equity of access (available, high-quality, and acceptable services) and outcomes for Māori
Māori-centred services
fostering Māori community integration
recognising the value of Māori health models and traditional healing
proactively identifying and removing barriers to participating in New Zealand society, including te ao Māori, for Māori with disabilities and their whānau
increasing Māori participation in decision making
increasing Māori capacity and capability and the size of the Māori health workforce – actively recruiting and retaining a Māori health and disability workforce
providing effective health and disability services for Māori where services are operating in ways that are culturally safe.
Annual plans show evidence of a selection of health equity and Māori health indicators.
Service delivery
Evidence shows that, at executive meetings that review health equity and Māori health indicators, discussion includes:
checking progress on health equity and Māori health key performance indicators
presenting dashboard data, including health equity and Māori health indicators.
Evidence shows service providers seek comprehensive feedback from Māori receiving services and their whānau (through interviews, patient feedback forms, or similar).
Evidence shows the workforce reviews their practice at defined intervals through a health equity and quality lens.
Evidence shows service providers work in partnership with iwi and Māori organisations within and beyond the health sector to improve service integration, planning, and support for Māori.
Self-review
Evidence shows self-review occurs at defined intervals, applying the sector guidance above to a culture of planning, review, and modification concerning Māori health and equity.
Robust performance improvement, monitoring, and accountability mechanisms demonstrate that organisations are on track to achieve equity of health outcomes for Māori.
Section 1.2: Ola manuia of Pacific peoples in Aotearoa
Criterion 1.2.1
Guidance for all providers
Service providers are centred on Pacific lived-experience, are whānau-centred and reflect Pacific worldviews and values.
Service providers have a cultural safety policy that is embraced, embedded, and enacted in the service provision and reviewed annually.
Service providers evidence their ability to engage with people in a culturally appropriate way; for example, understanding that the Pacific worldview is underpinned by connectedness of a person to whānau, communities, land, atua, and ancestors.
Service providers appoint or contract Pacific cultural advisors to provide cultural training and supervision. Smaller service providers show evidence of linking to or collaborating with relevant Pacific organisations who can provide this.
Information and resources about the services provided are relevant to the different nations of Pacific peoples and are readily available or displayed in appropriate forms and languages. These may include:
the Code of Health and Disability Services Consumers’ Rights
complaints information
the service that is being provided
public health information.
Criterion 1.2.2
Guidance for all providers
Service delivery reflects and is responsive to the health and disability needs of Pacific peoples in order to achieve health equity for Pacific peoples.
Service providers are centred on Pacific lived-experience, are whānau-centred and reflect Pacific worldviews and values.
Service providers demonstrate that they align with Ola Manuia: Pacific Health and Wellbeing Action Plan 2020–2025 and other Pacific health and wellbeing plans. This may include references to additional Pacific-related information, health planning, or research findings from:
the Ministry of Health (policy guidance)
Pacific non-governmental organisations
health and disability researchers, including Pacific health and disability researchers
Health Research Council
district health boards.
Criterion 1.2.3
Guidance for all providers
Service providers develop a Pacific plan that includes references to strategies relevant to Pacific peoples such as:
achieving equity of access (available, high-quality, and acceptable services) and outcomes for Pacific peoples
providing Pacific-centred services
reflecting the health and disability needs of Pacific peoples
fostering Pacific community integration and collaboration
recognising the value of Pacific health models, which acknowledge the fundamental importance of the relationships between Pacific peoples, their families, community, land, atua, ancestors, and traditional healing
removing barriers to Pacific peoples with disabilities and their whānau participating in Aotearoa society and Pacific communities
increasing the participation of Pacific peoples in decision making so that Pacific voices are meaningfully incorporated into service delivery
increasing Pacific capacity and capability through actively recruiting and retaining Pacific health care and support workers and, because service providers recognise the cultural roles Pacific health care and support workers will play, providing adequate time, additional to their normal hours, for them to fulfil these roles
improving their quality of service for Pacific peoples entering their service
providing effective health and disability services for Pacific peoples by operating in ways that are culturally safe
providing health promotion information and education that is culturally appropriate, is tailored to the Pacific population, and uses effective media, such as Pacific media channels. For example, the service provider may focus on reducing the leading causes of morbidity and mortality in Pacific populations.
Service providers embed and enact relevant national and regional Pacific health plans within their own strategic health plans with the main aim of improving the health outcomes of Pacific peoples.
Service providers work collaboratively with Pacific organisations, across sectors, to improve service integration, planning, and support for Pacific peoples.
Service providers put people using the services, whānau, and communities at the heart of their services.
Criterion 1.2.4
Guidance for all providers
Service providers:
work collaboratively with Pacific communities and spiritual leaders, with the aim of supporting Pacific peoples to take ownership of their own health
embed and enact Ola Manuia in their strategic plans
provide high-quality professional development for Pacific health care and support workers to enhance their health and wellbeing
actively recruit, appoint, and retain Pacific peoples in leadership roles
acknowledge the value of language and cultural expertise in their workforce
recruit and retain a Pacific workforce that reflects the population they serve
support their Pacific workforce through targeted education and training, which may include Pacific-related content or context.
Criterion 1.2.5
Guidance for all providers
Service providers:
work collaboratively with Pacific communities and cultural and spiritual leaders, with the aim of supporting people to take ownership of their own health
collaborate with Pacific communities, including cultural and spiritual leaders, to develop evidence-based and effective interventions that improve wellbeing outcomes for Pacific peoples
distribute well-conducted Pacific research and writings on the health of Pacific peoples from reputable sources
support, and may partner or affiliate with, Pacific health researchers or relevant research institutions that develop robust, well-designed, culturally tailored research to improve health outcomes for Pacific peoples
purposefully involve Pacific communities and cultural and spiritual leaders in the development of robust and culturally tailored interventions that may lead to improved health outcomes for Pacific peoples
link with other organisations, across the health and disability sector, to improve health outcomes for Pacific peoples
monitor Pacific health and disability outcome data, integrate key lessons and identified areas for improvement into practice and service delivery, and highlight and disseminate improvements through health promotion and positive media to Pacific peoples
evaluate service provision at defined intervals to measure the quality and effectiveness of the service for Pacific peoples
maintain ethnicity data on Pacific peoples to inform targeted interventions and solutions.
