Partners in Primary and Community Pānui: 20 January 2023

Posted 23 months ago by Carole Unkovich

Partners in Primary and Community Pānui: 20 January 2023

Tēnā koutou katoa

Nau mai, haere mai and welcome to 2023. I hope you were able to take a well-deserved break, despite the weather around some parts of the motu. Thank you to those of you who continued the mahi over this period, particularly those supporting communities in holiday hotspots and the urban urgent care centres. Kia kaha, to our colleagues recovering from flooding and other emergencies, our thoughts are with you.

Looking back to move forward

An immense amount of work has occurred since Te Whatu Ora and Te Aka Whai Ora were established just six months ago.

Collectively, we have developed Te Pae Tata, our interim New Zealand Health Plan and the first published under the Pae Ora legislation. This outlines the actions and priorities for our first two years of operation.

We have taken significant steps to get ourselves and the health sector ready for changes needed to build our future health system. Appointing our first Regional Wayfinders last month to provide rangatiratanga leadership was a key step in this journey, as was establishing Regional Integration Teams.

The title, ‘Regional Wayfinder’ is intentional in its description of the leadership required to create the environment for achieving Pae Ora. The Regional Wayfinders will organise local commissioning teams, working with health and local partners to find a way through, to remove barriers and to identify possible paths forward. They will uphold people’s right to participate in decision making by supporting Localities to establish and carry out Locality plans, as we collectively improve health outcomes and equity among New Zealanders.

Setting up Regional Integration Teams in early January, demonstrates the commitment to unify and simplify the system across the motu, while at the same time ensuring local autonomy close to community and whānau. These teams will play a key role in unlocking the whole-of-health potential, with partners including Te Aka Whai Ora, National Public Health Service, Hospital and Specialist Services, and Innovation and Improvement, at the table.

Looking ahead to 2023

As we begin 2023, there is no denying pressures exist across our health system, including primary and community. I am incredibly grateful for the efforts you make every day in challenging situations to continue caring for your communities.

There is no doubt delivering Pae Ora within existing resources will be challenging, particularly given the impacts of COVID-19, workforce pressures, severe weather events, and the catch-up needed around Planned Care. As you’ll know, there are no quick solutions to these challenges.

Despite all of this, you continue to deliver high quality care and good health outcomes relative to other OECD countries, but we know there is a way to go for us to achieve healthy futures for all New Zealanders. My hope for 2023 is that we will work together in the true spirit of partnership to address these challenges with whānau and communities.

Allan Moffitt (he/him)

Interim Clinical Director Commissioning

In this edition:

Introducing our Regional Wayfinders
Improving access for transgender and non-binary people
Workforce: Addressing pay disparities in the health funded sector
Localities: Receiving the first draft locality plans
Te Pae Tata: Kahu Taurima, maternity and early years, virtual hui recording
Mental Health and Addiction: Drug checking, How to recharge
Heads-up: Manatū Hauora release Commissioning for Pae Ora framework; Summer pressure telehealth service; Increased risk of polio
Missed it? First quarter performance metrics released; Funding for te ao Māori solutions

Abbe Anderson, National Director, Commissioning introduces our Regional Wayfinders

It is with great pleasure I announce the appointment of our three new Regional Wayfinders and one interim Regional Wayfinder:

Danny Wu | Northern Regional Wayfinder | Interim from 4 January
Nicola Ehau | Te Manawa Taki Regional Wayfinder | from 7 February
Tricia Keelan | Central Regional Wayfinder | from 14 February
Chiquita Hansen | Te Waipounamu Regional Wayfinder | from 14 February

While we have not yet appointed a permanent Northern Regional Wayfinder, Danny Wu has accepted an Interim appointment to the Northern region for up to six months while we recommence our recruitment in the new year.

These outstanding people are well known leaders and come into the Regional Wayfinder roles with incredibly impressive accomplishments already under their belts.

Read: Short biographies and initial comments on the role in attached document Introducing the Regional Wayfinders

Improving access for transgender and non-binary people:

Expressions of interest

On 1 July 2022, Budget 2022 allocated $2.182 million over four years to improve access to primary care for transgender and non-binary people.

The project team within Te Whatu Ora is now putting together an Advisory Group that will provide invaluable advice, experience, and expertise for this project over the next four years and is calling for expressions of interest (EOI).

The Advisory Group will draw together expertise from a variety of areas relevant to the project, such as clinical and consumer expertise, including Takatāpui and MVPFAFF+ perspectives. Applicants of all backgrounds are welcome to apply.

In responding to the EOI, please ensure that:

you have considered and fully declared any conflicts of interest you may have
you are available to serve for a full term of two years
you can commit to monthly meetings of approximately two hours
you are a resident of, and living in, Aotearoa New Zealand.

