One team

Kotahi te tīma

This theme is about:

  • operating as a team in a high-trust system that works together with the person and their family and whānau at the centre of care
  • using our health and disability workforce in the most effective and most flexible way
  • developing leadership, talent and workforce skills throughout the system
  • strengthening the roles of people, families, whānau and communities as carers
  • the Ministry of Health leading the system effectively
  • collaborating with researchers.

Why is it important?

‘… a key component of this theme is true integration of services across the health sector and also starting to improve integration with other agencies to support improved health and wellbeing outcomes.’
–Māori health provider

We will need to take a more cohesive team approach across our health and disability system to reach the goal of a high-performing system. We need to work towards shared goals and be able to work beyond organisational boundaries, proactively helping people and populations in need.

We need to reduce the fragmentation of services and care in our health system, and foster greater trust and collaboration. Getting rid of fragmentation will provide us with opportunities to improve the quality of services, improve timeliness of access and reduce duplication of resources.

It is important that we have a workforce whose size and skills match New Zealand’s current and future needs. This will mean developing new or stronger skills for some, especially those working in teams containing a range of health specialties to support integrated care that is closer to home. There is also a need to reduce the barriers that currently prevent people from using their skills flexibly and fully.

Another part of creating one team is strengthening the capability of NGO providers. This involves not only developing the capability of their people but also increasing their access to technology infrastructure to allow them to work to their full potential. Pacific health provider collectives, established across New Zealand since 2013, are one example of the way collaboration and capability building can progress among NGOs.

Whanganui DHB is using a team approach, working with whānau and community providers, to improve Māori health. A Haumoana (navigator) service helps whānau find their way through DHB services. It has an open-door approach, catering for any family, whatever the need. The service includes provision of a whare for families who experience the sudden death of a whānau member. The service is delivered by non-clinical Māori staff working alongside clinicians and health professionals. It is available 24 hours a day, 7 days a week.

‘This will require a new style of leadership: keeping people safe from harm whilst enabling a system that can innovate and deliver a new model of health and social services to New Zealanders.’
–Industry partner

Beyond the formal workforce, it will be important to support families, whānau and individuals in communities in their roles as carers of people close to them. This support could involve providing health literacy education, as well as information and training specially tailored for volunteers. It could also involve giving people the opportunity to contribute to the design of our health system.

We will need great leaders and managers to enable change. These leaders will make the most of the diverse skills in our system, use resources in the most effective way possible and continuously improve our management processes. Building on the leadership expertise already in the system, we want to foster a culture of adaptive and flexible leadership at all levels, including managers, clinicians and carers from across the health workforce. It is also important that we foster the next generation of leaders.

Healthy Auckland Together is a coalition working to make it easier for Aucklanders to eat better, exercise more and maintain a healthy weight. The focus is on five areas:

  1. streets, parks and places
  2. food environments and marketing
  3. schools and early childhood education services
  4. workplaces
  5. and community settings.

The 21 agencies involved include health entities, local government, iwi-based organisations and NGOs. Together, they have developed a regional action plan with 65 actions for working towards their goals.

The Ministry of Health has the role of stewardship and overall system leadership. This means it works with DHBs and other Crown entities, such as ACC and the Health Quality and Safety Commission (HQSC), to support their own leadership roles. It also looks at the links between different parts of the system, and strengthens these where needed to support a high-functioning system. Achieving the future envisaged in this Strategy will require strong system leadership. Steps to support the Ministry’s capability for this are among the early actions for putting the Strategy into practice.

The Health Research Council (HRC) in 2013/14 supported $42 million of research in collaboration with clinicians and other users. This research includes developing new technologies, carrying out evaluations and cost-benefit analyses, and designing effective interventions. This applied research is supported by the HRC’s broader investments in basic research that supports breakthroughs in knowledge.

A one-team approach also involves links with scientists and researchers, including those working in the health system as clinicians, and those in the wider tertiary education sector or in industry. Their expertise can help us identify opportunities for improvement, measure the impacts of our interventions and introduce new ideas into the system.

In addition, a one-team approach acknowledges the significant contribution Māori make to the health and disability system – as individuals partnering in their own care, as a key part of the health workforce and by contributing to DHB decision-making and service delivery.

This Strategy places particular emphasis on integration, which is critically dependent on a team approach. Examples of integration in the health system include:

  • integration of care for a disease condition or a population group to improve a person’s journey through the system; for example, a diabetes pathway
  • integration of health services to combine different services under one roof; for example, providing Well Child / Tamariki Ora checks in the same place as other primary care services
  • coordination with initiatives in other sectors; for example, the Healthy Homes Initiatives, Healthy Auckland Together, Healthy Christchurch and Healthy Families New Zealand
  • vertical integration and service planning that make the right services available in the right coverage areas; for example, access to specialists from remote locations, or sharing equipment across hospitals.

What great could look like in 2026

This is our vision for the one-team approach in 2026.

  • The health system is more than the sum of its parts, with each part clear on its role and working to achieve the aims of the system as a whole.
  • New Zealanders experience joined-up care that clearly shows different organisations and professionals working as one team.
  • The system has competent leaders who  have an unwavering focus on the system’s goals, and a culture of listening carefully and working together in the interests of people’s ongoing wellbeing.
  • New Zealand offers coherent pathways for developing leadership and talent that inspire and motivate people already working in the health system, and those considering health work as a career.
  • We invest in the capability and capacity of our workforce, including in NGOs and the volunteer sector, and make sure that investment fosters leadership, flexibility and sustainability.
  • The Ministry of Health is an excellent steward and system leader, playing its role effectively as part of the wider health and disability system, and partnering with other sectors.
  • New Zealand and international research, best practice and local innovations are shared freely and used to make improvements nationally.
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