2019–2025 Strategy Contact Us [email protected] CONTENTS www.thinkhauora.nz Foreword Each rohe has an office out of which THINK 2 Hauora staff operate. Contact details for Te Rautaki - Strategic Context 4 these locality offices are as follows: Palmerston North Our Strategy of Weaving 6 200 Broadway Ave, Palmerston North 4410 Our History PO Box 2075, Palmerston North 4410 8 Tel (06) 354 9107 Connecting Our Past and Future 10 Fax (06) 354 6107 Horowhenua Strategy Visualisation 12 62 Liverpool Street, Levin 5510 W. Whānau Ora PO Box 659, Levin 5510 14 Tel (06) 367 6433 E. Equity 18 Fax (06) 367 6434 Ōtaki A. Access 20 2 Aotaki Street, Ōtaki 5512 V. Value PO Box 659, Levin 5510 26 Tel (06) 364 8291 I. Innovation Fax (06) 364 7485 32 Pahiatua N. Networking 36 3 Centre Street, Pahiatua 4910 G. Growth PO Box 2075, Palmerston North 4410 38 Tel 0800 766 255 In Summary Fax (06) 354 6107 40 Strategy At A Glance 42 Outcomes Framework 43 References 44

THINK Hauora 2019–2025 Strategy Unuhia te rito o te harakeke Remove the centre of the flaxbush Kei hea te korimako e kō? Where then will the bellbird sing? Whakatairangitia, rere ki uta, rere ki tai. It will fly inland and seawards aimlessly. Kī mai koe ki ahau, You enquire of me, He aha te mea nui o te ao? What is the greatest thing in this world Māku e kī atu, he tangata, he tangata, I reply, it is people, it is people, he tangata it is people (Nā Meri Ngaroto o Te Aupouri) (Proverb by Meri Ngaroto of the Te Aupouri tribal nation)

THINK Hauora 2019–2025 Strategy 1 FOREWORD

Tēnā koutou and welcome to This outward-looking focus has born the “Wellbeing touches THINK Hauora 2019–2025 Strategy and the concept of WEAVING. Our new strategy looks at how For the last three years Central Primary so much more than the organisation can operate to weave Health Organisation (PHO) has followed a connected systems and processes for the health alone” forward-thinking strategy, and a significant betterment of the communities’ wellbeing. amount of mahi has been directed at improving services to our primary health This is not a change of direction but a care provider network, implementing a natural extension of the journey we have bold and extensive ICT programme and been on. To complement this new exciting continuing to partner with MidCentral strategy, the Trust Board has taken the District Health Board (DHB) to improve bold move to change the name of the health outcomes for the communities we organisation to reflect the direction of live in. travel. From July 2019 we will be known as “THINK Hauora”. The vision is “Connecting When developing the new strategy, Central Communities for Wellbeing”. PHO took a far reaching and outward- looking approach. This recognises that Exciting times are here – now the new mahi the wellbeing of people, whānau and begins. communities is not just an issue of health provision and health providers but involves complex and inter-related connections, systems, and organisations. Wellbeing touches so much more than health alone, and for us working to provide health services it is necessary to look Dr Bruce Stewart beyond our own borders and boundaries Chairman and connect the dots. THINK Hauora Board Recent experience in using collective impact July 2019 further highlights the need to work outside of the isolation of health.

2 THINK Hauora 2019–2025 Strategy “THINK Hauora links our Our journey began with developing a These partnerships connect on many strong foundation for primary health care levels. Thus the concept of WEAVING has focuses of technology, across our rohe twenty years ago. been created, both in its process and art, as a framework for this strategy. Our new This six-year strategy continues to focus health, innovation, name and branding, THINK Hauora, links on health care, however it is set within a our key focuses of Technology, Health, wider context, recognising the connections networks and knowledge” Innovation, Networks and Knowledge. It between health and other aspects of calls to partnerships. people’s lives. The strategy acknowledges the environments in which we live and work, With that said it is important this THINK and their significant impacts on the health Hauora strategy is viewed more widely than and wellbeing of individuals and whānau an organisational strategy. This strategy of the five distinct communities within belongs to our people, providers and our rohe. This strategy aligns well to the partners – together we are committed to Government’s Wellbeing Budget. connecting communities for wellbeing. Over recent years we have deliberately developed into a values-based network and have proven that working collaboratively with our contracted providers and communities through engagement and co- Chiquita Hansen design is not only enjoyable but has created a platform for excellence every day. CEO THINK Hauora We are committed to partnerships and are July 2019 proud of our local alliances with Te Tihi o Ruahine and Raukawa Whānau Ora, and the MidCentral District Health Board.

THINK Hauora 2019–2025 Strategy 3 TE RAUTAKI - STRATEGIC CONTEXT

The THINK Hauora strategy of Whānau Ora, Equity, Access, Value, Innovation, Networking and Growth is grounded by the Health Strategy, the New Zealand Māori Health Strategy and the MidCentral DHB Strategic Imperatives.

NZ Health Strategy NZ Māori Health Strategy MidCentral DHB Strategic Imperatives Rautaki ā-Motu He Korowai Oranga Me Mahi

All New Zealanders live well, stay well, get well Pae ora – healthy futures Quality Living, Healthy Lives, Well Communities

Te whāinga hua me te tika o ngā mahi Value and high performance Achieve quality and excellence by design Value and high performance

Closer to home Pae Ora Healthy futures for Māori Connect and transform primary, community and specialist care

One team Wai Ora Healthy environments Partner with people and whānau to support health and wellbeing Smart system Whānau Ora Healthy families Achieve equity of outcomes across communities People-powered Mauri Ora Healthy individuals

THINK Hauora Strategic Aims W E A V I N G Whānau Ora Equity Access Value Innovation Networking Growth Achieving wellbeing People, community voice Easy, available, cross- Teams, technology, Quality improvement, Relationships, Sustainability, system and data-driven sectors performance excellence, engagement partnerships, and alignment focus collective impact Tūhonotia te Hapori ki te Ora – Connecting Communities for Wellbeing

4 THINK Hauora 2019–2025 Strategy OUR ROHE The MidCentral district is made up of: We have a population of 19% 21% 17% 25% 18% 182,110 0-14 years 15-29 years 30-44 years 45-64 years 65+ years

Trend

Five Manawatū territorial local authority districts District are covered by MidCentral DHB 31,251 which is estimated to rise 12% to 186,040 by 2023/24 Horowhenua 71% District 80% 33,520 As a district, we have a higher proportion of Māori compared to 66% the national average 69% Tararua District 71% Māori 20% 18,410 42% Pasifika 3% Kāpiti District Ōtaki Palmerston North 8,890 City 67% Asian 9% 71% 90,039 76% Other 68% 65% 18% 80% 62% 82%