Renumeration is outlined in the draft Terms of Reference (ToR). Date and time of meetings will be agreed to by members when appointed. For further information, please see the attached EOI and draft ToR.

Applications will be open from 12.00 am 18 January to 11.59 pm 8 February 2023 and can be sent to: Max Whitehurst, Project Manager, Gender-Affirming Primary Care via email primary.care@health.govt.nz

Work progressing to address pay disparities in the health funded sector

Work is progressing at pace to implement the first part of a new initiative aimed at lifting pay rates for nurses and kaiāwhina (not subject to a pay equity claim). Tranche 1 focuses on nurses and kaiāwhina who work in aged residential care, home and community support services, kaupapa Māori and Pacific services, and hospice.

It is part of an initiative announced by the Government on 28 November last year to address pay disparities between approximately 20,000 nurses and kaiāwhina working in the health funded sector and their Te Whatu Ora-employed colleagues.

Cabinet agreed to additional funding of up to $40 million for 2022/23, which would increase to $200 million per annum from 2023/24 to address these pay disparities.

The initiative is being implemented in three tranches, prioritising first the sectors that have the greatest pay disparities and experience the worst impacts on service delivery.

Te Whatu Ora has been engaging with tranche 1 key stakeholders, including providers and unions. Soon we will also commence engaging with tranche 2 and 3 providers about lifting pay rates in the next financial year for their nurses and kaiāwhina.

Localities: Receiving the first draft locality plans

While most were turning computers off and taking a well-deserved rest over the holiday season, the locality prototype working groups continued with their mahi to submit the first draft of their locality plan.

Locality plans describe the needs and aspirations of communities and will be used to measure how health and social services meet those needs. Each locality will develop their own unique locality plan with Iwi Māori Partnership Boards and supported by Te Whatu Ora and Te Aka Whai Ora.

Localities Co-Director, Kylie Ormrod says she is thrilled with the draft plans and acknowledged the work that has been done to pull them together.

“This has been a very exciting start to the year to receive seven draft locality plans. There has been a huge amount of work and effort that has gone into producing these documents and reading them gave me hope for the future of our health system. This is the beginning of some exciting changes, and our prototype localities are doing an incredible job,” says Ormrod.

Locality plans must evidence and be guided by the voice of community. Having a deep understanding of the health and social needs of the community is essential to the authenticity and success of the locality plan.

“The most powerful aspect of the locality plans is te reo o te tangata, the voice of the people. They know intimately what they need to be well because they live it every day. Some of the themes we are hearing is that health isn’t restricted to a service you receive in a hospital. For some, health is about being safe, warm and dry in your home. For some, health is about being connected to your whakapapa and your community. For some, health is about the local economy and providing opportunities for education and well-paid jobs. This holistic view of hauora is what localities are all about” says Ormrod.

The National Localities team are continuing to receive and review draft locality plans over the next few months with a view to have final locality plans delivered and actionable in June 2023.

Te Pae Tata:

Kahu Taurima, maternity and early years, virtual hui

Thank you to everyone who tuned in for the Kahu Taurima, maternity and early years virtual hui at the end of last year, and in particular for the questions raised during the session.

Kahu Taurima is the joint Te Aka Whai Ora and Te Whatu Ora approach to maternity and early years, from conception to five years old, for all whānau in Aotearoa New Zealand. It’s a priority area of Te Pae Tata – the interim New Zealand Health Plan 2022-2024.

This area of work is about supporting parents and whānau to receive great, well connected, easy to navigate, culturally affirming health services no matter who they are or where they live.

We look forward to engaging with you further this year.

Watch: The full webinar can be viewed here, please feel free to share this link with your colleagues.

Mental health and addiction:

Drug checking boost keeps New Zealanders safer this summer

Keeping New Zealanders safer is the focus of more accessible drug checking services across the motu this summer.

The Government has boosted funding for those services to almost $4 million across three years. The funding also allowed the purchase of four spectrometers – the instruments used to check drugs – furthering capacity for the sector.

Pooled data across licensed drug checking providers showed 22% of drugs checked between August and November last year were partially or completely different to what people thought they had. Of the 22%, 12% were another substance entirely and 10% were a mixture.

There is also clear evidence that when a person is told that a substance is not what they thought it was, they will often choose not to take it. That is a decision which could save their life.

The new funding is not only reducing drug harm at summer festivals and events but greater accessibility to testing services is helping people make safer choices throughout the year.

Drug checking services were first legalised in 2020. They are now run by four licensed providers: KnowYourStuffNZ, New Zealand Drug Foundation, Needle Exchange Services Trust, and the Institute of Environmental Science and Research.

This summer, drug checking providers are working at pace, having already checked a record 2,400 samples across 30 events and clinics.

Thank you to everyone involved, especially those who have sacrificed their summer to deliver these essential services.

