Shifting of Services (Devolution)
In February 2009 the Health Minister set out the new Government’s expectations for DHBs and their subsidiary entities for 2009/10. While the focus of the 2009/10 year is on hospital services (i.e. reducing waiting times and improving service quality) from 2010/11 onwards the intention is to build on the Primary Health Care Strategy (PHCS) by shifting some secondary services to more convenient primary care settings - at no cost to patients.
This direction poses both opportunities and risks for PHOs and their Providers. During 2009/10 DHBs are required to work with their PHOs to prepare how some services may be best devolved in their regions.
In September 2009 the Ministry of Health called for Expressions of Interest (EoI) for the delivery of Better, Sooner, More Convenient Primary Health Care. This opened the process for a first wave of early adopters to implement innovative new models of care on a large scale, commencing 1 July 2010. Click here to see PHO Alliance Members associated with the development of the first round of EoI business cases.
Useful resources:
Primary Care into the Future- A Counties Manukau DHB Perspective, July 2009. Paper outlines models and structures that better support “Better, Sooner, More Convenient Primary Care” in the Counties Manukau District.
NZ DHBs Shared Services- A Guide and Approach, Price Waterhouse Coopers, April 2009.Paper provides suggestions as to how DHBs could combine some of their “front” and “back” office functions.
Draft Primary & Secondary Integration- Leading Secondary Development in Waitemata DHB, July 09. This draft paper outlines how the Waitemata DHB and its PHOs will work together to implement changes to improve health service delivery, health outcomes and value for money across the district, and the region.
Think-piece on shifting services, May 2009. This draft paper provides a personal view of a DHBNZ employee noting confusion to the terminology i.e. devolution or shifting? and suggests some intervention logic for DHBs when deciding when and how services should be devolved/shifted.
Shifting secondary services to more convenient primary care settings, PHCS Group Implementation Programme, March 2009. Provides a summary of DHB experiences with service shifting initiatives to date and in the process creates a ”shopping list” of potential service shifting opportunities.