Graphic adapted from: MidCentral DHB Strategy 2016

THINK Hauora 2019–2025 Strategy = Population = Deprivation = Home ownership = NCEA Level 2 5 OUR STRATEGY OF WEAVING

Unuhia te rito o te harakeke Preparation lays ground for our Weaving begins with planning, future process and discipline Kei hea te korimako e kō? As we look to the future, we have chosen Te Whare Pora is the House of Weaving Whakatairangitia, rere ki uta, weaving, both in its process and art, to where Hineteiwaiwa as the Spirit of all Māori rere ki tai. provide a lens to view our strategic direction weaving presides. and intention of ‘Connecting Communities for Harakeke is a commonly used material used Kī mai koe ki ahau, Wellbeing’. Weaving provides a blueprint for for weaving. Depending on the intended many things including purpose, preparation, use of the harakeke, kairaranga/weavers He aha te mea nui o te ao? foundation, rhythm, connectedness, will select specific varieties based on the prosperity and self-determination. Māku e kī atu, he tangata, pliability, colour and fibre quality. Included he tangata, he tangata As a network we are impacted, shaped and in the planning is ascertaining how many Nā Meri Ngaroto o Te Aupouri motivated by a wide range of strategies and rau harakeke will be required. The outer policies. Our strategy weaves these into a leaves are then harvested and prepared in strategic document that will help shape the accordance with custom. All of this requires Remove the centre of the annual plans of the network partners. planning, patience and discipline. Weaving is yet to start. flaxbush This whakatauāki indicates that should the rito (centre) of the harakeke be cut, the When weaving does begin, each whenu (warp Where then will the bellbird sing? harakeke will perish, resulting in far reaching strand) and aho (weft strand) is woven in consequences. With the loss of the harakeke, a deliberate fashion to form the papa, the It will fly inland and seawards there is no kōrari stalk for the korimako foundation for the artform being created. aimlessly. (kōmako) to perch upon, no nectar from the The whakatauāki speaks to the environment stalk flower for the korimako to suckle on You enquire of me, for weaving; to kaitiaki as those responsible to sustain itself, and thus no song would be for the guardianship of weaving, and to heard. Although the proverb origins and What is the greatest thing in everyone overall. this world purpose are unfamiliar to most, the adage endures—we are urged to treasure and work I reply, it is people, it is people, respectfully with what we have now, while it is people being cognisant of the future. Proverb by Meri Ngaroto of the Te Aupouri tribal nation

6 THINK Hauora 2019–2025 Strategy Pā

Whānau is a crucial building block of society W and is symbolised by pū, a single harakeke and Pū core root base which holds the rito, flanked by the awhi rito or mātua (parents) which are then surrounded by the tūpuna (grandparents). A cluster of harakeke is a pā. E Equitable conditions create the right environments for harakeke to grow and create Awhi rito/mātua (parents) strong foundations and ongoing sustainable Rito (child) thriving crops. A Access to harakeke was so desired that pā were Tūpuna (grandparents) cultivated, named and treasured. Values of suitability, durability, versatility abound in this humble plant to the point that V tūpuna questioned how other nations could live without it. Innovative modern designs build on the traditional materials, dyes, patterns and I techniques maintained by Kaitiaki and Kairaranga. Networks of mutual benefit are formed by interconnected, interdependent, synergetic relationships between pū and pā. N Growth comes from the centre. The middle shoot known as the rito or child is protected and nurtured by the awhi rito or mātua (parents) which are then surrounded by the tūpuna (grandparents). The more mature outer leaves G generally used for weaving.

THINK Hauora 2019–2025 Strategy 7 OUR HISTORY In the early 2000s MidCentral District initiatives to address the health of older These ventures ensured a “The amalgamation of Health Board’s (DHB) Primary Health Care people, creation of system enablers and continuity and access of four geographical PHOs (PHC) Strategy enabled investment and plans to ensure high-quality care. Many care in line with its founding growth across our rohe. Primary Health small general practices merged as Integrated vision of ‘working together, (Manawatū, Ōtaki, Organisations (PHOs), management Family Health Centres to provide broader co- towards healthy and flourishing Tararua, Horowhenua) support entity, Nursing Development ordinated care to their enrolled populations. communities’. followed, and Central Team (known as Health Care Development The Central PHO Board and Alliance In 2016 a three-year Strategic PHO was formed” between 2007–2018) and cohorts of new Leadership Team joined forces in 2013 Plan was developed with five long-term condition staff emerged. Access, and the alignment of annual plans on strategic aims: improve access and equity, community participation, service co- quality improvement, business intelligence, integrated care for priority populations, ordination, infrastructure, integration and specialist integration, and acute care began. partner with people, communities and quality provided the framework for the providers, activate smart systems and DHB investment. The Central PHO Māori Health Team was quality foundation for success. Central instrumental in the development of Te The Millennium marked a change — the PHO brought financial management and Tihi o Ruahine Whānau Ora Alliance (Te introduction of the Better Sooner More human resourcing capability in-house and Tihi) in 2011. Nine , Hapū and Māori Convenient 2010 policy, introduced by commenced preparation for digital health organisations are part of this Alliance. the Ministry of Health to improve primary transformation and the transition of data The Alliance works collectively to develop health care and integration commenced. The management in-house from 2019. whānau-centred projects, innovations amalgamation of four geographical PHOs and processes. In 2017 Te Tihi established Te Ara Rau, primary mental health (Manawatū, Ōtaki, Tararua, Horowhenua) their own Charitable Trust and a new service, was co-designed in 2018 and this followed, and Central PHO was formed with a entity emerged. The relationship between model of care has been supported by vision of ‘working together, towards healthy Central PHO and Te Tihi remains strong the 2019 Wellbeing Budget as part of the and flourishing communities’. A PHO-DHB with a Board-to-Board Memorandum Government’s response to the inquiry into Alliance Leadership Team was developed of Partnership in place. Te Tihi provide mental health and addiction, He Ara Oranga. to provide governance of the change and ongoing Māori health leadership and marked a new way of working in partnership. Today, THINK Hauora has a core staff of stewardship to Central PHO. 110, as well as 25 staff employed within At this time, the rohe was served by 42 Central PHO acquired Horowhenua Horowhenua Community Practice. It general practice teams and 50 contracted Community Practice in Levin in 2013. contracts through 29 General Practice Teams health providers. Priorities included Soon after, Central PHO, together with Te and Integrated Family Health Centres, and embracing a Whānau Ora approach and Rūnanga o Raukawa, opened Te Waiora 82 providers, for the health and wellbeing of the development of a Māori Health team, Community Health Services in Foxton. 182,110 people throughout the rohe.