Picture: KnowYourStuffNZ, one of four licensed drug checking providers helping people stay safer this summer, at Twisted Frequency festival in Golden Bay.

Mental health matters: How to recharge this summer

As we begin the year, how can you recharge and look after your mental health? Peter Carter, Director of Addiction Services at Te Whatu Ora, shares his tips for supporting your own and others’ wellbeing - and where to get help if you need it. His suggestions include disconnecting from technology, spending time in nature, and recognising and managing stress.

Read: Pete’s tips for recharging this summer

Heads-up:

New framework released: Commissioning for Pae Ora

Manatū Hauora (Ministry of Health) has today released the ‘Commissioning for Pae Ora’ framework and case studies to support the health system to apply a whānau-centred approach to commissioning.

The Ministry began developing the framework in 2020 as part of implementing Whakamaua: Māori Health Action Plan 2020-2025. In addition to being a key deliverable of Whakamaua, this framework also responds to:

Wai 2575
Te Piringa research on primary and community care
and the Health and Disability System Review recommendations.

Commissioning for Pae Ora seeks to bring the whānau ora vision into the health system, and builds on the insights from Enabling Good Lives, the nearest expression of whānau ora in the mainstream system. It takes a whānau-led approach to commissioning, which turns the conventional approach upside down. It starts with whakawhanaungatanga by connecting with whānau to understand what matters to them, and then working with them on how to respond.

Manatū Hauora has published the Commissioning for Pae Ora framework to support commissioning across the health and social sector and to improve outcomes for whānau Māori now and in the future.

Read: The full framework and case studies online

Seasonal Summer pressure clinical telehealth service in operation

Te Whatu Ora primary care team within national commissioning have worked with the National Telehealth Services provider, Whakarongorau Aotearoa, to implement a clinical telehealth service to support the increased seasonal demand over summer on rural, Māori and Pacific general practices. To date 110 practices have enrolled with the service and 229 calls have been made into the service.

The clinical telehealth service:

provides access to 24/7 nurse triage and GP overflow services (telehealth doctor consultations if required)
is for enrolled and casual patients accessing care through an eligible general practice
is provided at no cost to general practices (unless additional set up is required to enable automated phone system set up at the expense of the practice which is optional and subject to sufficient time to implement)
is provided at no cost to the patient
will operate from 12 December 2022 to 31 March 2023.

This service is not intended to replace existing arrangements for after hours or overflow clinical care. The service is also not intended to replace the rural telehealth service that is currently in development.

Increased risk of Polio

There is an increased risk of polio entering Aotearoa New Zealand due to an evolving international outbreak situation.

Te Whatu Ora and Manatū Hauora are working with a range of experts in this field together with laboratories on ensuring the national preparedness and response plans are fit for purpose.

Manatū Hauora is working with the Institute of Environmental Science and Research to establish wastewater surveillance for polio.

The international situation will continue to be monitored and updates will be provided when new information becomes available, when guidance documents are finalised and where specific actions are required from the health sector.

Find: Information for health professionals has been added to the News section of your local Healthpathways Homepage

Missed it?
Te Whatu Ora: First quarter performance metrics released

Te Whatu Ora Chief Executive Margie Apa released the first series of monthly metrics for the new entity on Wednesday 21 December, which will be followed up shortly by the first Quarter One Report.

“With Pae Ora – healthy futures as our central focus, publication of monthly performance metrics will provide transparency and accountability to both the public and our workforce and show progress as well as areas where we need to focus as we strive to improve New Zealanders' health and their lived experience of our health system.

“We acknowledge that the metrics we are reporting today do not cover all aspects of the services we provide for New Zealanders; however, we are committed to working with our health system partners to improve our approach incrementally, including greater reporting on primary and community services and looking at new ways of reporting, for example, interactive tools.

“Te Pae Tata Interim New Zealand Health Plan clearly outlines what Te Whatu Ora and Te Aka Whai Ora will do differently in the next two years to build the foundations of a sustainable, unified health system that better serves all our communities. I have confidence we can achieve this.”

Download: Performance metrics summary and data

Te Aka Whai Ora: Funding for te ao Māori solutions

Te Aka Whai Ora’s Board has prioritised funding for mātauranga Māori solutions and te ao Māori population health approaches for the 2022/2023 and 2023/2024 financial years. Te ao Māori solutions that are effective, dynamic and innovative, that utilise and build on cultural knowledge and experiences to deliver better health outcomes from te ao Māori.

Te Aka Whai Ora is inviting hauora Māori partners to submit proposals for one or both of the following:

Te Ao Māori Population Health Approaches
Mātauranga Māori Solutions

Te Aka Whai Ora is leading change in the way the health system understands and responds to the health and wellbeing needs of whānau Māori and the wider community. This is an investment in new service models, strategies and innovations grounded in te ao Māori.