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Localities Information gathering exercise
Localities Information gathering exercise
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The purpose of this information gathering exercise is to understand and catalogue existing Primary Health Organisation (PHO) practice and enablers that could support a population health approach to localities.
The key objectives of this information gathering exercise are to:
- understand the PHO’s perspective on the aspirations of communities, iwi and providers
- catalogue current practice across PHOs in relation to localities
- capture learnings from previous initiatives and current practice.
The Transition Unit will also be capturing information from District Health Boards (DHBs), iwi, Māori providers and other key stakeholder groups.
About the locality approach
The locality approach derives from the contemporary concept of population health management. The Kings Fund defines population health management as:
“An approach aimed at improving the health of an entire population. It is about improving the physical and mental health outcomes and wellbeing of people within and across a defined local, regional or national population, while reducing health inequalities. It includes action to reduce the occurrence of ill health, action to deliver appropriate health and care services and action on the wider determinants of health. It requires working with communities and partner agencies.”
There are four pillars underpinning a population health approach:
- the wider socio-economic determinants of health (e.g., housing, employment, inequalities in wealth and power);
- health behaviours and lifestyles (e.g., smoking, activity, nutrition, drinking, gambling);
- the places and communities we live in (the built and natural environment); and
- an integrated health and care delivery system.
Localities can be considered as a community of interest set in a geographic area used for the purposes of localising primary and community-based care. The locality sets catchments for community service design and input, population health needs, and accountability. Localities will be set in ways that make sense for the communities being served, which may mean localities could be aligned with council boundaries, iwi rohe, concentrations of particular population groups, or natural borders.
The locality is intended to drive a focus on equity and priority populations.
The locality approach creates a major opportunity to foster integration of care models and services and to ensure people have greater choice over the services they access. It also offers a platform to implement a population health approach, drive innovation and ensure that services are planned for all local people, delivered seamlessly, and that providers work collectively towards shared objectives.
In the future system operating model, Health NZ (in partnership with the Māori Health Authority) will have lead responsibility for service commissioning and other functions required to operationalise a locality approach, including:
- partnering with iwi Māori partnership boards to ensure the voice of Māori whanau are reflected in planning and decision-making;
- population health needs assessment and locality planning;
- engagement with community, iwi, and cross-sectoral agencies;
- service planning and service development;
- procurement including provider selection, pricing, and payment; and
- developing and implementing a monitoring framework including both provider performance and population health indicators.
It is envisaged that provider networks composed of a consortium of providers will deliver joined up primary and community care services to localities. It is expected that providers in these networks will:
- embed and enact Te Tiriti o Waitangi obligations, and ensure the viability and sustainability of kaupapa Māori service options and approaches;
- take a strong population health approach, including integration with wider social sector agencies;
- work collectively towards shared outcomes and objectives, including a singular focus on achieving equity of outcomes for Māori under Te Tiriti obligations;
- be subject to common service requirements, priorities, standards, reporting and monitoring processes.
To provide networks with the necessary support to operationalise the locality approach, a management function could be required to coordinate the integration of primary and community care providers within a provider network.
An indicative view of the key functions required to operationalise the locality approach are outlined below:
Commissioning functions | Network management functions |
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Locality prototypes
Funding will be available in Budget 2021 to enable early investments in developing prototypes for the locality approach. The learnings from these prototypes will inform and support policy development and further roll-out of the locality approach across New Zealand over subsequent years.
In order to inform the development of the prototypes, the Transition Unit is conducting a discovery phase which seeks to capture and understand the breadth of existing commissioning arrangements, provider management arrangements, integrated care models and enablers that have similar features to the future locality approach.
The purpose of this information gathering exercise is aimed solely at gathering information and is not a prototype selection process. The process for selecting prototypes will be undertaken in conjunction with the interim Māori Health Authority and interim Health New Zealand, and leverage existing relationships where possible.
An indicative prototype selection timeframe is provided below:
What information is being sought
Through this information gathering exercise, the Transition Unit seeks to capture and catalogue any current practice that is characteristic of a locality approach. We are keen to capture specific examples of current, planned or previously trialed initiatives that have features which are similar to the future locality approach.
The overall ask
“Please describe current, planned or previously trialed initiatives that have elements that are closely aligned to the locality approach as outlined in this brief.”
Please refer to Attachment 1 for the specific questions we would like to answer through this process.
If your current, planned or previous approach does not include a focus of this sort – that is fine, please do not feel obliged to answer the questions.
If you have taken action using similar approaches as described in this brief, you may have board papers or project briefs, or reports/evaluations that describe the interventions and resultant journey to date. We would appreciate copies of significant documents – and feel free to simply refer to attached documents rather than writing a summary in the response template.
A key objective of this exercise is to capture learnings from current practice and previously trialed initiatives - these initiatives do not have to be successful or fully implemented.
This information gathering exercise is a first step in an iterative discovery process. We are likely to have follow-up discussions with at least some PHOs to further understand the information provided and test our interpretation of responses.
Please aim to send responses back by Friday 16th July.
Attachment A: Response template
The questions outlined below are intended to provide a semi-structured format for responses based on the areas we are seeking to understand. If you would like to provide additional information that you think might be relevant, please feel free to do so.
These questions have been grouped into the following categories:
- Locality planning and needs assessment
- Partnership with Māori
- Community engagement
- Cross-sectoral working
- Integrated models of care / provider integration
- Alliance arrangements
- Pacific providers
- Data intelligence & governance
Feel free to skip any questions that are not relevant for you. The purpose of the questions is to understand learnings to inform the successful future development of localities. The information is not sought for evaluative purposes.
Questions
Locality planning and needs assessment
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Partnership with Māori
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Community engagement
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Cross-sectoral working
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Integrated models of care / provider integration
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Pacific providers
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Data intelligence & governance
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Additional information
Please provide any further information relating to locality planning and delivery you think might be relevant - particularly any learnings, reviews or evaluations you would like to share, or advice for shaping of the future locality approach. |