THINK Hauora Board is made up of 13 representatives from across the provider network, Māori, Iwi and community. They are also members of the 8 Alliance Leadership Team alongside other system-wide representatives. THINK Hauora 2019–2025 Strategy THINK Hauora 2019–2025 Strategy 9 CONNECTING OUR PAST AND FUTURE

Connecting our past and future We move forward, keeping our values Introducing our new vision Our origin from four PHOs into one ‘central’ at the forefront PHO was translated through the physical Trust Tūhonotia te Hapori elements within the Central PHO logo. The ki te Ora Tararua maunga; the Ruahine maunga, the Whakapono/Rangatiratanga Manawatū awa; the Ōtaki prow; and Maintaining open and honest relationships Connecting Communities the Horowhenua waka stern represent each Respect community. The maunga symbolises the for Wellbeing life-force giving rise to nurturing water— Whakaaro nui/Manaakitanga common and unifying. The elements within Embracing diversity, uniqueness and ideas the Central PHO logo carry meanings of connected systems, health and wellbeing, Unity community and continuity. Kōtahitanga Our new strategic direction provides Valuing strengths and skills an opportunity to reflect and to find an identity which connects our origins with Accountability our aspirations. He mana tō te kupu Central PHO logo 2010–2019 THINK Hauora is this new identity. Working in a transparent and responsible THINK Hauora links Technology, Health, manner Innovation, Networks and Knowledge to the wellbeing of all. It calls to partnerships. Courage This draws inspiration from the prow of Ka tū te ihiihi/Whakamanawanui/Hautoa a waka drawing all people forward into a Participating with confidence and shared future. It speaks to equity. Awa is enjoyment the system which connects people to land THINK Hauora logo and people through time. It gives access to 2019–present health-giving nourishment and ensuring growth. The logo also evokes imagery of the rohe landscape: mountains, hills, plains, rivers, and a wave surge.

10 THINK Hauora 2019–2025 Strategy COMMITMENT TO TE TIRITI O WAITANGI We are committed to Te Tiriti o Waitangi (The ), recognising and respecting the principles of Partnership, Protection and Participation, and the articles of Kawanatanga – governance and the relationship between Treaty Partners, – the right to be self-determining in all areas, Oritetanga – authentic contributions that drive equitable access and outcomes and Te Ritenga – honouring the beliefs, values and aspirations of Māori. • Implementing Te Tiriti o Waitangi articles and principles into the overall governance, planning and delivery of services • Acknowledging Te Tiriti o Waitangi articles and principles that underpin our strategy • Being responsive to Māori interests and ensuring these are protected

THINK Hauora 2019–2025 Strategy 11 COMMUNITIES Horowhenua Ōtaki

WHĀNAU ORA EQUITY ACCESS STRATEGIC AIMS STRATEGIC TIRITI O WAITANGI

COMMITMENT TO TE TE TO COMMITMENT Achieving wellbeing People, community voice Easy, available, and data-driven cross-sectors

• Positively support and influence cross- • Connect information and people to • Provide leadership for the inclusion of sector Whānau Ora and Wellbeing inform and transfer knowledge to develop bold political choices for health across all policy setting and direction innovative ways to improve equity sectors • Align activities and effort to the • Health intelligence provides quality • Develop a strong affinity between Whānau Ora outcomes-based and context-based insights to support the Health Care Home, Iwi and Māori framework and the Stats NZ Wellbeing decision-making to improve equitable providers and other community-based indicators health outcomes health, social and specialist services • Continue to drive the uptake and • Effective data stewardship and system • THINK Hauora will give effect to Te Awa– for Wellbeing for utilisation of Ka Ao, Ka Awatea Māori interoperability will improve the access Digital Strategy by continuing to drive the Health Strategic Framework and flow of information digital connectedness in our rohe KEY AREAS OF FOCUS Connecting Communities Communities Connecting Tūhonotia te Hapori te Ora ki te Tūhonotia

WHĀNAU ORA Rangatiratanga Hauoranga OUTCOMES Self-Managing Living Healthy Lifestyles

Kōtahitanga Whānau Cohesion

QUADRUPLE AIM Affordable care Excellent outcomes Manawatū Tararua Palmerston North

VALUE INNOVATION NETWORKING GROWTH Teams, technology, Quality improvement, Relationships, partnerships, Sustainability, system and performance excellence, engagement collective impact alignment focus

• Establish locality-based teams across the • Recognise and celebrate our provider • Partner with people, community and • THINK Hauora will give effect to the rohe to support whānau to meet their network achieving excellence every providers to collectively support our MidCentral DHB Health and Wellbeing health and wellbeing needs day in improving health outcomes communities’ aspirations Locality and Cluster Plans • Locality-based teams will be supported • Drive the implementation of the • Strive to become a trusted backbone • Diversify revenue streams to achieve by technology that enables mobility, district’s ‘Quality Agenda Shared organisation that supports cross-sector primary health care clinical and productivity, knowledge and safety Clinical Governance’ alliances within a collective impact financial sustainability methodology • THINK Hauora Outcomes Framework will • Achieving our local response to the • Cultivate innovative approaches focus expectations on equity of outcomes Mental Health Inquiry ‘Realising • Partner with local, national and to primary health care workforce and any related consumer and practice W.A.I.O.R.A - A Collective Voice’ international organisations to development to improve the incentives across our communities Programme of Action improve our approach to research and experience of providing care development

Tiaki Taiao Pukenga Rawa Responsible Stewards of Living & Economic Security & Natural Environments Wealth Creation

Tuakiritanga Pāporitanga Participating in Te Ao Māori Participating in Society

Excellent experience for Excellent experience those we serve for providers Developing a Whānau Ora Whānau Ora Outcomes approach to accelerate and Rangatiratanga ensure equity of Māori health Self-Managing outcomes W Kōtahitanga WHĀNAU ORA Whānau Cohesion Achieving wellbeing Whānau Ora Whānau Ora Outcomes Whānau Ora ensures the collective capacity Seven priority areas have been Hauoranga within all whānau to problem solve, to identified for concerted focus and Living Healthy nurture each other and to realise aspirations. attention which will ensure whānau Lifestyles Whānau is a crucial building block of flourish and on-going gains are made in society. Whānau Ora is about working in Māori health.

a way that recognises and builds on the Tuakiritanga Participating in Te Ao strengths and leadership with whānau, and Māori ensure whānau are supported to move in Positively support and a positive and self-managing way of life. influence cross-sector Tiaki Taiao In essence, the inclusion of Whānau Ora Whānau Ora and Wellbeing policy setting and direction Responsible Stewards principles within the values and philosophy of Living & Natural of primary health care providers will ensure Environments whānau-centred initiatives are embedded into everyday practice. Whānau Ora is one part of a systematic approach to Māori Pāporitanga health and improving outcomes for Māori. Participating in Society

Pukenga Rawa Economic Security & Wealth Creation Throughout the document you will see this tohu. It indicates our key areas of focus. The orange colour reflects Ka Ao, Ka Awatea (see page 16). Whānau ora tohu © Te Tihi

