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Key Primary Health Players Feel Excluded In Development Of Commissioning Framework

The country’s leading primary and community health membership organisation says time is running out for the group responsible for developing a Commissioning Operating Model for Te Whatu Ora, to engage with key players in the primary health sector.

Chair of the Federation of Primary Health, Steve Chadwick, says they understand a draft commissioning model is due to be presented to the Te Whatu Ora design council by the end of this month.

“Clearly the Federation wants to be central to the commissioning work that is underway, and at this stage, our members know nothing about what is proposed. We would welcome the opportunity to be actively involved and suggest it is critical that those working at the coal face have significant input into a number of key areas and the commissioning model is one,” she says.

The Federation hosted a commissioning workshop on Friday 2 September which was facilitated by Professor Don Matheson, a public health expert and a Federation board member. It was well attended, with 24 of the Board and Federation member primary health organisations represented.

Professor Matheson says one of the key aims of the workshop was to drill down into what the primary health sector sees as essential to effective commissioning.

“The Federation supports the move to a partnership-based commissioning approach, recognising the leadership role that whānau and communities’ play,” he says. “One of the very strong positions that came out of the workshop was that primary and community care providers and patient’s families/whānau

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and caregivers, must be enabled to actively participate in the commissioning processes.”

Additionally the workshop galvanised the Federation’s position that there must be a move away from micromanaging contracts, towards an increased emphasis on achieving health and wellbeing outcomes.

“There is a real opportunity for the sector to do things differently with a commissioning approach. Currently we tend to run with a bright idea from a policy person, a political party, or because it has been done in England or USA. We then try and manage that through a contract, which inevitably focuses more on the money and the outputs. A decade later, we will do a review and wonder why we haven’t made any impression on health equity? A commissioning approach will still value bright ideas, but equally the insights from providers, patients and whānau, as well as the policy setting of health equity and Te Tiriti compliance. With these outcomes in mind, effective commissioning is a dynamic process, using monitoring and evaluation to mark progress, and makes adjustments in a timely way.

The Federation of Primary Health also makes very clear that the rural community must not be left behind in the commissioning process, and supports actively linking health commissioning with local government and other government agencies, and local Iwi Māori Partnership Boards.

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