The Transition Unit is currently establishing a Charter reference group to drive the design process. It will be made up of key sector stakeholders to guide engagement with our broad and diverse workforce and help ensure the Charter effectively reflects the core values and motivations of our health workforce.

Engagement will begin in the second half of this calendar year, with the final Charter launched once Health New Zealand and the Māori Health Authority are formally established in June 2022.

Still time to express interest in Interim Board member appointment process

Kia hiwa rā! Kia hiwa rā! Kia hiwa rā i tēnei tuku!
Kia hiwa rā i tērā tuku! Kia hiwa rā! Kia hiwa rā!

The Expression of Interest process for interim Board members for the Māori Health Authority and Health New Zealand has been live since the end of May, and we are encouraged by the level of interest to date from a diverse range of people throughout Aotearoa New Zealand.

It is not too late to submit an expression of interest and prospective candidates are invited to visit the website below where they can find a comprehensive information pack about the health and disability reform, the new organisations being formed and the range of leadership capabilities and experiences required for interim Board members.

Prospective candidates must possess several of the leadership capabilities and experiences to be considered as possible interim Board members for either of the two new organisations.

Expressions of Interest must be received by midnight Friday 18 June.

Submit an expression of interest(external link)

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