On this page you'll find information outlining the system achievements for organisation function and capabilities as part of the health system reform implementation roadmap.
Horizon 1 – Financial year 2022-2024
- Each entities final organisation structures and functions are defined
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What will be achieved
For each organisation (Ministry of Health, Te Aka Whai Ora and Health New Zealand), core operating model, functions and leadership structures are defined to a level to enable the structural and other changes to commence.
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- Clinical governance arrangements in place
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Responsible organisation: Health New Zealand
Context
Strong clinical governance is essential for the delivery of high quality and safe services. It is important to standardise the quality of care so people can be assured that no matter who they are or where they live in Aotearoa, they will be treated well and receive excellent care from any health service provider. Clinical leadership will be a critical part of this change, to ensure that standards of care are based on evidence about best practice and reinforced through strong clinical governance across the system.
What will be achieved
A clinical leadership team will be established and national clinical governance arrangements in place, to ensure a national agreed approach to clinical governance and that clinical advice and expertise will underpin all Te Whatu Ora decision making from strategy to service design and delivery.
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- Procurement and supply chain optimisation (initial) business case completed
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Responsible organisation: Health New Zealand
Context
The procurement and supply chain system is currently led by multiple teams across the motu. There is a need to achieve greater efficiencies, cost savings, transparency, implement national catalogues and contracts, and improve inventory systems.
What will be achieved
A business case will be approved to optimise a future national operating model for procurement and supply chain, with a focus on sustainability and equitable system outcomes.
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- Monitoring and reporting on the performance of the health Crown entities
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Responsible organisation: Ministry of Health
Context
Within the reformed health system a new approach to system performance management and entity monitoring is required to enable the Ministry of Health to fulfil its role as system steward.
What will be achieved
Entity performance management, monitoring and reporting systems implemented, including:
- Crown entity monitoring system implemented
- Reporting systems established
- Embedding operating models of Iwi-Māori partnership boards across the health sector
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Responsible organisation: Te Aka Whai Ora
Context
Iwi-Māori partnership boards (IMPBs) are an essential feature in the new health reforms, with decision making roles at a local level, and jointly agreed local priorities and delivery with Te Whatu Ora.
What will be achieved
Iwi-Māori partnership boards are established and functioning as intended with capability and maturity developing to support delivery change for Māori locally.
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- Clinical networks established
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Responsible organisation: Health New Zealand
Context
Te Pae Tata identifies establishing regional and national networks as a key step in removing unwarranted variations in access to care, waiting times and clinical practice. National Clinical Networks are a vital clinical enabler of the new health system. They involve health professions from across the system working with whānau and consumers to influence how we prioritise, drive system change, and remove unwarranted variation through the development of national standards and models of care.
What will be achieved
National and Regional clinical implemented to provide governance to clinical service delivery for complex issues through; developing national standards and models of care, identifying ways to address variation in service quality and outcomes, addressing equity, and developing innovative, efficient, and evidence-based solutions that will inform investments and workforce planning and be applied nationally.
- Each entities organisations, governance, leadership and functions are in place (Health New Zealand, Te Aka Whai Ora, Ministry of Health)
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Context
Each entity must be established in accordance with legislative requirements and good practice guidance.
What will be achieved
Each entity will have implemented its organisational structure, governance systems, has its leadership roles in place, and is delivering to agreed functions, which include:
- Purpose, vision and strategy is clear
- External governance is in place and functioning effectively (if applicable)
- Internal governance and decision-making responsibilities are in place and functioning effectively
- Organisation leadership structures in place with roles and responsibilities clear
- People have been appointed to key leadership positions on a permanent basis
- The organisational values, behaviours and culture it needs to be successful are clear
- The core elements of the new operating model (“the how”) are understood and in place, or are being implemented
- Core administrative processes, including planning, finance, asset management, data/analytics, digital, people/workforce, risk and assurance, internal and external communications are in place
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Achieved 2022-23
- Regional integration teams established
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Responsible organisation: Health New Zealand
Context
The establishment of Regional Integration Teams will strengthen alignment and integration between public health, hospital and specialist services and commissioning, including between national, regional and local levels of activity across the four regions of Aotearoa New Zealand. Regional Integration Teams will provide system leadership for developing integrated annual regional health and wellbeing plans.