14 THINK Hauora 2019–2025 Strategy Te Puni Kōkiri Whānau Ora Stats NZ Wellbeing Indicators Outcomes Framework Empowering Whānau into the Future W Health

Whānau are self-managing and empowered leaders Social connections Whānau Ora and the Wellbeing Whānau are cohesive, resilient Indicators: and nurturing Indicators has worked alongside Education, skills and Stats NZ to develop a source of measure for Whānau are leading healthy training New Zealand’s wellbeing. These indicators lifestyles go beyond economic measure to include wellbeing and sustainable development. Wellbeing looks at current wellbeing, future Whānau are confidently Income wellbeing and trans-boundary impacts participating in Te Ao Māori (The (our impact on the rest of the world). Māori World) The wellbeing indicators have a direct relationship to the Whānau Ora Outcomes Whānau are responsible stewards Environment Framework and to Treasury’s Living of their living and natural Standards Framework. environment Align activities and effort to Whānau are participating fully in the Whānau Ora outcomes- society based framework and the Stats NZ Wellbeing indicators

Whānau are economically secure and successfully involved in wealth creation

THINK Hauora 2019–2025 Strategy 15 Ka Ao, Ka Awatea INNOVATION The Whānau Ora Outcomes Framework provides a tuarā (backbone) to the Māori Iwi and Integrated Health Strategic Framework of our rohe, Māori Family Ka Ao, Ka Awatea. Four areas have been General Providers Health TE REO WHAI PĀNGA TE MATATIKI Practices Centres identified as a pathway to improving Primary Whānau Input Resourcing whānau health: whānau input, resourcing, , i Health Health Care āor St Nursing new ideas and scaling up solutions. Ka Ao, Churches, M ra a t Kōhanga e e Ka Awatea recognises the many partners t g i Reo a c

delivering health services collectively to F PATHWAY TO w Te Tihi r A contribute to both individual and community IMPROVING a

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health. Sound relationships between WHĀNAU ,

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k a and effective communication systems K THINK Hauora are all pivotal to innovation and quality TE AUAHATANGA TE WHAKAWHĀNUI Community improvement in delivery of health services Pharmacy New Ideas Scaling up Solutions in our community. Manawhenua Hauora MidCentral Pae DHB Ora Continue to drive the uptake Q and utilisation of Ka Ao, Ka U T AL EN Awatea Māori Health Strategic ITY EM Framework IMPROV

16 Diagrams adapted from: Ka Ao, Ka Awatea, 2017–2022, Māori Health Strategic Framework THINK Hauora 2019–2025 Strategy W

THINK Hauora 2019–2025 Strategy 17 Driving equity of outcomes through people, community voice and data

E THINK Hauora knows that pursuing health “In Aotearoa New Zealand, people have EQUITY equity requires both equal and equitable differences in health that are not only opportunities for all social groups to be as avoidable, but are unfair and unjust. Equity People, community voice healthy as possible. This requires creating recognises different people with different and data-driven the right environments and having a clear levels of advantage require different focus on improving outcomes for those approaches and resources to get equitable groups who have had fewer opportunities health outcomes.” 1 – particularly Māori and Pasifika. Achieving Ministry of Health’s definition of Equity 2019. equity requires us to acknowledge that different groups of people may benefit from different approaches to achieve “Health equity, or equity in health implies comparable or equitable outcomes. We that ideally everyone should have a fair will partner alongside providers, whānau, opportunity to attain their full health and community to use data to support potential and that no one should be decision-making and drive innovation. This disadvantaged from achieving this will contribute to equitable health outcomes potential.” and lay the foundation to connecting World Health Organisation. communities for wellbeing.

Connect information and people to inform and transfer knowledge to develop innovative ways to improve equity

1. Dr Bloomfield, Director-General of Health, states that ‘having a common understanding of equity is an essential foundation for coordinated and collaborative effort to achieve equity in health and wellness. The definition fits the New Zealand context and aligns with Te Tiriti o Waitangi obligations. It also reflects international equity literature and the World 18 Health Organisation’s definition of equity.’ THINK Hauora 2019–2025 Strategy Health intelligence Data management has transitioned in-house The THINK Hauora data warehouse will over the last few years and has grown our enable a common lens across primary health E dynamic approach to health intelligence. Our care and support integration of multiple health intelligence team is responsible for data sources both within and outside of the capturing and utilising information to support health sector. Effective data stewardship decision-making to improve the health of the and system interoperability will enable population across our communities. Bringing a focus on equity, adverse variation and our data in-house will strengthen our trends to move us from a reactive analysis approach to improve health outcomes and (what has happened); to an informative address equity at the forefront. analysis (why did it happen); to a predictive analysis (what will happen). THINK Hauora is passionate and committed as a network to curate and use data, information, knowledge, and wisdom in co- Health intelligence provides operation with our health and social sectors. quality and context-based This data will be enriched with consumer, insights to support decision- whānau and community voice, and will be making to improve equitable made available for consumers, whānau and health outcomes communities to inform their decision-making. It is important that we propel our health system forward by enabling the meaningful Effective data stewardship and flow of health and social information to drive system interoperability will equitable health outcome improvement. improve the access and flow of information

THINK Hauora 2019–2025 Strategy The Manawatū River, image courtesy of Te Tihi 19 Ensuring access to health care is Five most pressing social determinants easy, available, cross-sectors of health to inflect to drive equity A strong primary health care system is Aligning health care with social services central to improving the health of all will encourage clinicians to think in broader New Zealanders and to reducing health terms about investment in health – and A inequalities between different groups. In this greater alignment has the potential ACCESS 2016, the Ministry updated the New Zealand to improve population health outcomes Housing Health Strategy. The Health Strategy while lowering spending on more expensive Easy, available, highlights the need for: traditional approaches. THINK Hauora is committed to providing leadership for the cross-sectors • a shift from treatment to prevention, inclusion of bold political choices for health improving consumers’ lives and across all sectors, therefore cultivating, Food supporting greater financial naming and treasuring relationships. sustainability • overcoming inequities across the health system to strive to deliver healthy Provide leadership for the outcomes for every New Zealander inclusion of bold political Economics • a thorough understanding of how to choices for health across all access the appropriate health options sectors available • creating customer-friendly services Interpersonal and removing barriers in order to achieve equity • the Ministry, health providers, other government agencies, NGOs and communities working together to Education address the social determinants of health

Source: NZ Health Strategy 2016 Source: Engaging Patients in Ongoing Care

20 THINK Hauora 2019–2025 Strategy Health Care Home The Health Care Home model is a key driver to improving access for increased services closer to home, more proactive care, improved self-management, improved consumer experience, and better community health and social service integration. Health Care Home has four core domains: • Ready access to urgent and unplanned care • Proactive care for those with more complex needs A • Better routine and preventative care • Improved business efficiency and sustainability The Health Care Home summary characteristics described on page 22 are supported by a national data set. They focus general practice teams on diversifying access, population health, long term condition, and acute care management at a practice and system level. These measures are part of the THINK Hauora Outcomes Framework on page 43.

