Mā te iwi hei kawe
This theme is about:
- making New Zealanders ‘health smart’; that is, they can get and understand the information they need to manage their care
- enabling individuals to make choices about the care or support they receive
- understanding people’s needs and preferences and partnering with them to design services to meet these
- communicating well and supporting people’s navigation of the system, including through the use of accessible technology such as mobile phones and the internet.
Why is it important?
‘…we should have consumers involved at all levels of the health system … it would be a catalyst for driving change to make services be more responsive to consumers.’
–Health sector workshop attendee
The health system plays an important role in providing people with the information they need to fully understand issues to do with health and wellness, including how to be healthy, access health services and manage their own health care. ‘Health literacy’ is the term used to describe people’s ability to get and understand basic health information and services in order to make informed health decisions. To improve health literacy, service providers need to work in partnership with service users, supporting and encouraging them to be ‘health smart’.
In this partnership between providers and users, different groups of people will need different forms of support, depending on factors such as their age, ethnicity, expectations and beliefs, location and existing conditions or disability. Some people may have service preferences that need to be heard in order to find the best match between their needs and the right solution.
We can strengthen people’s role in the system not only through improving their health literacy, but also by better understanding how health fits into people’s lives and how it relates to their needs, interests and priorities. With this knowledge, we can partner with people to design care that better meets their needs and wants.
MidCentral DHB employs a Clinical Nurse Specialist focusing on intellectual/learning disabilities in an acute health care setting. The role is designed to meet the needs of people with intellectual and developmental disabilities in hospital and in the community so that they are well supported and have individual care plans. The nurse meets with people throughout their journey: during pre-admission, before surgery, at emergency departments, on the wards and at outpatient appointments. The nurse also supports staff to do things differently to meet each individual’s needs and to focus on seeing the person first and the disability second.
Such partnerships can involve tailoring services to better cater for particular population groups; for example, providing access to health services in community settings such as schools or churches rather than in a clinic. It can also involve providing the user with more integrated services, both within health and across social services (see the section on integration).
He Korowai Oranga, the Māori Health Strategy, uses the concept of mauri ora to reflect its focus on individual people. It says that people using health services need pathways to care that meet their immediate needs as well as their future needs, across all stages of their life. In addition, the New Zealand Public Health and Disability Act 2000 provides ways for Māori to contribute to decision-making on health and disability services and to participate in the delivery of those services. People-powered actions described later in this Strategy are consistent with these elements of He Korowai Oranga and legislation.
Although of course the people-powered theme is focused on people, it goes hand in hand with digital technologies. Using tools like telehealth systems and mobile health apps, health services can engage with people wherever they are located. Moving to a stronger customer-focused approach is important to the Government, and is part of its ‘better public services’ priority. This Strategy takes this approach, though it uses the term ‘people’, rather than ‘customer’.
The health system can learn many lessons from disability support services about how to provide more people-powered services. Some people choose to receive their disability support funding as a personal budget. This ‘Individualised Funding’ model gives people choice and control about how, from whom and when they get support. It means they can get the services that best suit their needs. Around 2330 New Zealanders now have an Individualised Funding allocation.
To enable people-powered health, we need to use data to better understand people and populations, know what works for people and why, and continuously adapt service and funding approaches. Across the health, disability and wider social sectors there are examples of new initiatives that are taking more people-centred approaches. These provide models for the approach that should become more widespread across the system.
Patient portals are secure online sites provided by GPs where people can access their health information and interact with their general practice. Using a patient portal, people can better manage their own health care. For example, through Medplus on the North Shore, people can request repeat prescriptions and book appointments online. As well as being convenient, portals are efficient for practices; they reduce administration time and allow practice teams to deal with more acute, critical care needs. More than 75,000 people enrolled at 181 general practices across the country can now use a patient portal.
The Prime Minister’s Youth Mental Health Project is a cross-agency programme, led by health, to improve mental health and wellbeing of 12- to 19-year-olds. The programme includes 26 initiatives in schools, health settings and communities, and online. One of these initiatives, SPARX, is an interactive fantasy-based computer program to help young people learn skills to deal with feeling down, depressed or stressed. It is an evidence-based tool developed by The University of Auckland that has won several international awards and was a finalist in the 2015 New Zealand Innovators Awards.
What great could look like in 2026
This is our vision for people-powered health by 2026.
- People are able to take greater control of their own health by making informed choices and accessing relevant information when they need it; for example, through electronic patient portals.
- Everyone who delivers and supports services in the health and disability system understands the needs and goals of the individual they are supporting as well as their family, whānau and community, and focuses on the person receiving care in everything that they do.
- People access practical, evidence-based health advice from a range of service providers that makes it easier for them to make healthy choices and stay well.
- Technology tools such as mobile devices, smartphones and wearable devices are options for everyone to use.
- New Zealand has a reputation for having innovative and effective health and disability services that are designed with the input of the people who use them.
- People receive high-quality, timely and appropriate services in the most convenient way, from the most appropriate service provider.
- The Ministry of Health is working seamlessly with other government agencies to address other factors that influence people’s health.