The first prototype areas to adopt the localities model to improving health and wellbeing service delivery have been annouced as Ōtara/Papatoetoe, Hauraki, Eastern Bay of Plenty, Taupō/Tūrangi, Wairoa, Whanganui, Horowhenua, Porirua and West Coast.
A locality is essentially a place-based approach to improving the health of populations, as well as a mechanism for organising health and social services to meet the needs identified by whānau, community and mana whenua.
Defined by the local community and iwi themslelves, it is a new approach to delivering healthcare in an informed manner that focuses on prevention and promotion. It will be a mechanism in which different healthcare providers can ’join-up’ more easily and will take a more holistic approach to people’s wellbeing.
Where localities are being rolled out, existing DHBs and PHOs will start to work in different ways, in collaboration with community and social care organisations. Good work being done by DHBs and PHOs today will be picked up by the Māori Health Authority and Health NZ as they come into being from July 1.
Where localities are yet to be rolled out, PHOs will continue to operate through existing arrangements until the new locality approach rolls out.
The expectation is that around half of the population will be covered by this new approach by the end of 2023. All of New Zealand will be covered by a locality by July 2024.
Frequently asked questions
How will the locality boundaries be decided?
Iwi and community will work together to determine the geographic area that makes sense to them, with an over-riding principle that it still feels “local”. It may follow iwi or local government boundaries, but not necessarily. The only hard ‘rules’ are that everyone must be part of a locality, and locality boundaries can’t overlap.
How many localities will there be?
That depends on the boundaries being determined by iwi and communities – they are leading that process because a locality needs to make sense to the people that live and work there. It is predicted there could be around 80 localities across the country. Healthcare providers will, in most cases, deliver care across multiple localities.
What is a prototype? What makes it a prototype?
This is the term being used to describe the first set of areas to roll out the locality approach. Another way to think about these first nine areas is “early adopters”.
These early adopters are confirmed localities and provider networks will be established to provide services to people in these localities.
The only difference with these first areas, as opposed to the next localities that are rolled out, is that they will have additional support wrapped around them so the sector can learn how to best refine the roll-out over time.
The timeframe for having confirmed locality plans is the same for every locality across the country, but the first areas will be a little ahead of the pack.
What will people see that is different when the prototypes are stood up?
Organisations responsible for providing care will start to work more closely together, and that will be evident in communities. For example, there will be increased collaboration on common social problems such as family violence, mental health and obesity.
There will also be more opportunities for members of the community to have a say in how care and support is delivered.
How quickly will we see change in the prototype areas?
The way organisations work together and opportunities for community input into health and care services will start to change over the next six months. Over time, this will result in tailored approaches for communities and increased access to care.
How long will they be ‘prototypes’ before they become permanent localities?
The prototypes are permanent localities from the outset. The only difference is that additional support and resources will be wrapped around this first nine areas to gain as much learning as possible.
What does it mean for me and the care I already receive?
It will be easier to get the care that you need, and you won’t have to tell your medical history to lots of different people. Instead, the people that you already get care and support from will work together as a team to give you what you need.
It also means that communities will have more options to tailor the services they get access to locally to respond to their unique needs.
How is it different to the way things are now?
Currently there are gaps in communication across different care and support providers, so people receiving care can feel like they are repeating themselves and that it’s difficult to get the care they need in a way that works for them.
In addition, under the locality approach iwi and communities will get more say over what should be prioritised in their community.
Also, health and wellbeing providers will work alongside social care and other community organisations to deliver healthcare in a more holistic way that doesn’t ignore key parts of a person’s life, such as their housing situation or employment.
How will people get to have a say in what happens in their community without DHBs?
Health NZ, the Māori Health Authority and health providers will work with communities to determine priorities for their area. This will result in a locality plan, which captures the aspirations of whānau, communities and iwi for what the focus should be in that area.
What will change if I need to go to hospital?
Your local hospital will continue to be the hospital you currently visit for specialist or emergency care. However, there will be better connections between the hospital and healthcare providers within the community. This will make things easier if you already access care in the community and need to visit the hospital.
Also, your hospital will be part of a national network. This means that if you need a particular type of care that is not available locally, it will be easier for you to get access to those services.
How will things be different for Māori and other communities that aren’t well supported?
Ensuring Māori have a strong voice at all levels of decision-making is a key part of the changes to the health system. This starts at the community level with the establishment of Iwi-Maori Partnership Boards which will represent iwi.
The focus on engaging with the community to develop plans for healthcare delivered in communities will ensure Maori, and other population groups, are able to inform the decisions that are made.
How is it being funded?
Budget has been allocated to start rolling out localities. Because this will be a core part of the health system, and replace the way things are done now, it will be funded through the normal health budget process.
How will you ensure that the healthcare priorities reflect what the community wants?
Each locality will have to develop a plan tailored for its community. This will require demonstrable engagement with the community. The plans will also need to be endorsed by Iwi-Māori Partnership Boards which are boards representing iwi.
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Last updated: Monday, August 15, 2022