Section 1.3: My rights during service delivery
Criterion 1.3.1
Guidance for all providers
In addition to Te Tiriti o Waitangi and tikanga, health care and support workers’ induction and education on the legal framework for rights relevant to the service being provided may cover:
United Nations conventions
human rights instruments, including under the New Zealand Bill of Rights Act 1990
Privacy Act 2020
the Code of Health and Disability Services Consumers’ Rights
Care of Children Act 2004
Substance Addiction (Compulsory Assessment and Treatment) Act 2017
Contraception, Sterilisation, and Abortion Act 1977
Protection of Personal and Property Rights Act 1988
Intellectual Disability (Compulsory Care and Rehabilitation) Act 2003
Mental Health (Compulsory Assessment and Treatment) Act 1992.
Service providers demonstrate an understanding of the rights frameworks listed above and how each of these frameworks applies to their service.
Adequate information on people’s rights is available to people receiving services and their whānau in an accessible format for the people receiving services. Service providers include opportunities for explanations, discussion, and clarification at defined intervals throughout the time of a person’s contact with the service.
Service providers demonstrate an understanding of how the Protection of Personal and Property Rights Act 1988 affects the rights of a person who has a legally appointed representative under the Act.
In addition to the rights frameworks listed in the first point, service providers include in health care and support workers’ education and application to practice:
strategies to counter racism, discrimination, and stigma in all its forms, including unconscious or implicit bias
communication, including concepts such as empathy
privacy and person-centred service provision
clinical approach.
Service providers incorporate the iwi and hapū affiliations of people receiving services into service provision.
Service providers demonstrate they meet cultural rights giving consideration to the percentage of Māori employees, people’s right to speak their own language, tikanga, and connections to iwi, hapū, and whānau.
Service providers demonstrate an understanding of the United Nations conventions related to people with a disability, and the rights of people to live where and with whom they choose.
Criteria 1.3.2
Guidance for all providers
Service providers’ services are sufficiently flexible to meet each person’s needs.
Service providers are aware of and actively embed the principles of Enabling Good Lives and the New Zealand Disability Strategy.
Additional guidance
Aged care
People receiving services have the right to determine where they live and who they live with where possible. Service providers have a mechanism in place to support this right.
Home and community
People receiving services have the right to determine where they live and who they live with where possible. Service providers have a mechanism in place to support this right.
Residential disability
People receiving services have the right to determine where they live and who they live with where possible. Service providers have a mechanism in place to support this right.
Residential mental health and alcohol and other drug
People receiving services have the right to determine where they live and who they live with where possible. Service providers have a mechanism in place to support this right.
Hospice
People receiving services have the right to determine where they live and who they live with where possible. Service providers have a mechanism in place to support this right.
Criterion 1.3.3
Guidance for all providers
Information about the Nationwide Health and Disability Advocacy Service and other advocacy services is available to people receiving services (and, where appropriate, their whānau) in accessible formats. People receive this information when they enter the service and during service delivery.
Service providers have:
mechanisms in place to verify they are meeting people’s rights
implemented a proactive process to verify that whānau understand the rights of people receiving services
implemented a process that allows time for discussion with people receiving services and their whānau. They offer follow-up conversations.
Where people are receiving services under legislation, service providers offer them follow-up conversations about their rights under the Mental Health (Compulsory Assessment and Treatment) Act 1992, Substance Addiction (Compulsory Assessment and Treatment) Act 2017, Intellectual Disability (Compulsory Care and Rehabilitation) Act 2003, and the Code of Health and Disability Services Consumers’ Rights.
Information is provided in a manner directed by the person receiving services (or their legal representative where appropriate) and can be reviewed at any point during service contact.
Service providers access available resources to support discussion, such as the Health and Disability Commissioner’s ‘You have rights’.
Information about the Code of Health and Disability Services Consumers’ Rights in a residential home is not intrusive. While it should be available and accessible, it should not make a person’s home feel like a facility.
Health care or support workers advise people of their right to seek counselling and facilitate their referral to a suitably trained and credentialled professional whose counselling practice meets these standards.
This may include facilitating referral to a culturally appropriate person such as a kaumātua, kuia, or cultural expert.
Criterion 1.3.4
Guidance for all providers
The service provider:
informs people receiving services of their right to have a support person of their choice
equips health care and support workers with knowledge about advocacy services and support situations through initial and ongoing education as needed
provides access to appropriately skilled advocates and makes information on this available and visible
provides access to cultural advocates
provides access to interpretation and translation services.
Advocacy support, including the national advocacy service, is accessed through a developed relationship and actively promoted.
Independent advocates are available. These may include faith-based or spiritual support workers, cultural experts, chaplains, kaitūhono (connectors for people using disability services), and support workers for rainbow communities.
Service providers may use an internal advisory group (or similar) of people who have lived experience of the relevant services to systematically advocate for people receiving services.
Service providers have established relationships with Māori experts, including:
chaplains
kuia and kaumātua
tohunga.
Service providers offer and provide access to Māori experts for support.
Criterion 1.3.5
Guidance for all providers
Service providers display the Code of Health and Disability Services Consumers’ Rights so that it is visible and is also available in accessible formats in te reo Māori, New Zealand Sign Language, and English, so that Māori understand their rights.
Service providers have processes that support building resilience and that encourage and support whānau self-management and self-advocacy.
Service providers identify and remove processes that prevent whānau-centred service provision and whānau ora.
Service providers demonstrate an understanding of Māori indigenous rights and current issues in relation to Māori health and health equity. See Medical Council of New Zealand (2019) He Ara Hauora Māori: A pathway to Māori health equity (PDF, 70 KB), the United Nations Declaration on the Rights of Indigenous Peoples, and the United Nations Convention on the Rights of Persons with Disabilities.
Service providers respond to tāngata whaikaha needs as well as enable their participation in te ao Māori as a right.
Section 1.4: I am treated with respect
Criterion 1.4.1
Guidance for all providers
Service providers allow for the involvement of whānau, advocates, and other representatives when people receiving services request or agree to it.
Service providers use a person-centred approach during discussions.
Service providers support people to choose what they want to do, and can demonstrate that they do this.
Service providers acknowledge that people’s whānau may be unavailable where court orders or bail conditions are involved.
