2015-16 Annual Report

FROM THE invest in Tui Ora Family Health and the new technology platform. Going Board Chairman forward, Tui Ora aims to diversify its revenue sources and reduce the very high weighting from government contracts. Tui Ora Family Health Financial Performance of Tui Ora The development of our Tui Ora Family Health centre 2016 (000’s) 2015 (000’s) 2014 (000’s) 2013 (000’s) was one of two large investments the board Income 14,078 13,971 13,034 10,302 authorised. Modernising the facility, opening more Expenses 13,758 13,327 12,500 9,981 consultation rooms, improving the reception area and designing the facility from staff and patient Net Surplus 320 644 533 321 insights has meant Tui Ora and our community can Assets 6,821 6,852 6,179 4,427 look forward to an enlarged and improved GP clinic. Liabilities 3,949 4,300 4,271 3,145

Modernising technology platform The Tui Ora Board This was the second major investment authorised by the board. Tui Ora Finance, staff, whether located in New Plymouth, Patea, Hāwera, Waitara, Opunake, Role Audit & Risk Cultural Clinical Okato or Stratford can locate information much more easily and respond to requests more quickly. The new platform removes the reliance on old Wayne Mulligan Chair hardware and servers and now is a Cloud-based solution. Debbie Packer Deputy Member Liana Poutu Director Member Chair Strengthening Tui Ora Dr Diane Jones Director Chair Tui Ora is a large employer in and that brings many responsibilities Robin Brockie Director Chair for the board, management and staff. The new Health and Safety Act Te Urumairangi Ritai Director Member Member requires new reporting, plus an absolute commitment to training staff and Hayden Wano Executive holding them equally accountable for health and safety. The board is Director resolute that staff safety is paramount, and Tui Ora wishes to be a leader in its practices. Shelley Kopu Director Member Te Raukura Tui Ora appointed two directors, Robin Brockie and Te Urumairangi Ritai in January 2016. At the time of writing Shelley Kopu will be appointed as a third Tui Ora has initiated Te Raukura, a cultural competency programme. It new director. They each add key skills and experience (for details see over commenced this year and there’s an expectation that all staff will the page) which are complementary to the skills and experience of our complete the cultural training. existing directors. Financial performance On behalf of the board, I and my fellow directors look forward to 2017 and the continued development and growth of Tui Ora. Sound financial performance is central to developing the programmes outlined above and for building transparency. The board has achieved Nāku noa iti, surpluses for the past four years. These surpluses have enabled Tui Ora to Wayne T Mulligan

FROM THE business guru Peter Drucker). A business can reach more people and help provide better Chief Executive have the best ideas and strategies in the world access to services – general practice is typically but unless the culture is supportive, strategies the front door for many people entering healthcare. Over the past year we can be significantly compromised over time. Te Kawau Mārō, our alliance with Ngāti Ruanui, have begun introducing This was also the year that Tui Ora initiated two Ngā Ruahine and Taranaki District Health Board Te Raukura, our large projects as we looked to the opportunities (TDHB), has increasingly matured to a point where investment in staff and of new technology and greater collaboration in it is normal practice to talk about service the wider organisation. the health sector. opportunities in a unified way. Our current It’s a cluster of tikanga Moving our data to a Cloud-based system was an collaboration is centred around a common principles that can be ambitious project for an organisation of our size. model of care for māmā, mātua, pēpe and tamariki. This is about putting whānau and people at the applied universally. Existing infrastructure was ageing and we didn’t want to continue spending capital on technology centre of the model; one of the impacts will be to About 55% of Tui Ora encourage staff to work in team settings – a different staff are Pākehā and that needed regular replacement. The project also reflects a shift away from hardware to a focus way of practising to the traditional model of health. 40% Māori so this on data and information, and how it can be best I would like to acknowledge the board and kaimahi provides them with confidence as well as used to understand our population and their needs. of Tui Ora - the board for its strategic leadership practical ways in which to engage The other investment has been in Tui Ora Family and colleagues and staff for their commitment to sympathetically and build more effective Health. Renovating and expanding the practice in supporting the vision of Tui Ora. We have seen relationships as a practitioner. Maratahau St, New Plymouth, came about because another strong financial performance for our These core principles or values enable us to we lacked capacity to employ additional staff and organisation, thus ensuring our future sustainability. reward and reinforce behaviours considered to grow our service. It’s an integral part of the new We are an intergenerational organisation, that is Annual Reportinvesting in our future and that of the people we serve. be supportive of our vision. It’s generally accepted model of care which is driving better integration in many sectors, including business, ‘that culture across Tui Ora and within the wider health and Noho ora mai eats strategy.’ (A phrase arguably attributed to social system. This is an important response to Hayden Wano

