School Based Health Services Enhancements programme

Information and updates on the School Based Health Services (SBHS) enhancements programme.

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Background

In Budget 2019, the Government committed to extending and enhancing School Based Health Services (SBHS) as an action to ‘inspire active, healthy and creative children and young people’ in the Government’s Child and Youth Wellbeing Current Programme of Action.

The enhancement of SBHS was also a key initiative of Budget 2019’s ‘Taking Mental Health Seriously’ package of initiatives.  

The Ministry’s SBHS enhancements programme, is a five-year programme (2020-2024) to build assurance that the SBHS programme is effective and efficient in improving outcomes for young people and achieving equity.

The enhancements programme has a focus on populations currently not well served by the system, including:

  • rangatahi Māori
  • Pacific young people
  • rainbow young people
  • young people in care
  • young people with disability.

The enhancements programme is focussed on progressing the following enhancements to SBHS:

  • commissioning for equity and wellbeing (see below)
  • workforce development and support
  • improved linkages with other services and sectors
  • SBHS Year 9 health check model of care.

Commissioning for equity and wellbeing will include:

  • the aims and objective of the services
  • the quality and workforce expectations
  • the reporting and monitoring mechanisms
  • form the basis for quality improvement initiatives alongside an evaluation.

The commissioning work will:

  • reflect Te Tiriti o Waitangi (Te Tiriti) principles
  • ensure the needs and concerns of young people are central to the measures and indicators and are addressed by the services
  • link to the Child and Youth Wellbeing Strategy and other relevant government agency strategies. 

The implementation phase of the enhancements programme will begin in 2022.

Key themes: for the success of the mahi

1. Giving effect to Te Tiriti o Waitangi

Whakamaua: Māori Health Action Plan 2020-2025 guides the Ministry, the whole health and disability system, and government to give effect to He Korowai Oranga: Māori Health Strategy. Whakamaua is underpinned by the Ministry of Health’s Te Tiriti o Waitangi framework – which provides a tool for the health and disability system to fulfil its stewardship obligations and special relationship between Māori and the Crown. Te Tiriti o Waitangi not only describes Crown obligations and Māori rights, but is also a key improvement tool for achieving health equity and wellbeing for Māori. 

Tino rangatiratanga

The SBHS Enhancements Programme fully supports Māori and their whānau to exercise their right as Māori to be Māori and have mana motuhake over their health and wellbeing through the stewardship of Te Rōpū Mātanga o Rangatahi, our Māori youth advisory group (part of Te Tatau Kitenga, our youth advisory group). Te Rōpū Mātanga o Rangatahi and Māori youth advisory group members will have time independently to reflect on rangatiratanga as part of this programme.

Equity

The programme has a focus on meeting the needs of rangatahi Māori to enable equitable health outcomes. Ōritetanga is a key value of the enhanced program to reflect the importance of this in this work in the future.

The programme is an important tool for identifying gaps within current SBHS and addressing inequity. Rangatahi Māori are involved in our youth partner group, and their voice and views will be facilitated and focussed on during consultation. Key areas should be identified as part of the programme that can be measured over time as achieving equity between Māori and non-Māori

Active protection

The programme recognises the importance of protecting Māori health and is based on a kaupapa Māori approach to ensure the model of care delivers for Māori. Initial actions include putting in place a values framework and service model based in te ao Māori and mātauranga Māori, and resource allocation and service reach that prioritises Māori. Our service monitoring and evaluations will include analysis by ethnicity so we can identify and respond to impacts on Māori outcomes and equity.

The programme is committed to being clear and respectful on ownership of data, seeking of consents and permissions appropriately, and preparing and disseminating findings in open and mana enhancing ways. 

Options

By putting in place a values framework and service model based in te ao Māori and matāuranga Māori, and resource allocation and service reach that prioritises Māori, SBHS will be supported to deliver high quality and culturally safe services in both full immersion Te Reo Māori education settings, bilingual units and mainstream secondary school settings. Te Reo Māori is a key value of the enhancement programme and should reflect language preference options into the future.