All measures will be reported through an appropriate equity lens

THINK Hauora 2019–2025 Strategy Image courtesy of Te Tihi 21 Health Care Home Summary Characteristics

Equity lens Health plans Prework Continuity of Information Affordability care Technology systems support

Same day access Access to care Patient wait Telephone Cultural needs Patient Fully Alternatives to Patient Proactive and appointment during business times assessment engagement functional F2F consults experience planning systems hours and treatment portal (clinical triage)

Health literacy Call demand Appointment Extended Health records monitored systems hours Urgent and Routine and Business efficiency Proactive care unplanned care preventative care and sustainability

LEAN process Continuous Staff training Workflow Standardisation in place quality improvement

Risk Development Cultural Interdisciplinary Community Care co- Family Practice layout Reception F2F Workforce Clinical Extended stratification of care plans consideration approach based ordination infrastructure and call free planning and leadership practice team in care plans resources development

22 Source: Health Care Home, Model of care requirements, December 2018 THINK Hauora 2019–2025 Strategy fluences all aspec h in ts o alt f li He fe

Our approach to Health Care Home Effective relationships and linkages with Iwi and Māori providers along with community- based health and social services are Individual Family Education Environment paramount to achieving the four domains Health Whānau Housing Economy of Health Care Home. Community Social support System connection with MidCentral DHB A Workplaces specialist services is instrumental. The Transport development of the new DHB integrated Recreation service models and accompanying clusters have outlined their commitment to support M the Health Care Home programme across a th ny eal our rohe, enabling a partnership focussed fact to h Source: New Zealand Health Strategy, Future direction ors contribute on care delivery closer to home.

Develop a strong affinity between the Health Care Home, Iwi and Māori providers and other community-based health, social and specialist Community- Iwi and DHB services THINK based health Māori specialist Hauora and social providers services service

THINK Hauora 2019–2025 Strategy 23 Digitise our consumers, Digital, data-enabled Inclusive information families and whānau decisions stewardship and experience Improve safety and outcomes, reduce management individual and population inequity through Improve access to information enabling Quality and trustworthiness of information use of data for better insights, real- greater involvement of people and whānau for all system participants with timely, safe time decision-making, risk stratification, MidCentral DHB Te Awa–Digital in wellness and planning, better and more and appropriate access to knowledge and population wellness planning, analysis of Health Strategy Objectives convenient access to services, easier information. wellness outcomes to improve pathways, navigation and proactive, individualised The district’s Te Awa–Digital Strategy system performance analysis and reporting. wellness and care. supports improved access and achievement of the four Health Care Home domains.

THINK Hauora will give effect to Te Awa–Digital Strategy by continuing Digitise our end-to-end to drive the digital Interconnected Stable, secure, connectedness in our rohe processes communication and responsive and Smoother, safer, more informed and collaboration sustainable ICT services co-ordinated wellness journeys across organisational boundaries and between Greater level of communication, co- Ensure the integrity, continuity, services with optimised workflow, and better ordination and teamwork amongst all interoperability and performance of alignment of resource to demand. system participants. systems, rationalise applications, consolidate infrastructure, automate, simplify and digitise processes with continued co- investment in innovation and emerging technologies with a vibrant ecosystem of industry partners.

24 THINK Hauora 2019–2025 Strategy Realising digital transition in our rohe THINK Hauora will drive digital connectedness in our rohe.

The enablers IT Infrastructure Cloud-based PMS e-referrals Data warehouse Data stewardship and = Influencing governance Technology Telephony Shared electronic Collaborative clinical Self-service health national activity health record pathways intelligence System transition Cyber-risk and interoperability and security MDT shared care plan Electronic discharge Monitoring design dashboards READcodes to Patient portal DHB appointment SNOMED CT scheduling tool Data management A Clinical portal

= enabling the consumer to shape service delivery

Underpinned by identity management to enable management of access and single sign on to all systems Rohe ecosystem change ecosystem Rohe Achieving = health knowledge professionals co- Health Reactive analysis–what has happened? Why did it happen? Predictive–what will happen? designing people- intelligence centred services transition in partnership with other sectors

THINK Hauora 2019–2025 Strategy 25 Creating value through teams, technology and performance

Locality-based teams teams and will be responsible for preventing and managing long term conditions. The lf-Manageme THINK Hauora will continue to partner Se nt Long Term Conditions Population to Last V to develop suitable, durable and Self-Testing Days of Life framework on page 28 will be versatile locality-based teams across our VALUE used to organise the long term condition communities. A key focus will be on self lf-Awarene approach across the localities. THINK Se ss Teams, technology, care and the alignment of community health Hauora long term conditions, mental health, and social services. performance acute care, population health programmes Priorities for service alignment at a and resources will be aligned to the primary locality level will be identified through the health care teams. A strong affinity between aspirations and needs of the community. the Health Care Home, Iwi and Māori Self-Care This will involve establishing new ways of providers and community-based health and Everyday life working, reconfiguration of the workflow social services will be established. Effective and identifying efficiencies and capacity processes and technology to work in release to enable staff to work closely across collaboration with the specialist services will primary, community, specialist and social be enhanced. services. Technology will play a key role. Self care is the ability of individuals, whānau The locality teams will align to six principles: and communities to promote health, prevent Establish locality-based teams disease, maintain health and to cope with • People and whānau-centred across the rohe to support illness and disability with or without the • Accessible and virtual whānau to meet their health support of a transdisciplinary primary health and wellbeing needs care team. • Comprehensive • Co-ordinated • Continuity and choice-enabled • Accountable Comprehensive primary health care teams provide the foundation of the locality-based Source: WHO Consolidated Guideline on Self-Care Interventions for Health, 2019

26 THINK Hauora 2019–2025 Strategy Transdisciplinary Primary Health Care Team (Health Care Home)

People and whānau are leaders in their care and are supported by their primary health care team Strong affinity with who they know and trust. The team provides comprehensive health care Iwi and Māori providers and across the lifespan and co-ordinates care to community-based health meet the health and wellbeing of the community. and social services

People, whānau and their local community are leaders who are actively included in creating solutions for achieving their health and wellbeing. V People are able to access health and wider sector services which promote Aligned specialist health outcomes that are important to district-wide services them. If required, support and guidance from their primary health care teams will contribute to this. Collaboration between specialist services and primary health care teams will be enhanced to deliver comprehensive health care.