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felt at hearing Tui Ora staff – of all that attracted him to the opportunity Legacy ethnicities – singing waiata and Appointments of joining the board of Tui Ora. remembered engaging in the tikanga. “He was so to Tui Ora Board Te Urumairangi (Pam) Ritai comes to proud of the developments of all Kei ō tātou aituā kua hinga Tui Ora welcomed two new the board with many years’ kaimahi, Pākehā and Māori, and experience, including 50 years as a atu rā. Kua karangatia ō of everyone coming together as board members this year. tātou ā. Kua [hinga] atu rā registered nurse and for the past 20 one,” said his daughter Mary Jane Robin Brockie is a recently retired years in clinical management and ngā manu tīoriori. Kua pāngia Waru. partner of the chartered accounting leadership roles for Manaaki Oranga ō tātou mate e te ringa kaha o In the past two years Tui Ora has practice of Staples Rodway Taranaki Ltd and Tui Ora. Recently retired, Te aituā. Haere haere haere. farewelled other people significant where he had been a partner for 31 Urumairangi has continued to be an Matua Mahau Waru was to its development. Alex Ritai, the years. During that time, he provided a active participant on health and iwi variety of services to businesses as remembered and farewelled husband of board member Te governance boards. She is Urumairangi (Pam) died in March, well as the wider Taranaki community. committed and dedicated to Māori by Tui Ora kaimahi this year Throughout his career, Robin has following his sudden death. Kuia Makere Wano and Kuia Mere health kaupapa to improve the Broughton passed away in 2015, worked with a variety of Māori health and social wellbeing of Māori As Executive Kaumātua he and in 2014 Matua Pue Whakaruru organisations and it was this experience and high needs communities. was widely acknowledged as was farewelled. a man who took time with All had contributed over the years people and was generous to the development of Tui Ora, with his cultural knowledge. noted CEO Hayden Wano. He began with the organisation “There’s a dynasty that has been after first working in the mental part of us that has gone. It is now health area with Te Rau Pani, an up to a new generation to carry early Māori health provider. At an the mantle forward.” organisational farewell his family noted the pleasure he would have

and he has links to Ngā Ruāhine, Ngāti Early immersion Ruanui, Taranaki and Ngāti Mutunga. in te reo Most recently he taught at Te At the age of seven, Sonny Pihipihinga Kākano mai i Rangiatea in New Plymouth, sharing the tikanga, Murray was speaking on the the knowledge with young Māori.​ Talking teeth in marae. Now he brings his wealth Seeing students grow from new Tui Ora already had a relationship of cultural knowledge to Tui Ora entrants to sitting on a paepae, with the Otago Faculty of Dentistry the community where he has started as the participating in and leading pōwhiri, which saw it supporting dental Understanding the links Executive Kaumātua. was hugely satisfying. students in Taranaki. The new between culture and health is agreement cemented the Brought up by his great-aunt in At Tui Ora he sees himself as a young more tangible for relationship as well as ensuring the Normanby, he spoke only te reo until kaumātua, working alongside the dental students thanks to a university is now linked with all the he started school in Hāwera. organisation’s existing group of formal relationship between iwi of Taranaki through the Graduating from primary school to kaumātua/kuia. “I think with Otago University and Tui Ora. ownership structure of Tui Ora. Hato Pāora College, the expectations kaumātua it’s about wisdom, it’s A Memorandum of Agreement Otago University has similar stuck: “At all the schools I went to I not necessarily about age. It’s signed on 17 February 2016 ensures agreements with seven other iwi was the speaker. It was embedded what you can provide whether it’s students at Otago gain first-hand health providers, and says it’sAnnual serious in me I suppose.” Reportkarakia, whether it’s taking groups work experience of a kaupapa about providing multi-cultural Sonny’s whakapapa encompasses on to a marae, welcoming others, Māori organisation. It will also help programmes to prepare students the three of the region, there is a lot to do with facilitate research into Māori health. for dentistry in the “real world.” Tokomaru, and Kurahaupō, manaakitanga.”