Partnership

The programme recognises the importance of establishing meaningful working relationships that reflect partnership with Māori. We hold a partner relationship with the Māori youth health sector through Te Rōpū Mātanga o Rangatahi and ensure consultation and communication with Māori in each of our stakeholder groups. Meaningful partnerships will be sought with Māori Health Directorate, Māori Education, Te Rūnanga Nui o Ngā Kura Kaupapa Māori o Aotearoa and Ngā Kura ā Iwi o Aotearoa in the development of enhanced service delivery models.

2. Equity

In Aotearoa, people have differences in health that are not only avoidable, but unfair and unjust. Equity recognises different people with different levels of advantage require different approaches and resources to get equitable health outcomes. 

We have clearly identified priority population groups in the enhancements programme that are not currently well served by the system.

The work with Te Tatau Kitenga and Te Rōpū Mātanga o Rangatahi has been the main channel for ensuring an equity focus. The leadership of the Ministry through our equity definition, and specific strategies for various populations groups (eg, Ola Manuia: Pacific Health and Wellbeing Action Plan (2020–2025)) are very significant. This is supported by our district health board (DHB) partners who have a strong equity lens.

3. Building relationships with stakeholders.

The Ministry is committed to informing, consulting and collaborating with our stakeholders to achieve the purpose of the enhancements programme. Our approach is guided by Te Arawhiti engagement framework.

Our stakeholder groups include:

  1. young people
  2. whānau and community
  3. health service providers
  4. education service providers
  5. youth and social services
  6. youth health workforce
  7. district health boards
  8. Ministry of Education
  9. Ministry of Health
  10. other government agencies
  11. research.

The six collaboration partners

Through stakeholder analysis we identified six collaboration/partners to support the ongoing development, projects and implementation of the Programme. We put in a huge amount of time and effort in building relationships with these partners because we recognise relationships as foundational to success. Our programme partners are:

  • the Youth Advisory Group
  • Te Tatau Kitenga and Te Rōpū Mātanga o Rangatahi
  • DHB Working Group
  • Malatest International
  • Ministry of Education
  • Ministry of Health.

We will continue to develop and implement our planning and mahi through this partnership approach. Together, we are building an overall plan for the development and implementation of the enhancements within the five-year time frame (2020 – 2024). The collaborative relationship between partners will be maintained to ensure cohesion and consistency across the development and implementation of enhancements to SBHS.

To achieve better outcomes, it is important that youth, whānau, equity, strengths based and mana enhancing approaches are central to the mahi.

The partners

The School Based Health Services Youth Advisory Group

Young people are the primary stakeholders for the enhancements programme, especially those in population groups currently not well served by the system.

The views, experiences and perspectives of young people, whānau and the wider community are vital to helping us create a valued service that genuinely contributes to the lifelong wellbeing of young people.

To ensure we achieve the benefits of the enhancements programme for youth, we will need to deliberately seek and act on the voices of our priority young people across all levels of the decision making and implementation process.

More information on the School Based Health Services Youth Advisory Group.

Te Tatau Kitenga

Te Tatau Kitenga was established in February 2020. Te Tatau Kitenga was tasked with providing recommendations to the Ministry on what an extended and enhanced model of SBHS should look like for the young people of Aotearoa, and the steps needed for the appropriate implementation of the enhancements.

Te Rōpū Mātanga o Rangatahi: a partner group to Te Tatau Kitenga has developed te ao Māori and mātauranga Māori based vision and values for SBHS.

Follow the link for more information on Te Tatau Kitenga.

DHB planning and funding

We are working closely with DHB planning and funding functions and SBHS portfolio managers to access key operational advice and input on SBHS and youth health. 

Evaluation and quality improvement provider (Malatest international)

The objective of the evaluation is to ensure that the SBHS is contributing to improving health outcomes of young people and achieving equity. This includes setting the standard for equitable, effective and efficient SBHS, and driving quality improvement to further build the evidence base for investment in and implementation of SBHS.

For more information see School Based Health Services evaluation.

Ministry of Education

The Ministry of Education is the kaitiaki of the education system, which is the setting for SBHS delivery. The Learning Support Delivery Model and Action Plan 2019–2025 and the National Education and Learning Priorities provide an opportunity for greater cross sector collaboration.

Ministry of Health

The Ministry is responsible for leading the programme in collaboration with its partners.

Updates

We will update the SBHS enhancements programme webpage as new information becomes available. For more information or to ask questions about the SBHS enhancements programme, please email the SBHS inbox at [email protected].

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