Service providers provide for people to:
make informed decisions about the service they are receiving
exercise their right to manage acceptable levels of risk for themselves.
People are supported to make decisions about whether they would like whānau members to be involved in their care or other forms of support.
Service providers may use an internal advisory group (or similar) of people who have lived experience of the relevant services to systemically advocate for people receiving services.
Criterion 1.4.2
Guidance for all providers
Health care and support workers understand what Te Tiriti o Waitangi means to their practice.
Assessment and service provision may consider gender, marital status, religious belief, colour, race, ethical belief, ethnic origins, disability, age, political affiliation, employment status, family status, sexual orientation, gender identity, gender expression, and/or variations of sex characteristics.
Service providers build rainbow awareness and understanding through providing training for health care and support workers and education of people using the service, available resources, assessment tools, and data collection.
Service providers implement policies to guide health care and support workers in how to act on advance directives and maximise people’s independence.
Service providers have and promote a philosophy of genuine inclusiveness (for example, in terms of rainbow awareness and cultural awareness) and show evidence of applying it in practice.
People receiving services choose whether they would like whānau to be involved.
People receiving services are encouraged and supported to do what is important to them and agreed to by them.
People receiving services have control over activities they participate in.
People’s identities and the things that are important to them shape the care and support they receive.
Service providers understand and respect the mana in the community of the person receiving services.
Service providers demonstrate and implement a rights-based model of service provision.
Rainbow awareness training provided to health care and support workers specifically includes the unique needs of transgender and gender diverse people.
Cultural assessments are evident.
In developing a person's care or support plan, the person receives support to connect cultural identity to their care or support goals.
Service providers demonstrate delivery of training that is responsive to the diverse needs of people accessing services.
Service providers:
seek out agreeable matches between people receiving services and support workers
verify people are not discriminated against based on their identity
inform people that they have the right to change clinician.
Criterion 1.4.3
Guidance for all providers
Service providers demonstrate an understanding of the United Nations conventions and principles that are relevant to health and disability service providers.
Orientation and ongoing education for health care and support workers cover the concepts of personal privacy and dignity.
Providing visual, auditory, and physical privacy may include:
moving to a more suitable area to conduct an examination or consultation
providing dedicated areas for people to keep their personal property and possessions
allowing people to wear their own clothing (with the exceptions of clinical requirements such as for those within operating theatres)
ensuring people have visual and auditory privacy when attending to personal hygiene requirements
enabling people to meet with whānau and friends where appropriate, in a private space or room other than their bedroom
health care and support workers closing doors and curtains as appropriate.
People receiving services are addressed by their chosen name and correct pronouns, and their name is pronounced correctly.
Services are always delivered in the least intrusive manner.
Service providers allow whānau, advocates, and other representatives to be included when people receiving services request or agree to it.
Communication with people receiving services is respectful in language, tone, and messaging, without sarcasm, negative comments, or yelling.
People are informed that service providers are unable to assure confidentiality in situations where there is a risk of homicide, suicide, abuse, neglect, or maltreatment.
Service providers support people receiving services to follow cultural practice, including tikanga.
Service providers demonstrate cultural responsiveness to the needs of Māori.
Service providers seek cultural advice and support from other providers, if required.
Versatile, flexible spaces that follow principles of open design are available, allowing a ‘marae-style’ environment.
Clinicians offer to examine each person receiving the service in private when more than one person attends the same appointment.
People’s bodies are covered during clinical procedures to maintain their dignity.
Additional guidance
Aged care
Service providers respect people’s right to have space to engage in intimate and sexual relationships.
Service providers use person-centred and respectful language.
Service providers give people receiving services adequate time to use hygiene facilities such as showers and bathrooms, with respect for their dignity, privacy, confidentiality, and preferred level of interdependence.
Health care and support workers operate in a manner that minimises interruptions to the sleep of the people receiving services.
Fertility services
Specimen collection rooms allow visual, auditory, and physical privacy.
Home and community
Service providers respect people’s right to have space to engage in intimate and sexual relationships.
Service providers use person-centred and respectful language.
Service providers give people receiving services adequate time to use hygiene facilities such as showers and bathrooms, with respect for their dignity, privacy, confidentiality, and preferred level of interdependence.
Health care and support workers operate in a manner that minimises interruptions to the sleep of the people receiving services.
Service providers give people receiving services adequate time to use hygiene facilities such as showers and bathrooms, with respect for their dignity, privacy, confidentiality, and preferred level of interdependence.
Health care and support workers operate in a manner that minimises interruptions to the sleep of the people receiving services.
Residential disability
Service providers respect people’s right to have space to engage in intimate and sexual relationships.
Service providers use person-centred and respectful language.
Health care and support workers communicate with people with respect, and without sarcastic or mean comments about people living in the service.
People have full access to all facilities in their own home. This should include:
a key to the home
access to Wi-Fi
access to the kitchen (including the fridge).
Support workers and other people living with people receiving services respect their personal items.
Support workers and others living with people receiving services respect their personal space when they are frustrated, processing emotions, or seeking quiet time.
People have the freedom to be spontaneous.
If room searches occur, the person should always be present.
Service providers give people receiving services adequate time to use hygiene facilities such as showers and bathrooms, with respect for their dignity, privacy, confidentiality, and preferred level of interdependence.
Health care and support workers operate in a manner that minimises interruptions to the sleep of the people receiving services.
Residential mental health and alcohol and other drug
Service providers respect people’s right to have space to engage in intimate and sexual relationships.
Service providers use person-centred and respectful language.
Service providers give people receiving services adequate time to use hygiene facilities such as showers and bathrooms, with respect for their dignity, privacy, confidentiality, and preferred level of interdependence.
Health care and support workers operate in a manner that minimises interruptions to the sleep of the people receiving services.
Public/private hospital
Service providers give people receiving services adequate time to use hygiene facilities such as showers and bathrooms, with respect for their dignity, privacy, confidentiality, and preferred level of interdependence.
Health care and support workers operate in a manner that minimises interruptions to the sleep of the people receiving services.
Birthing units
Service providers give people receiving services adequate time to use hygiene facilities such as showers and bathrooms, with respect for their dignity, privacy, confidentiality, and preferred level of interdependence.
Health care and support workers operate in a manner that minimises interruptions to the sleep of the people receiving services.