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WAIRUATANGA

TINO RANGATIRATANGA

WHANAUNGATANGA

MANAAKITANGA patients and better treatment Dual role for outcomes. It is a process I truly KOTAHITANGA new Clinical believe in, am familiar with from my previous experiences, and Director hope to implement soon.” TIKANGA O TUI ORA Midway through 2016, Dr Gal Gal moved with his family from Carmi was named clinical Israel, having spent the previous director at Tui Ora Family six years as a family physician and Health (TOFH) in a newly- the last one and a half years as a created role. clinic manager in the Northern part of the country. The family has Currently working as a GP at TOFH, settled in Oakura. Gal is enthused about the dual nature of his new job which will see Getting used to the Kiwi health Taking him continue in the practice as system was a priority when he first well as stepping up to the Tui Ora started at Tui Ora Family Health in executive leadership team. October 2015. Another focus was culture the role that culture plays in the The clinical director role will relationship between patients and enhance services at TOFH and GPs. “Both my clinical experience to heart add to the quality of treatment for over the past year and the ongoing clients. An essential element of Our innovative cultural cultural studies and events, which succeeding will be team work, says training called Te Raukura, are part of the kaupapa of Tui Whanaungatanga, Manaakitanga, Gal, who also hopes to improve launched this year, is named Ora, have helped me gain a better Kotahitanga and Tikanga O Tui Ora. working interactions between after the three white feathers understanding of the culture, the The project team of Glenarr other Tui Ora services. which hold significance for all role it plays in my clients’ lives, Huntley, Hinenui Wano-Bryant and “Achieving good integration will and a better appreciation of the Taranaki iwi. The symbolic trio Trenton Martin developed the result in better support for the concept of whānau.” are an emblem of peace and content for a series of face-to-face of the passive resistance workshops. movement that began at They describe it as getting the in coastal Taranaki. principles off plaques on the wall providers to ensure the local Te Raukura aims to support and and into everyday practice. Fun Promoting service is more integrated and educate staff in cultural awareness and interactive workshops are better targeted. by providing a base level of Tikanga designed to give staff confidence healthy ways Māori. It also builds upon the Tui and ultimately make them more to the public The suicide action plan developed Ora organisational culture outlined capable in their respective jobs. by a range of Taranaki organisations in the six core principles: The programme will run over the Our public health team lead to the appointment of a suicide Wairuatanga, Tino Rangatiratanga, next 18 months-two years. continues to build the profile prevention co-ordinator who is of Tui Ora and its services in employed and hosted by Tui Ora. the community. Other kaimahi worked hard to Its health promotion programmes deliver programmes for pēpe, encompass nutrition and physical tamariki and their whānau. The activity, injury prevention, problem Oranga Mokopuna programme ran gambling and cervical screening. in 22 early childhood centres The pāhake programme provides (ECE’s), kōhanga reo and opportunities for people to age home-based carers throughout positively and reduce social Taranaki. Through it, over 900 isolation among older people. tamariki and 158 kamahi received Smoking cessation is delivered by education and support on healthy trained quit coaches with one-on- kai, the benefits of breastfeeding, one and peer support programmes. and the links between active This year Tui Ora was part of a movement and brain development. national realignment of stop smoking Tiaki Ūkaipō continued to provide Annualservices and by Report 1 July 2016 it had regional-wide breastfeeding been announced as the lead assistance through a co-ordinator, regional provider. In the coming volunteer peer supporters and year it will work closely with other lactation consultants.