People self-manage and access support virtually and close to where they live, work and play

THINK Hauora 2019–2025 Strategy 27 Long Term Conditions Population Health to Last Days of Life

Well/at risk population Self Care, health promotion and prevention, early detection and intervention, diagnosis and treatment

Diagnosed: mild complications or impact Clinical and wellbeing indicators are within acceptable range Predominantly general practice based with referral to Iwi and Māori and other health and social service providers

Diagnosed: mild complications or impact Clinical and wellbeing indicators are not within acceptable range Self-management support is required Predominantly general practice based with referral to Iwi and Māori and other health and social service providers

Moderate complexity, severity or impact Structured co-ordinated care provided by a responsive comprehensive PHC team, this may include Iwi and Māori and other health and social service providers

High complexity severity or impact Case management provided by teams as above and in collaboration with specialist services

End stage Integrated palliative care

28 THINK Hauora 2019–2025 Strategy Equity and innovation Security

Digital health initiatives and innovations are to be Establish cyber citizenship (one secure log in) consumer-led Technology Build resilience in the new cyber world Digital health initiatives in the district will Enable interoperability in information systems to be consumer-led and will encompass the ensure a streamlined flow of information models of care that provide for hauora. Robust governance, compliance and auditing that Consumers will help co-design inclusive provides confidence in the use of information for district information stewardship and Invest in health IT such as wearable devices, smart consumers and the workforce security policies to support the quality watches, in-home digital support domains and whānau ora outcomes. Contribute to national architecture design that Technology will enable a connected up Introduce tools and services that simplify health and enables data translation to knowledge environment where information is readily wellness for consumers, whānau and the workforce shared to support timely, digital, decision Tools and training to develop a skilled workforce making and equity-based population Digital health literacy for consumers, whānau and the conversant with health informatics health investment decisions. Locality based workforce teams will be supported by technology V that digitizes the consumer, whānau and workforce experience and will change the Knowledge and analytics way we communicate and collaborate. Productivity and mobility Processes will be automated wherever possible to enable the workforce to focus on Bidirectional data flows activity that best uses their skills. Develop autonomous ICT infrastructure that is secure and self-governing Predictive population health data that drives equity- based investment Locality-based teams will be Introduce workforce efficiency supported by tools supported by technology that and services that allow teleworking and cloud-based Democratize data to enable evidence-based decision enables mobility, productivity, anywhere, anytime collaboration knowledge and safety making across the workforce Replace manual processes with digital tools-based Curated and centralised data repository to be workflows responsive to local health intelligence needs

Operate from anywhere, anytime, using any device

THINK Hauora 2019–2025 Strategy 29 Performance Our performance will be aligned with a & Quad nau Or ruple A WEAVING and will be reported at a locality Whā im level within the THINK Hauora Outcomes Framework on page 43. The overarching THINK Hauora outcomes encapsulate the Whānau Ora outcomes and Home Nation Care al Da the quadruple aim: alth ta S He et • Affordable care • Excellent outcomes • Excellent experience for those we serve Quailty Domains • Excellent experience for providers High levels of performance in aligning health and social care will be achieved em Level Measu through engaging clinicians and system Syst res leaders in collecting and monitoring performance data. A feedback loop on key outcome measures will be used to effect change and connect local quality Ka Aw improvement activities. Ka Ao, atea The specific measures in the THINK Hauora Outcomes Framework include Ka Ao, Ka Awatea, System Level Measures, Quality Domains and the National Health Care THINK Home Domains (outlined on page 33). Hauora WEAVING

30 THINK Hauora 2019–2025 Strategy System Level Measures

Preventing and detecting disease early Ensuring patient-centred care System Level Measures are set by the Ministry of Health and the Contributory Measures are co-designed measurements focusing on children, youth and high priority Amenable mortality rates Patient experience of care populations. All the measures and indicators will be set annually and supported by agreed local consumer and practice incentives. This Outcomes Framework will foster high Keeping children out of hospital Ensuring a healthy start trust outcome-based agreements across our provider network. V

Ambulatory sensitive hospitalisations (ASH) Proportion of babies who live in THINK Hauora Outcomes 0-4 years old smoke-free households Framework will focus expectations on equity of outcomes and any related consumer and practice incentives across our communities Using health resources effectively Youth are healthy, safe, and supported

Acute hospital bed days per capita Access to, and utilisation of, youth appropriate health services

THINK Hauora 2019–2025 Strategy 31 Activating innovation, improvement, engagement and delivery of excellence

I The THINK Hauora network will build on Central to the THINK Hauora quality INNOVATION our track record of co-designing innovative improvement approach has been the co- approaches in response to the aspirations of designing of a district-wide Quality Agenda Quality improvement, the communities we serve. Building on the Shared Clinical Governance Framework excellence, engagement traditional through modern design. Over in collaboration with MidCentral DHB. recent years we have deliberately developed Underpinning quality improvement are into a values-based network and have engaged consumers, providers and system. proven that working collaboratively with our contracted providers and communities through engagement and co-design is not Drive the implementation of only enjoyable but has created a platform the district’s ‘Quality Agenda for excellence every day. Shared Clinical Governance’

Recognise and celebrate our provider network achieving excellence every day in improving health outcomes

32 THINK Hauora 2019–2025 Strategy Quality Domains The quality domains and consumer, provider and system meanings depicted below are incorporated into the THINK Hauora Outcomes Framework.

Domain Consumer/Whānau Meaning Provider Meaning System Meaning

Our safety system is robust and will identify Haumaru My whānau and I will not be harmed by the The care our consumers receive does not if things are going wrong. It looks after our health system. cause harm. Safe people (our population and our providers).

My whānau and I receive the right The care provided is based on best Whaihua Our quality culture supports quality treatment for conditions, and it contributes evidence and produces the desired improvement, innovation and research. Effective to improving health. outcome.

My goals and preferences drive my Arotahi ki te Joint decisions about our consumers’ We have an organised consumer voice wellbeing/care plan. My whānau and I are kiritaki care reflect the goals and preferences of across our rohe that ensures we partner treated with respect and dignity. I am at the consumer and his or her whānau or with people and whānau to support health Consumer- the centre of all my care decisions. Nothing caregivers. and wellbeing. centred about me without me.

We deliver care to our consumers using Our models of care ensure health and The care my whānau and I receive from Māia available human, physical and financial social care alignment. Resources are all practitioners is well co-ordinated and resources efficiently, with no waste to the deployed to ensure best value for our Efficient efforts are not duplicated. system. community. I

I know how long I must wait to see my Our consumers can receive care within an Wā tōtika health care team for tests or treatments Our aligned system will ensure people appropriate and acceptable time after the I need and why. I am confident this wait receive health care in a timely way. Timely need is identified. time is safe and appropriate.

Our consumers have access to the services they need regardless of their location, age, We have strong and enduring health Kia tōkeke ai No matter who I am or where I live, I can gender or socio-economic status. The equity leadership across the rohe at all access services that benefit me. treatment provided aims to ensure equity Equitable levels. of outcome so may be different to suit the specific needs of the person.