Service providers give people receiving services adequate time to use hygiene facilities such as showers and bathrooms, with respect for their dignity, privacy, confidentiality, and preferred level of interdependence.
Health care and support workers operate in a manner that minimises interruptions to the sleep of the people receiving services.
Criterion 1.4.4
Guidance for all providers
Health care and support workers model respect for and appreciate te reo Māori and tikanga Māori and demonstrate the relevance and importance of both.
Organisations’ strategies include provision for:
te reo Māori classes
correct pronunciation of Māori names
bilingual signage
access to applications and online modules for learning te reo Māori and tikanga.
Health care and support workers are provided with time to complete training and access to suitable platforms for it.
Criterion 1.4.5
Guidance for all providers
All health care and support workers complete Te Tiriti o Waitangi training.
Te Tiriti o Waitangi training is reflected in day-to-day service delivery.
Criterion 1.4.6
Guidance for all providers
Service providers demonstrate an awareness of tāngata whaikaha needs and enable them to access te ao Māori.
Section 1.5: I am protected from abuse
Criterion 1.5.1
Guidance for all providers
Service providers are aware that abuse is not always obvious, and subtle forms of abuse occur. They adopt a broader definition of abuse in all operating documents and implement it into practice.
Service providers implement:
a zero-tolerance abuse policy
policies and procedures that have regard for the range of abuse that may occur, and include a mechanism to manage allegations and events
comprehensive training for health care and support workers so they have the capability to intervene
models of care that support the policy and procedures of the provider.
Service providers:
undertake assessment to determine if people using the service are at risk
demonstrate strategies taken to mitigate risks that they have identified through assessment
have a referral process to access external resources if they are required, and people receiving services know about this process.
Service providers notify whānau when appropriate. They document how these assessments and strategies are communicated to whānau and document in the clinical record when such communication is not appropriate.
Service providers consider establishing a committee to address discrimination and stigma issues.
Service providers demonstrate strategies taken to mitigate risks of abuse that they have identified through assessment.
Service providers demonstrate an understanding of best practice guidelines for abuse prevention.
Additional guidance
Aged care
Service providers demonstrate an understanding of the Ministry of Health’s (2016) Healthy Ageing Strategy.
Home and community
Service providers demonstrate an understanding of the Ministry of Health’s (2016) Healthy Ageing Strategy.
Residential disability
Service providers demonstrate an understanding of the Ministry of Health’s (2016) Healthy Ageing Strategy.
Criteria 1.5.2
Guidance for all providers
Employment practices include criminal record-checking, particularly in regard to vulnerable children. This includes health care and support workers, contractors, access holders, and volunteers. Health care and support workers follow a code of conduct.
Policies and procedures outline safeguards to protect people from discrimination, coercion, harassment, and exploitation, along with the actions that will be taken if inappropriate or unlawful conduct occurs and the safety of a person is compromised or put at risk. This relates to discrimination that is unlawful under Part 2 of the Human Rights Act 1993. As applicable, these policies can include:
responsiveness to complaints of any form of impropriety
management of finances and personal accounts of people receiving services
safety and identification of a person’s property.
Service providers have documented processes to facilitate effective referral pathways to support services, such as services for psychological and physical trauma. They notify whānau when appropriate.
Service providers understand their legal obligations and best practice; these may relate to the:
Crimes Act 1961
Children’s Act 2014
Code of Health and Disability Services Consumers’ Rights
national guidelines.
Service providers:
provide an opportunity for a person receiving services to have a consultation on their own
undertake family violence routine enquiry and provide referral to appropriate community resources
develop strategies to reduce stigma, including by training health care and support workers to be non-judgemental, using rights-based messages and materials, and creating a caring and welcoming environment.
Service providers’ escalation processes enable people receiving services to contact the relevant health care and support worker to respond to a report of abuse.
Service providers take a proactive approach to support people receiving services when a health care or support worker and whānau report suspected abuse or neglect.
Service providers uphold mandatory requirements and initiate involving other agencies when abuse or neglect is suspected. People receiving services give informed consent or are provided access to supported decision-making when accessing other agencies.
Service providers inform people receiving services that, if abuse occurs, they have safe places to go and people other than their health care and support workers to talk to. These information could include:
access to mātua
information about external agencies.
Residential mental health and alcohol and other drug
Service providers implement policies and procedures for handling a person’s property.
Service providers implement policies and procedures for handling taonga, which include:
providing an explanation to the person and their whānau before touching or removing taonga
seeking permission from the person and their whānau before touching or removing taonga.
Additional guidance
Aged care
Service providers implement a process to manage residents’ comfort funds, such as sundry expenses. The person receiving services, the person given enduring power of attorney or their representative, as appropriate, manages all other financial matters.
Home and community
Service providers implement policy and procedures that clearly identify processes for:
ensuring health care and support workers only undertake financial affairs or money handling with the knowledge of the service provider, as documented and agreed in the relevant individual care or support plan with the person and whānau, and under the Mental Health (Compulsory Assessment and Treatment) Act 1992 or in accordance with the Protection of Personal and Property Rights Act 1988
specifying record-keeping requirements and the collection of receipts for any activities that a support worker may have undertaken in order to provide an auditable record
receiving gifts.
People’s care or support plans clearly state agreement on money and mail handling.
Residential disability
Supported decision-making processes are always followed in relation to people’s funds. The person receiving services, the person given enduring power of attorney or their representative, as appropriate, manages all other financial matters.
People are supported to self-determine and take risks. Agreements are in place to manage associated risks.
People are involved in all decisions made with their money.
Service providers’ operating policies determine what action to take if the spending of a person with enduring power of attorney is extraordinary.
Service providers are aware of and access courses offered by organisations that represent the views of people who use the service.
People and their support workers have delegated authority in respect of accessing discretionary funds.
Residential mental health and alcohol and other drug
Supported decision-making processes are always followed in relation to people’s funds. The person receiving services, the person given enduring power of attorney or their representative, as appropriate, manages all other financial matters.
Service providers have systems that identify, list, and cater for adequate and safe storage of people’s property.
Public/private hospital
People receiving services and their whānau are encouraged to take money and property off site.
