Changing The Way We Work

Evolving and adapting to Northland’s changing healthcare landscape

New focus on partnership with General Practice, Māori Health Providers and the wider primary healthcare sector 

November 2021 

We’re consulting with staff and our partners in the Northland primary health sector around proposed changes to the way we support healthcare providers.

We have traditionally focused on funding, planning, commissioning and delivering services to primary healthcare providers mandated through contracts we have with the Northland DHB.

On completion of this consultation we propose to end these contracts and to focus only on delivering those services that primary healthcare providers specifically request.

A wide range of voices within the Te Tai Tokerau primary healthcare sector have been telling us for some time about what they want from Mahitahi Hauora. We spent the third quarter of 2021 assessing their feedback and taking a look at how we might re-design our offering, not just for General Practices but also for the wider primary healthcare sector in our region.

The result is a proposed approach that seeks to move us away from the role of ‘middleman’ to a much more service-oriented relationship with General Practices and a ‘locality enabler’ for Māori Health Providers and the wider primary healthcare sector.

We propose to negotiate with GPs and others in the sector the services they may wish to purchase, and then create bespoke packages that meet the needs of individual organisations. All practices would be funded using the same funding formula, ensuring 100% financial transparency.

Under this proposed new approach there would be no compulsion to buy.

General Practices would still be able to access their Mahitahi Hauora relationship partner for all their everyday needs, as they do now, and we would still operate as a PHO in supporting them to meet all their commitments.

Subject to the outcome of our transition consultation process with customers and staff over the next few weeks, we propose to end top-slicing on funding for Services to Improve Access, Care Plus (Kia Ora Vision), Health Promotion, Rural Funding and half of its System Level Measures funding.

That would put an extra $2.5 million a year straight into the accounts of our General Practice customers so they can use it in the ways they know work best.

This, in turn, would mean an end to our complex contract arrangements and their obligations. General Practices would receive all funding through a single contract with Mahitahi Hauora, with the minimum deliverables laid out in a services agreement.

Te Tai Tokerau is a complex landscape of primary health providers operating in different spaces and with many different and sometimes competing priorities.

Collectively, the region has all the ingredients it needs to offer communities and whānau a thriving, efficient and effective primary healthcare service. But these ingredients exist across complex relationships, boundaries and professions. We believe we can provide this infrastructure in an effective and safe way that respects and upholds the mana of Te Tiriti partners.

We have identified opportunities to bring our skills, expertise and intimate knowledge of the Northland health system to bear in a way that provides significant value to General Practices, Māori Health Providers and others in the primary healthcare space.

Many smaller organisations do not have the same level of capacity and capabilities that we are fortunate to have. For example; understanding data and trends, engaging with whānau and papa tikanga, clinical and medical knowledge, and project management. 

We know that we’re able to share these skills, and more, with others in a way that enables their priority mahi to be delivered.

If our transformation proceeds as planned the focus of some staff roles will change. We’re therefore consulting with staff on changes, a process we expect to complete by the end of November. We plan to complete discussions with our GP partners by 23 December this year (2021), have negotiations wrapped up and all funding in place by 31 March 2022, and complete our restructuring and organisational change by 30 June 2022.