THINK Hauora 2019–2025 Strategy 33 The W.A.I.O.R.A Model Whānau Ora Resiliency and recovery THINK Hauora is poised to work with Models of care such as Whānau Ora and Resiliency refers to the ability of individual partners across the sectors to drive new whānau-focused initiatives have been and whānau to respond adaptively to life innovative ways of realising the aspirations identified as offering significant potential events, human development stages and of our five distinct communities. THINK benefit within the revitalisation/re-think of rites of passage. Hauora through engagement with partners mental health. has been at the forefront of working across All together sectors in co-designing improvements Access and availability across the system. A recent example Waiora/wellbeing is achieved using a Whānau of partnering to collectively support Access to and availability of appropriate Ora, whole-of-system and cross-sectoral community aspirations was our contribution wellbeing services that facilitate flourishing approach across all services and activities to the response in 2018 to the Government’s individuals, whānau and communities over which have the potential to contribute Inquiry into Mental Health and Addictions. the life course and along the wellbeing to flourishing individuals, whānau/family, continuum. communities and environments. The key drivers for the Inquiry were inequalities in mental health and addiction The Wellbeing Budget 2019 is taking outcomes, underfunding of mental health and Identity and indigeneity mental health seriously and has announced addiction services, and high suicide rates. A strong and flourishing personal, cultural additional investment in strengthening and improving services. Locally, we garnered our combined and community identity is considered within strengths and used this Inquiry to provide the context of overall wellbeing. a collective and intersectoral, robust voice Opportunities Achieving our local response on the specific changes needed to enable to the Mental Health Inquiry improved and equitable outcomes. Our The focus for prevention, early intervention ‘Realising W.A.I.O.R.A - A vision for the future direction, structure and health promotion at a wider system Collective Voice’ Programme and delivery of mental health services is level is considered. of Action harnessed in W.A.I.O.R.A.

34 THINK Hauora 2019–2025 Strategy Achieving Whānau Ora THE W.A.I.O.R.A MODEL Rangatiratanga Self-Managing Holistic wellbeing across the wellbeing continuum and life course with a focus on flourishing individuals, whānau/family, communities and environments

Kōtahitanga Whānau Cohesion

Hauoranga Living Healthy lbeing › Resilie Lifestyles Wel nce › Prev ry ention › Recove Tuakiritanga Participating in Te Ao W A A Māori Whānau Access & I Availability R All Together Tiaki Taiao Ora Identity & O Responsible Stewards indigeneity Opportunities Resilience & of Living & Natural I Recovery Environments mariki Chi fants Ta ldren R ēpi In angat P ahi Yo uth P Pāporitanga akeke ersons Adults Kaumātua Older P Participating in Society

Pukenga Rawa Economic Security & Wealth Creation

THINK Hauora 2019–2025 Strategy Whānau ora tohu © Te Tihi 35 Enabling networking and relationships to achieve partnerships

N Partnering with people, community THINK Hauora believes that the people, NETWORKING and providers to collectively support providers and communities we serve have communities’ aspirations is fundamental to great strengths upon which to base change Relationships, our success. strategies. Collective impact engages partnerships, collective people, providers and communities as partners in the capacity building process. impact Partner with people, Collective Impact nurtures relationships and community and providers to appreciates that relationships are key to collectively support community everyone’s success. aspirations

Strive to become a trusted THINK Hauora strives to become a trusted backbone organisation that backbone organisation that supports cross- supports cross-sector alliances sector alliances within a collective impact within a collective impact methodology. Synergistic relationships will methodology be focused on the basis of mutual benefit. This methodology recognises that issues We are committed to building authentic and faced by organisations and communities strong partnerships locally, nationally and are multi-faceted and require holistic internationally. One aspect of this will be to approaches. Many organisations and continue to develop our approach to research communities operate in fragmented, and development as this is central to the restrictive, and systems-driven execution of our THINK Hauora strategy. environments. Their efforts are often isolated within categorical silos according to funding streams, operational regulations, Partner with local, national and and disciplinary theories and methodologies. international organisations to improve our approach to research and development 36 THINK Hauora 2019–2025 Strategy Collective Impact

Shared whānau and community aspirations drive our partners’ shared vision for change Common Agenda including a common understanding of the joint approach

Diverse Voices • Responsive • Community Aspiration

Collecting data, measuring results consistently across all partners to facilitate insights and Shared Measurement strategic learning

Alignment • Tracking Progress • Insights • Strategic Learning

A mutually-reinforcing plan of action with a focus on high leverage and loose/tight working Mutually-Reinforcing Activities relationships

Weaving • System • Supportive • Centred

Consistent and open communication to partners and pathways for authentic engagement Continuous Communication for whānau and communities

Trust • Transparency • Ongoing • Engagement

Creating and managing collective impact requires dedicated staff and skills to serve as the N Backbone Support container for change for the entire initiative to coordinate participating organisations and agencies

Facilitate • Convener • Co-ordinate • Movement

Source: Collective Impact: A Framework for Community Change, 2017

THINK Hauora 2019–2025 Strategy 37 Driving sustainability through system and alignment focus

THINK Hauora has contributed to the THINK Hauora is confident that the An engaged networked healthcare MidCentral DHB Health and Wellbeing elements of WEAVING outlined throughout workforce is vital to achieving this G Locality and Cluster Plans. These plans the strategy will demonstrably contribute strategy. THINK Hauora aspires to meet are supported by an Integrated Service to the achievement of MidCentral’s four the quadruple aim of affordable care, GROWTH Model and at the heart of the model is the strategic imperatives. excellent outcomes, excellent experience development of seven clusters supported for those we serve, and excellence for Looking to the future, THINK Hauora is Sustainability, system by enabler groups. The cluster arrangement providers. This includes fostering an well-positioned to develop, investigate and is a structure to enable MidCentral DHB engaged networked healthcare workforce. and alignment focus secure firm partnerships to diversify revenue to organise services to achieve their four THINK Hauora is committed to cultivating streams that enhance elements contained strategic imperatives: innovating approaches to primary health within this 2019–2025 Strategy. Work is care workforce development to improve the • Achieve quality and excellence by occurring in this arena. We have an exciting experience of primary care. design future ahead developing relationships and forming new alliances. With the new An engaged workforce is vital to achieving • Connect and transform primary, initiatives on the horizon, THINK Hauora, in the goals of our strategy. At the core of community and specialist care partnership with the provider network, will workforce engagement is the experience • Partner with people and whānau to strive to achieve primary health care clinical of joy and meaning in healthcare work; support health and wellbeing and financial sustainability. the sense of accomplishment and purpose • Achieve equity of outcomes across of contribution. THINK Hauora values communities its workforce. Like the harakeke, growth Diversify revenue streams and development of the THINK Hauora to achieve primary health workforce is both protected and nurtured. THINK Hauora will give effect care clinical and financial to the MidCentral DHB Health sustainability and Wellbeing Locality and Cultivate innovative Cluster Plans approaches to primary health care workforce development to improve the experience of providing care

38 THINK Hauora 2019–2025 Strategy G

THINK Hauora 2019–2025 Strategy Image courtesy of Te Tihi 39 IN SUMMARY

THINK Hauora – Technology, Health, Ehara taku toa i te toa Innovation, Networks and Knowledge – is the overarching focus of our mahi being takitahi, engari he toa carried out across our network as we strive to achieve excellence every day. takitini Our 2019–2025 Strategy is aspirational. We My strength is not that are aiming high for what is truly valuable — HAUORA. We must partner with people of an individual but that and whānau as we connect communities for of the collective wellbeing. To achieve WEAVING, together Māori proverb we must commit to staying focussed, persistent, and gain momentum to propel us toward our goals and to deliver our areas of key focus. THINK Hauora will refresh its key areas of focus in partnership with our five communities over the next six years. The network will agree on a suite of measures that are aligned to the THINK Hauora Outcomes Framework annually. The following two pages provide a high level overview of the THINK Hauora Strategy and THINK Hauora Outcomes Framework.