Service providers have an implemented policy and associated procedures related to property and money that:
are person-centred
provide people with secure facilities where they can keep their property and money on arrival
include a mechanism of open communication or disclosure that operates if incidents occur with property or money
include a mechanism of internal audit and corrective action planning.
Birthing units
People’s property is respected, and nothing is ever taken away from them.
Hospice
Service providers have a policy that reflects that hospices do not manage property or money.
Criterion 1.5.4
Guidance for all providers
Training is provided for health care and support workers, so they fully understand the range of behaviour that constitutes discrimination.
As applicable, policies related to professional boundaries include:
conflict of interest (for example, policies and procedures addressing accepting of gifts and personal transactions with a person receiving services)
the appropriate code for the provider. This may include the Code of Ethics and Code of Practice.
Additional guidance
Aged care
Service providers offer people the opportunity for a support person where applicable.
Fertility services
Service providers offer people the opportunity for a support person where applicable.
Residential disability
Service providers offer people the opportunity for a support person where applicable.
Service provider training covers what best practice looks like.
Employment practices include criminal record-checking for people who are supporting vulnerable people.
Residential mental health and alcohol and other drug
Service providers offer people the opportunity for a support person where applicable.
Public/private hospital
Service providers offer people the opportunity for a support person where applicable.
Birthing units
Service providers offer people the opportunity for a support person where applicable.
Hospice
Service providers offer people the opportunity for a support person where applicable.
Abortion services
Service providers offer people the opportunity for a support person where applicable.
Service provider training covers what best practice looks like.
Employment practices include criminal record-checking for people who are supporting vulnerable people.
Criterion 1.5.5
Guidance for all providers
Service providers have in place policies, practices, and programmes that are focused on abolishing institutional racism.
Service providers encourage health care and support workers to keep up to date with the latest literature on institutional racism and use it to inform the way they design and deliver services.
Service providers identify racism, demonstrate their willingness to address racism, and evidence how they are doing something about it.
Criterion 1.5.6
Guidance for all providers
Service providers set the expectation for responsive health care within health teams.
Service providers deliver equitable care and support services.
Health care and support workers receive training to look at their own practice and professional commitment and responsibility in ensuring equitable health outcomes for Māori.
Service providers use strengths-based language when discussing the care or health of people using their service.
Service providers look for opportunities to support Māori to engage with services and receive the care and support they need.
Service providers actively reduce and eliminate deficit-based language and practice. For example, they use alternatives to ‘Did not attend’.
Section 1.6: Effective communication occurs
Criterion 1.6.1
Guidance for all providers
Service providers give people receiving services understandable, clear, and concise written and verbal information about a service, treatment, or therapy. The information may include potential benefits, risks, alternatives, costs, and predictable inconvenience, as applicable.
Communication may include:
using interpreters and advocates
providing information in a variety of languages and accessible formats
a system of checking that information is understood
providing information suggesting other available methods of treatment and therapy
communicating with the whānau, person with enduring power of attorney, or nominated representative of the person receiving services, where applicable, so they are well informed
using language appropriate for the person and whānau
if providing services to non-verbal people, augmented communication.
The person receiving services and whānau determine the format in which information is provided. This could include different technologies, such as text messaging.
Communication between the service provider and the person and their whānau is sustainable, especially during transitions of care such as post discharge. To support this, service providers consider the health literacy of the people involved.
Service providers seek feedback from people using services to determine if they received information in a timely manner and in a preferred format.
A corrective action plan is implemented based on feedback received and outcomes are reported back to the community.
Service providers understand their responsibility to be health literate in such a way as to meet the needs of people at all levels. See the Ministry of Health’s webpage ‘Health literacy reviews’.
Additional guidance
Home and community
When support workers are not attending, service providers give people timely notification, where possible. Service providers involve people in determining what alternative measures will be taken to meet their needs, wherever possible.
Service providers have an implemented prioritisation process to cover the unplanned absence of support workers, and people receiving services know about this process. A mechanism is in place to monitor the effectiveness of this process.
Criterion 1.6.2
Guidance for all providers
Service providers may achieve effective communication with other agencies through:
involving a multidisciplinary team
service coordination
minimising duplication and service fragmentation.
Before communicating with other providers or agencies, service providers document consent from the person, if possible. There may be instances where the person does not wish communication to occur with certain health professionals. Supported decision-making is available.
People’s consent is evident when service providers communicate with other agencies, and give consideration to health sharing information under section 22F of the Health Act 1956.
Additional guidance
Residential disability
Every person is given the option of having a health passport.
Public/private hospital
There is appropriate cultural assessment and support, and service providers consider a framework such as Pae Ora to guide practice.
Service providers adopt a person-centred approach in which:
the voice of the person receiving services is heard
communication is with the person and whānau
communication is understood
people are empowered to self-determine.
Service providers consider a multi-agency approach to meet people’s holistic needs.
Birthing units
There is appropriate cultural assessment and support, and service providers consider a framework such as Pae Ora to guide practice. Service providers adopt a person-centred approach in which:
the voice of the person receiving services is heard
communication is with the person and whānau
communication is understood
people are empowered to self-determine.
Service providers consider a multi-agency approach to meet people’s holistic needs.
Hospice
There is appropriate cultural assessment and support, and service providers consider a framework such as Pae Ora to guide practice. Service providers adopt a person-centred approach in which:
the voice of the person receiving services is heard
communication is with the person and whānau
communication is understood
people are empowered to self-determine.
Service providers consider a multi-agency approach to meet people’s holistic needs.
Service providers show in their service delivery that they:
engage in open communication with people that aligns with national guidelines
have a process to verify people are informed of their rights to information and open disclosure.
Service providers understand the Accessibility Charter.
Service providers inform people of all things in relation to their care.
Criterion 1.6.4
Guidance for all providers
Service providers have implemented processes to provide people receiving services with time for discussion, time to consider decisions, and opportunity for further discussion, if required.
Service providers encourage people to have support people or whānau attend discussions.
Language among health care and support workers and between them and people receiving services is respectful.
Service providers adopt a collaborative approach at people’s homes to clarify expectations. This can cover a wide range of topics, such as which cloth to use for floors, showers, and hand basins.
Residential disability
People receiving services are involved in all meetings about their care.
Criterion 1.6.5
Guidance for all providers
Service providers provide access to appropriate interpreter services, including:
independent interpreters
New Zealand Sign Language interpreters
technology where appropriate for the service.