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Partners in They will be based at Ngāti Ruanui, Three-year NEET helps young people aged Tu Tama Wahine and Tui Ora. between 16 to 18 who are at risk of, regional alliances As part of the relationship with Te journey with or already disengaged from Tui Ora moves into 2016 with Pou Matakana, Tui Ora is focused youth education, employment or training. a focus on regional projects on establishing a collective impact The Youth Payment provides initiative which includes other Our Rangatahi Youth Service financial assistance to youth who that involve representatives partners such as the Department threw a third birthday bash in have had a family break-down from iwi, including our Te of Conservation, Next Foundation, October 2015 – opening its between the ages of 16-18 and YPP Kawau Mārō partners, Ngāti the Health Promotion Agency and doors to the community and is for 16-18-year-old parents. Ruanui and Ngā Ruahine. iwi. Ultimately it aims to involve celebrating its impact around Another development for Rangatahi rangatahi, who will co-design a The projects are about models of the region. Youth Service was the consolidation care around māmā, mātua, pēpi programme that is meaningful for of South Taranaki services. and tamariki, and how to make them, in their connection with the Team leader Julie Armstrong Previously it operated from a site, services better and more maunga. acknowledged the service’s separate from the Tui Ora office in whānau-centred. In July 2016 Tui A third project is about supporting achievements over the past three Hawera. The two offices were Ora was appointed by communities to design a way of years, noting it had outgrown its combined early in 2016, enabling a commissioning agency Te Pou tackling a social issue that affect previous premises and bolstered ‘one-stop’ shop of help and Matakana as the lead for Whānau tamariki in the early years. There the strength of its delivery. Youth support for young people. Also Ora. In the coming year kaiarahi will will be different stages to it, including Service moved from St Aubyn based in Hāwera are the mental be employed to work alongside the chance for community members Street to Devon St West in 2015. health & addictions services, whānau, helping them navigate to become co-designers and Youth Services has two strands to vocational support, consumer through health and social services. practitioners. its service: NEET (Not in advocacy and peer support, Employment Education or kaumātua services and staff in our Training) and Youth Payment (YP) restructured Child Adolescent or Youth Parent Payment (YPP). Mental Health (CAMH) team. New tools enable kaimahi to become more flexible and mobile in order to of the job provide more responsive services Substantial work has taken to whānau. That has meant Developing A Tui Ora service for those place in all facets of Information improvements to mobile devices grappling with mild to moderate Communication Technology such as laptops and mobile mental wellness mental health issues was phones as well as the roll out of the (ICT) over the past year. relaunched in February. Taranaki Whānau Tahi Navigator application capability There have been many steps to the Mama Mātua P�pe Tamariki Primary Connections co-ordinates in this process, with an overall team. It allows staff to centre Leadership in our mental the brief intervention of aim to build a more resilient services around a whānau rather health & addictions services counselling and psychological organisation better able to than an individual, the downfall of was enhanced early in 2016 support with support available provide services. other client management systems. with the addition of new staff, throughout the region. Non-clinical services were The initial priority was to stabilise These three things (laptop, mobile including Andrea Rowe, MHAS our current infrastructure in order phone and the Whānau Tahi Service Leader and Linda strengthened during the year with to eliminate business risks, a lack Navigator application) have become McCulloch, Clinical Team additional staff recruited to our of Microsoft licencing and a core tools of the job for most staff Leader. vocational support, consumer and that’s where we continue to advocacy, kaiāwhina, kaumātua, disconnect between staff Andrea had previously worked in a capability and new technologies. head – ensuring that kaimahi can and day activity and physical share and have better access to hospital setting as well as in health outcomes services. Over several months all Tui Ora non-governmental organisations infrastructure was moved to the current and relevant information wherever they are located. across the wellness, mental health Cloud. Although necessitating and addiction fields. She was Support for rangatahi change for staff, key risks were The final part of the ICT work has drawn to the role at Tui Ora A review of our Rangatahi Infant mitigated as well as many been to enhance and develop our because of interest and Child and Adolescent Mental long-term benefits achieved. reporting and collaboration with experience in kaupapa Māori Health (ICAMH) service took place Laying down those core key stakeholders and partners. organisations. in 2016, as the first stage in foundations allowed us to develop Ground work in the past year puts Linda McCulloch was previously on developing services more applications such as email, video us in a strong position to employ the Tui Ora Trust as a provider responsive to children, youth and conferencing, instant messaging, new technology for this aim. representative and has worked in their whānau. Two community- document management and Spearheading this work has been primary and secondary mental based roles were created. One client management. At the same Chief Information Officer Ian health for over 16 years. works alongside the Taranaki time, one of the strategic focuses Blackburn and a dedicated team District Health Board (TDHB) Child of the organisation has been to of ICT staff and contractors. This year the recovery model gained momentum in our and Adolescent Mental Health residential services team. Tui Ora Service ensuring that there is a runs two live-in houses for adults kaupapa Māori option for youth nature of the job but replaced transitioning from hospital to requiring a secondary mental Staff system health intervention. timesheets with an electronic community-based mental health services. Traditionally services clocks in system, reducing paperwork The second role arose out of the were run under a medical model, Social Sector Trial in South A new payroll and rostering and increasing transparency. whereas the recovery model Taranaki, SWEET, which Tui Ora system called Ezitracker was This was a sizeable project that empowers tangata whai ora, exited from in June 2016 following introduced into the Home provided some challenges, encouraging independence and a decision by the Ministry of Social Based Support team late in however the co-ordination of our the development of life skills. One Development (MSD). However, it 2015. It didn’t change the Finance and HBS teams ensured example is cooking – under the was clear the local community had the new system was implemented. traditional model staff shopped an ongoing need for a clinician to and cooked for everyone. The new work in primary mental health. This model supports tangata whai ora Hāwera-based role focuses on to prepare their own meals, giving young people aged up to 18 years. Marae included an introduction to Te them choice and enhancing a Raukura, team activities, shared kai, sense of ownership and dignity in SWEET ran for three years and overnighter to cultural learning and an opportunity their own recovery. Tui Ora has worked with youth between 12 and for staff from different partsAnnual of the employed more Report registered nurses 18 years, trialing a community- build cohesion organisation to meet each other. and their support as well as that of based approach to funding and Tui Ora staff slept over at Owae Almost all of the organisation’s our recovery support workers, has co-ordinating support services. marae in May for a two-day 260 staff took part, and there are meant a strong team of staff is Many of the initiatives and wananga. The overnight gathering hopes it can be an annual event. being built around clients. partnerships continue.

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