40 THINK Hauora 2019–2025 Strategy THINK Hauora 2019–2025 Strategy Pohangina Valley, Image courtesy of ManawatūNZ.co.nz 41 STRATEGY AT A GLANCE 2019–2025 Tūhonotia te Hapori ki te Ora Connecting Communities for Wellbeing

STRATEGIC AIMS KEY AREAS OF FOCUS WHĀNAU ORA OUTCOMES Positively support and influence cross-sector Whānau Ora and Wellbeing policy setting and direction Whānau Ora Affordable care Align activities and effort to the Whānau Ora outcomes-based framework and the Stats NZ Wellbeing Rangatiratanga Achieving indicators Self-Managing wellbeing W Continue to drive the uptake and utilisation of Ka Ao, Ka Awatea Māori Health Strategic Framework Connect information and people to inform and transfer knowledge to develop innovative ways to improve Equity equity People, Kōtahitanga Health intelligence provides quality and context-based insights to support decision-making to improve community voice Whānau Cohesion equitable health outcomes outcomes E Excellent and data-driven Effective data stewardship and system interoperability will improve the access and flow of information Provide leadership for the inclusion of bold political choices for health across all sectors Access Develop a strong affinity between the Health Care Home, Iwi and Māori providers and other community- Hauoranga Easy, available, A based health, social and specialist services Living Healthy cross-sectors THINK Hauora will give effect to Te Awa–Digital Strategy by continuing to drive the digital connectedness Lifestyles

in our rohe QUADRUPLE AIM Excellent experience for those wefor those serve Value Establish locality-based teams across the district to support whānau to meet their health and wellbeing needs Tuakiritanga Teams, Locality-based teams will be supported by technology that enables mobility, productivity, knowledge and safety Participating in technology, V THINK Hauora Outcomes Framework will focus expectations on equity of outcomes and any related Te Ao Māori performance consumer and practice incentives across our communities Innovation Recognise and celebrate our provider network achieving excellence every day in improving health Tiaki Taiao Quality outcomes Responsible improvement, Drive the implementation of the district’s ‘Quality Agenda Shared Clinical Governance’ Stewards of Living & excellence, I Achieving our local response to the Mental Health Inquiry ‘Realising W.A.I.O.R.A - A Collective Voice’ Natural Environments COMMITMENT TO TE TIRITI O WAITANGI TO COMMITMENT engagement Programme of Action Partner with people, community and providers to collectively support our communities’ aspirations Networking Excellent experience Strive to become a trusted backbone organisation that supports cross-sector alliances within a collective impact Pāporitanga Relationships, for providers methodology Participating partnerships, in Society collective impact N Partner with local, national and international organisations to improve our approach to research and development Growth THINK Hauora will give effect to the MidCentral DHB Health and Wellbeing Locality and Cluster Plans Pukenga Rawa Sustainability, Diversify revenue streams to achieve primary health care clinical and financial sustainability Economic Security system and Cultivate innovative approaches to primary health care workforce development to improve the experience & Wealth Creation alignment focus G of providing care COMMUNITIES HOROWHENUA MANAWATŪ ŌTAKI PALMERSTON NORTH TARARUA OUTCOMES FRAMEWORK Tūhonotia te Hapori ki te Ora Connecting Communities for Wellbeing

SYSTEM LEVEL QUALITY HEALTH CARE STRATEGIC AIMS KA AO, KA AWATEA WHĀNAU ORA OUTCOMES MEASURES DOMAINS HOME DOMAINS Affordable care Preventing and

Whānau Ora Te Reo Whai Pānga detecting disease early Rangatiratanga Achieving wellbeing Whānau Input Reduce amenable Self-Managing W Haumaru mortality rates Whānau aspirations, Safe priorities and values Equity are sought, heard and Keeping children out of People, community Kōtahitanga considered. Whānau are hospital Urgent and outcomes voice and data- Whānau Cohesion Excellent at the core of all decisions Reduce ASH rates for unplanned care driven E 0-4 year olds Whaihua Te Matatiki Effective Resourcing Access Using health resources Hauoranga Easy, available, Build capacity and Living Healthy supporting structures effectively cross-sectors A Reduce acute hospital Lifestyles Proactive Care to allow system wide Arotahi ki te QUADRUPLE AIM

bed days per capita Excellent experience understanding of complex kiritaki wefor those serve problems Consumer-centred Value Tuakiritanga Teams, technology, Te Auahatanga Ensuring patient Participating in performance V New Ideas centred care Te Ao Māori Whānau and Iwi are the Improve patient Routine and Māia Innovation centre for collaboration experience of care preventative care Efficient Tiaki Taiao Quality where diverse and local Responsible improvement, groups can develop new Stewards of Living & excellence, I ideas and solutions Ensuring a healthy start Increase proportion Natural Environments COMMITMENT TO TE TIRITI O WAITANGI TO COMMITMENT engagement Te Whakawhānui of babies who live in Wā tōtika

Scaling up Solutions Excellent experience Networking smoke-free households Timely Business efficiency and Pāporitanga Relationships, Successful innovation for providers Participating partnerships, N is linked by systematic sustainability in Society collective impact changes in mindset, Youth are healthy, safe, supported policy, process and Kia tōkeke ai structure to sustain Increase access to, and Growth Equitable whānau utilisation of, youth Pukenga Rawa Sustainability, appropriate health Economic Security system and G & Wealth Creation alignment focus CONTRIBUTORY MEASURES, QUALITY AND WELLBEING INDICATORS (ANNUAL)

COMMUNITIES HOROWHENUA MANAWATŪ ŌTAKI PALMERSTON NORTH TARARUA REFERENCES

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44 THINK Hauora 2019–2025 Strategy Mā te whiritahi, ka whakatutuki ai ngā pūmanawa ā tāngata

Together weaving the realisation of potential 2019–2025 Strategy