Service providers provide ready access to interpreters for fluent speakers of te reo Māori. Service providers do not expect Māori receiving services and their whānau to revert to te reo Pākehā (the English language) in face-to-face and/or telephone engagement with their services.
People who are fluent speakers of a Pacific language have access to interpreters for the Pacific language of their choice.
Service providers consider how long interpreters need and the individual interpreter’s consistency and gender appropriateness, and provide alternatives if possible.
In some instances (for example, in migrant or refugee groups), the person and whānau may already personally know the interpreter. In these instances, where possible, service providers arrange for an alternative interpreter.
Criterion 1.6.6
Guidance for all providers
Service providers use tools to minimise the health literacy demands organisational policies and services place on people and whānau.
Service providers share with their health care and support workers the Ministry of Health’s (2015) A Framework for Health Literacy.
Service providers work with Māori health practitioners, traditional Māori healers, and organisations to benefit Māori individuals and whānau.
Section 1.7: I am informed and able to make choices
Criterion 1.7.1
Guidance for all providers
Service providers give people receiving services understandable written and verbal information on the potential benefits, risks, alternatives, costs, and predictable inconvenience associated with a treatment or therapy. Where required, and with the person’s informed consent, they give whānau the same information. Communicating this information before consent is considered may include:
using interpreters and advocates, cultural advisors, or whānau advisors
providing information in a variety of languages and formats
using a respectful system of checking the information is understood
providing information suggesting other available methods of treatment and therapy.
Service providers uphold the values of Māori and other cultures.
Service providers demonstrate an understanding of the Accessibility Charter.
Service providers consider establishing a ‘knowledge hub’. This could involve using employees with cultural knowledge to support practice.
People have the choice to refuse treatment and to withdraw consent to services.
People are fully informed about alternative options.
Service providers have an implemented policy and process to inform people that public health services (including pre-assessment, counselling, and follow-up appointments) are free to all people eligible for publicly funded health services in New Zealand.
Service providers give young people accurate, age-appropriate education, information, and support related to their chosen health care plan. Service providers may refer to the Gillick competence test and Fraser guidelines. See also the Privacy Commissioner website.
Service providers have implemented policies to support people who have been impacted by family violence or sexual assault. This includes ensuring the person understands their options for:
counselling
making an Accident Compensation Corporation (ACC) claim
making a complaint to the police
contraception
referral and follow-up care
relevant services in their area that are available to them.
Service providers and health care and support workers are familiar with the Code of Health and Disability Services Consumers’ Rights and, in particular, Right 7(4)(c).
Additional guidance
Fertility services
Service providers give information about access to public funding and treatment.
Residential mental health and alcohol and other drug
Service providers consider court orders and instructions such as bail conditions.
Public/private hospital
Service providers consider court orders and instructions such as bail conditions.
Criterion 1.7.2
Guidance for all providers
Service providers consider cognitive and behavioural impairment due to substance misuse.
Decision making is a part of any choice or consent procedure.
Service providers have implemented processes to provide for people choosing the support worker(s) who can undertake different tasks.
Health care and support workers seek verbal consent each time they are undertaking an activity.
Additional guidance
Home and community
The consent process starts as soon as a support worker enters a person’s home.
Service providers have implemented processes that allow people receiving services to choose the number and type of support workers who can undertake different tasks, including tasks such as reading mail, supporting personal care, and preparing meals.
Support workers seek verbal consent each time they are undertaking an activity.
Criterion 1.7.3
Guidance for all providers
Evidence shows supported decision-making is used in all decisions a person makes.
People receiving services are made aware of national collection and/or reporting of personal data on procedures they are undergoing, where either or both of these activities occur.
Additional guidance
Residential disability
Service providers consider court bail conditions where people cannot make decisions about services.
Residential mental health and alcohol and other drug
Service providers consider court bail conditions where people cannot make decisions about services.
Public/private hospital
Service providers consider court bail conditions where people cannot make decisions about services.
Birthing units
Service providers consider court bail conditions where people cannot make decisions about services.
Criterion 1.7.4
Guidance for all providers
Service providers welcome the involvement of whānau in decision making where the person receiving services wants them to be involved.
When the whānau of a person receiving services hold an activated power of attorney or another legal authorisation, service providers enable them to give consent.
If no official authorisation is in place, service providers invite whānau to help make the best decision for the person.
Service providers identify health and social barriers to decision making that people receiving services and their whānau experience and provide health and social support services to enable effective decision-making.
Service providers make whānau aware of and offer them high-quality information and resources in different formats to support them in deciding whether to give consent.
Criterion 1.7.5
Guidance for all providers
Service providers are aware of legislation underpinning consent practices, including legislation related to court-appointed guardians, enduring powers of attorney, and advanced care and/or support planning, and the Code of Health and Disability Services Consumers’ Rights.
Service providers have policies and processes that support informed choice and informed consent.
Where verbal consent is given, it is recorded.
Service providers have implemented consent processes for situations that may include:
routine situations
emergency situations
electroconvulsive therapy
do-not-resuscitate orders
people receiving services who are unable to consent
people receiving services who are able to consent only if provided with additional support
children and young people receiving services
involvement in teaching
involvement in research
storage, disposal, and return of body parts/tissues and bodily substances
advance directives
meeting the needs of people receiving services.
Service providers have implemented consent processes for other situations appropriate to the service where informed consent is required.
The choices and decisions recorded and acted on may vary according to the nature of the service.
Written consent is required when contraception is implanted or inserted as part of a procedure.
Abortion services
Written consent is required when contraception is implanted or inserted as part of a procedure.
Criterion 1.7.6
Guidance for all providers
Service providers understand how supported decision-making and welfare guardianship work, as well as the law related to enduring power of attorney and court orders under the Protection of Personal and Property Rights Act 1988 and the law related to parents or legal guardians of children, and the limitations of these processes.
People understand legal capacity.
Criterion 1.7.7
Aged care: Guidance
Service providers communicate how to make advance directives. An advance directive is a written or oral directive:
by which a person makes a choice about a future care procedure
that is effective only when the person is not competent.
In some situations, it may not be possible to uphold or action an advance directive. When deciding whether to follow an advance directive, clinicians refer to the Health and Disability Commissioner’s webpage ‘Advance Directives & Enduring Powers of Attorney’.