What has been achieved
Regional integration teams were formally established in early 2023
- New health system entities established
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Context
In 2018, the Government commissioned an independent review into our health system: the Health and Disability System Review/Hauora Manaaki Ki Aotearoa Whānui(external link) (the Review). The Review was based on widespread consultation with the health and disability sectors and interested parties over an 18-month period. The Review was the starting point for reform – it found a fragmented health system that does not serve everyone well and produces unequal outcomes, particularly for vulnerable populations. This reform accepted the clear case for change and builds on the future direction set by the Review.
What has been achieved
From 1 July 2022 two new health organisations assumed some of the responsibilities for our health system – Health New Zealand and Te Aka Whai Ora. These two organisations will work with Ministry of Health and a new Public Health Agency within the Ministry. Whaikaha was also established on 1 July 2022.
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- Permanent Hauora Māori Advisory Committee established
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Responsible organisation: Ministry of Health
Context
To establish the permanent membership of HMAC as required under the Pae Ora Act.
What has been achieved
A permanent HMAC appointed, including 6 members from Iwi Māori Partnership Boards and 2 members from hauora Māori organisations listed in Schedule 2 of the Pae Ora Act.
Horizon 2 – Financial year 2024-2027
- Formal recognition of fifteen Iwi-Māori partnership boards
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Responsible organisation: Te Aka Whai Ora
Context
Iwi, hapū and whānau need to be enabled to exercise rangatiratanga in their rohe. Tangata whenua must be heard and local health services must reflect those who need and use them. A stronger Māori workforce must be built to support the growth in capability and capacity of hauora Māori healthcare providers and encourage more innovation in services that deliver better outcomes for Māori.
Iwi-Māori partnership boards (IMPBs) are an essential feature in the new health reforms, with decision making roles at a local level, and jointly agreed local priorities and delivery with Te Whatu Ora.
What will be achieved
Fifteen Iwi-Māori partnership boards (IMPBs) will be formally recognised under the Pae Ora (Healthy Futures) Act.
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- Each entities performance management, monitoring and reporting systems are fully established
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Context: Ministry of Health
Within the reformed health system a new approach to system performance management and entity monitoring is required to enable the Ministry to fulfil its role as system steward
What will be achieved
Entity performance management, monitoring and reporting systems will be implemented, including:
- A health system performance model designed and implemented
- The co-design of monitoring framework with Te Aka Whai Ora
- A system performance and crown entity monitoring system implemented
- Reporting systems will be established
Context: Te Aka Whai Ora
A system monitoring approach is required while comprehensive monitoring frameworks are co-designed with Manatū Hauora and key stakeholders to ensure health outcomes agreed by whānau, hapū and iwi Māori are met, health inequities for Māori are reduced and Māori health outcomes improve. Implementation of performance management within Te Aka Whai Ora is required to provide a joint assessment with Health New Zealand of outcomes specified in Te Pae Tata (the New Zealand Health Plan).
What will be achieved
Entity performance management, monitoring and reporting systems will be implemented, including:
- Agreed and documented outcomes, ways of working, processes and reporting templates for system monitoring alongside the Ministry of Health and Te Puni Kōkiri
- Comprehensive monitoring frameworks will be co-designed with Manatū Hauora and key stakeholders
- Preparation of an annual performance report against Te Pae Tata (the New Zealand Health Plan) (with Health New Zealand)
Context: Health New Zealand
Implementation of performance management and reporting model is required to as part of its responsibilities as a Crown Entity. It will provide the basis of monitoring and assessment with Te Aka Whai Ora of outcomes specified in Te Pae Tata (the New Zealand Health Plan).
What will be achieved
Entity performance management and reporting systems implemented, including preparation of an annual performance report against Te Pae Tata (the New Zealand Health Plan) (with Te Aka Whai Ora).
- National commissioning operating model completed
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Responsible organisation: Health New Zealand and Te Aka Whai Ora
Context
The commissioning of providers to deliver health services to patients and whānau is fundamental part of the health system. The reformed system requires a number of changes to the approach to commissioning to enable more efficient and effective health service delivery.
What will be achieved
The commissioning operating model will be established in accordance with the Pae Ora Act and will include key processes and capabilities for market-building, planning services, funding systems, contracting, service design, management, delivery, monitoring and evaluation.
This will include any co-commissioning between Health New Zealand and Te Aka Whai Ora where they will work in partnership to plan how services will come together to deliver on New Zealanders’ expectations for the health system.
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- National provider networks established
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Responsible organisation: Health New Zealand
Context
The establishment of national provider networks is needed as part of resetting ways of commissioning health services and working with service providers.
What will be achieved
National provider networks will be established to meet the requirements for health services nationally, regionally and in communities in accordance with the commissioning operating model.
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