Although service providers do not develop advance directives or advance care and/or support plans, when one is in place, they make a copy available to support the services being provided.
Fertility services: Guidance
Service providers uphold the wishes of people receiving services about the fate of the stored gametes or embryos, as stated in consent forms.
Home and community: Guidance
Service providers communicate how to make advance directives. An advance directive is a written or oral directive:
by which a person makes a choice about a future care procedure
that is effective only when the person is not competent.
In some situations, it may not be possible to uphold or action an advance directive. When deciding whether to follow an advance directive, clinicians refer to the Health and Disability Commissioner’s webpage ‘Advance Directives & Enduring Powers of Attorney’.
Although service providers do not develop advance directives or advance care and/or support plans, when one is in place, they make a copy available to support the services being provided.
Residential disability: Guidance
Service providers communicate how to make advance directives. An advance directive is a written or oral directive:
by which a person makes a choice about a future care procedure
that is effective only when the person is not competent.
In some situations, it may not be possible to uphold or action an advance directive. When deciding whether to follow an advance directive, clinicians refer to the Health and Disability Commissioner’s webpage ‘Advance Directives & Enduring Powers of Attorney’.
Residential mental health and alcohol and other drug: Guidance
Service providers communicate how to make advance directives. An advance directive is a written or oral directive:
by which a person makes a choice about a future care procedure
that is effective only when the person is not competent.
In some situations, it may not be possible to uphold or action an advance directive. When deciding whether to follow an advance directive, clinicians refer to the Health and Disability Commissioner’s webpage ‘Advance Directives & Enduring Powers of Attorney’.
Public/private hospital: Guidance
Service providers communicate how to make advance directives. An advance directive is a written or oral directive:
by which a person makes a choice about a future care procedure
that is effective only when the person is not competent.
In some situations, it may not be possible to uphold or action an advance directive. When deciding whether to follow an advance directive, clinicians refer to the Health and Disability Commissioner’s webpage ‘Advance Directives & Enduring Powers of Attorney’.
Service providers give multiple opportunities for the person receiving services and their whānau to discuss advance directives.
Tikanga is followed in the context of advance directives.
Service providers have implemented policies and associated procedures to support practice.
Service providers communicate how to make advance directives. An advance directive is a written or oral directive:
by which a person makes a choice about a future care procedure
that is effective only when the person is not competent.
In some situations, it may not be possible to uphold or action an advance directive. When deciding whether to follow an advance directive, clinicians refer to the Health and Disability Commissioner’s webpage ‘Advance Directives & Enduring Powers of Attorney’.
Service providers give multiple opportunities for the person receiving services and their whānau to discuss advance directives.
Tikanga is followed in the context of advance directives.
Service providers have implemented policies and associated procedures to support practice.
Although service providers do not develop advance directives or advance care and/or support plans, when one is in place, they make a copy available to support the services being provided.
Criterion 1.7.8
Fertility services: Guidance
The consent process includes storage, disposal, and return of gametes, embryos, and reproductive materials.
Service providers have a consent process for the use of gametes and embryos for training.
Service providers have a process for contacting people well before the end of their storage period and informing them about when and how to apply for an extension if they wish to do so.
The policy on gamete or embryo storage makes it clear to people receiving services that gametes or embryos will be disposed of if storage is not extended, or when the period of extension ends.
Service providers have procedures to follow regarding gametes or embryos if the consenting person dies or becomes incapable of varying their consent.
Service providers have a process for disposing of gametes and embryos where a person can no longer be contacted.
Public/private hospital: Guidance
The consent process includes storage for disposing of the placenta, fetus, or any other reproductive parts, or return of such parts on discharge for the consenting person or whānau to take home.
The consent process includes the process for a fetus, placenta, or any other reproductive parts sent to pathology or for post mortem to be returned to the consenting person or whānau.
Service providers demonstrate that they comply with the Human Tissue Act 2008 and with the New Zealand Standard on Non-therapeutic Use of Human Tissue NZS 8135:2009.
Service providers provide an appropriate interim vessel for people who wish to take their products of conception home with them.
Service providers inform people receiving services in advance of the procedure involved in their opportunity to bring an appropriate vessel for the purpose of taking their products of conception home with them.
Service providers have an implemented policy for undertaking forensic analysis as part of their procedure.
Birthing units: Guidance
The consent process includes storage for disposing of the placenta, fetus, or any other reproductive parts, or return of such parts on discharge for the consenting person or whānau to take home.
The consent process includes the process for a fetus, placenta, or any other reproductive parts sent to pathology or for post mortem to be returned to the consenting person or whānau.
Service providers demonstrate that they comply with the Human Tissue Act 2008 and with the New Zealand Standard on Non-therapeutic Use of Human Tissue NZS 8135:2009.
Service providers provide an appropriate interim vessel for people who wish to take their products of conception home with them.
Service providers inform people receiving services in advance of the procedure involved in their opportunity to bring an appropriate vessel for the purpose of taking their products of conception home with them.
Service providers have an implemented policy for undertaking forensic analysis as part of their procedure.
Abortion services: Guidance
The consent process includes storage for disposing of the placenta, fetus, or any other reproductive parts, or return of such parts on discharge for the consenting person or whānau to take home.
The consent process includes the process for a fetus, placenta, or any other reproductive parts sent to pathology or for post mortem to be returned to the consenting person or whānau.
Service providers demonstrate that they comply with the Human Tissue Act 2008 and with the New Zealand Standard on Non-therapeutic Use of Human Tissue NZS 8135:2009.
Service providers provide an appropriate interim vessel for people who wish to take their products of conception home with them.
Service providers inform people receiving services in advance of the procedure involved in their opportunity to bring an appropriate vessel for the purpose of taking their products of conception home with them.
Service providers have an implemented policy for undertaking forensic analysis as part of their procedure.
Criterion 1.7.9
Guidance for all providers
Service providers follow relevant best practice tikanga guidelines. Health care and support workers demonstrate competency.
Some examples are:
Service providers have an implemented policy and associated procedures around complaint management and resolution or escalation.
Service providers use national guidelines and resources to support the complaint process.
Service providers take account of survey feedback and outcomes.
Service providers support people receiving services to access independent advocates.
Service providers give people receiving services understandable written and verbal information about how to make a complaint.
With people’s informed consent, service providers give whānau the same information where this is required.
Safeguards are in place for people receiving services who make complaints.
Māori processes for complaint resolution (for example, whānau hui) are evident.
When working towards resolving a complaint, service providers consider the diverse needs of the person and/or whānau who have made the complaint. They:
evidence discussion with the person making the complaint to put in place a process that is acceptable to the person
demonstrate how they have maintained cultural safety when people make complaints
have processes in place to protect people making a complaint
meet the person’s environmental, social, accessibility, economic, and personal health needs.
Service providers monitor trends in complaints, including the actions they take.
Service providers can receive complaints in any format, including by email and over the telephone.
Service providers ask people who are raising concerns what outcome they want as part of an internal investigation (for example, they might want a different support worker).
Service providers educate support workers to seek feedback during service provision.
People know they can have their rights met without them risking the loss of funded services.
Complaint processes are described to people on entry. This includes service providers’ internal processes, and how to complain to external agencies such as the Health and Disability Commissioner.
Additional guidance
Residential disability
House meeting minutes reflect issues raised by people; service providers consider independent (from house support workers) minute taking.
a formal process for recording and investigating complaints
brochures, forms, or equivalent documentation on how to make a complaint in different formats and media.
Every person receiving services knows they have a place to go to make a complaint, and how to complain.
Access to making a complaint is inclusive of everybody. This access is not limited by barriers such as internet access, finance, or travel.
Service providers have a process in place to manage informal complaints.
Evidence shows service providers have a proactive approach to addressing concerns before issues escalate, which includes an opportunity to improve.
People have a variety of avenues they can adopt to make a complaint or express a concern.
People have an opportunity to complain at any time.
People making a complaint can involve an independent support person in the process if they choose.
Criterion 1.8.3
Guidance for all providers
Service providers reference relevant professional standards when investigating complaints.
Health care and support workers understand their responsibilities in supporting the requirements of the Code of Health and Disability Services Consumers’ Rights.
Service providers maintain an up-to-date register that includes all updates and actions related to complaints.
Criterion 1.8.4
Guidance for all providers
Service providers inform complainants of outcomes of internal investigations.
Criterion 1.8.5
Guidance for all providers
The Code of Health and Disability Services Consumers’ Rights is visible, and available in te reo Māori, English, and New Zealand Sign Language in accessible formats.
Service providers use their best efforts to verify Māori and whānau understand their rights.
Communication and information about the complaints process are easy for all people to access, understand, and use.
The complaint resolution policy and procedures, forms, surveys, guidelines, and resources are designed to adequately capture complaints made by Māori. Service providers consider:
any under-reporting of complaints from Māori
the level of access Māori have to the complaints process
The service provider asks: what works best for Māori?
Section 1.9: Health and wellbeing of children born as a result of, and people accessing, reproductive technology services
Fertility services: Guidance
Criterion 1.9.1
Requirements outlined in the Human Assisted Reproductive Technology Act 2004 (HART Act) guide service providers’ practice.
Service providers implement policies and procedures that guide their practice in addition to meeting regulatory requirements. Policies should cover:
multiple pregnancy
ovarian hyperstimulation syndrome
ovarian torsion
infection
reaction to medication.
Service providers develop a risk register for assisted reproductive technology services. They monitor the register through their quality and risk management system.
Service providers monitor assisted reproductive technology outcome data.
Health care and support workers are aware of current best practice.
Service providers actively participate in research that addresses the health and wellbeing of children born as a result of assisted reproductive technology services.
Criterion 1.9.2
Service providers collect the information required by the HART Act.
Service providers submit data to the Australian and New Zealand Assisted Reproduction Database.
Criterion 1.9.3
Service providers have written information about the HART Act available for people receiving services.
Criterion 1.9.4
Service providers give people information about services a clinic offers, noting services may vary.
Section 1.10: Requirements of donation and surrogacy
Fertility services: Guidance
Criterion 1.10.1
Service providers:
have written policies and procedures in place before offering donation or surrogacy services
follow the principles outlined in the HART Act
support and encourage people receiving services to inform offspring of their genetic origins
for Māori, provide opportunities for whakapapa linkages to occur, recognise these linkages and incorporate them into the process of donor linking.
Criterion 1.10.2
Service providers inform potential donors of:
the storage and potential use of their gametes or embryos, and the processes involved in donation
the procedures involved in collecting gametes, the degree of pain and discomfort, and any risks to the person (for example, from the use of ovarian stimulation drugs)
the screening to be carried out and the implications of potential results
the purposes for which the gametes or embryos might be used
the legislation that defines the legal status of children born as a result of the procedure
the information that service providers collect and the extent to which that information may be disclosed to people born as a result of the donation
the requirement for them to disclose any health or genetic conditions that may mean it is possible for a child to be born with that condition
the lack of any financial or other penalty if they withdraw consent before completion of donation or surrogacy
their inability to use the donated gametes and embryos created to generate more than the number of families specified in the relevant legislation or guidelines
their right to withdraw or vary the terms of their consent and specify limits, subject to any relevant guidelines and policies in place
what will happen with their gametes if they die
the possibility of their identity becoming known through ‘direct to consumer’ genome information or social media without their consent.
Criterion 1.10.3
Screening may include infectious diseases and genetic conditions.
Service providers undertake risk assessment to determine safe donation and that reproductive tissue is safe for donation.
Criterion 1.10.4
Policies require a donor to make a declaration that they will follow the service provider’s policies on the maximum number of families created from their gametes, covering past and future donations.
The service provider has a documented policy that limits the number of children generated by any one donor to a maximum of 10 families.
Criterion 10.10.5
Service providers follow, where relevant, the guidance in the Reproductive Technology Accreditation Committee, Fertility Society of Australia (2017) Code of Practice for Assisted Reproductive Technology Units and Advisory Committee on Assisted Reproductive Technology guidelines.
Counsellors follow ANZICA (2018) Guidelines for Professional Standards of Practice Infertility Counselling.
Service providers provide joint counselling in instances of known donation.
The process includes partners where appropriate considering the length and intention of the relationship.
Service providers consider and support ‘all parties’ during decision making, and have policies covering this.
