Primary, Community, and Rural Early Actions Programme

The Primary, Community and Rural Early Actions programme is the joint Te Aka Whai Ora and Te Whatu Ora approach to build the foundations of a sustainable, unified health system that better serves our communities, whilst also supporting and growing the healthcare workforce. 

Te Pae Tata interim New Zealand Health Plan 2022 sets out the first two years of action as we transform health care in Aotearoa.   It identifies a need to strengthen primary, community and rural care to achieve better and more equitable health and wellbeing for all New Zealanders. 

This is about achieving ‘Pae Ora’, better health and wellbeing in our communities.

There are four main priority areas within the Early Actions programme:

1. Equity Adjustment
2. Comprehensive Care Teams
3. Extended Community Care
4. Health Pathways

From May 2023, we are pleased to implement targeted investment for primary care, to address the burden of under-funding for Māori and Pacific providers and enable them to continue delivering high-quality services.

This is part of the Budget 22 initiative ‘Primary Care Funding Formula – Equity Adjustments to Capitation’ and will allocate $12.758m in FY 22/23 and $24.414m in FY 23/24 and beyond to Māori and Pacific providers and specific practices based on their enrolled Māori and Pacific (high needs) populations.

It comes about following the Waitangi Tribunal WAI2575 report and the subsequent Sapere Capitation Review which criticised the capitation funding system in New Zealand for not considering important factors such as ethnicity, socio-economic status when distributing funds to primary healthcare providers.

We know that hauora Māori partners and Pacific providers tend to have a higher proportion of patients with complex health needs and higher rates of chronic illnesses, and as such the current funding formula is neither adequate nor fair.

We also acknowledge that whilst this doesn’t solve the problem, it’s a first step towards addressing the current shortfall in the funding formula, which is part of a longer-term primary and community care funding review.

For more information about the equity adjustment, see the FAQs below.

To enable better health and wellbeing in our communities, we have  adopted a preventative and proactive approach to supporting whānau.  We are working to build the capacity of our workforce, so that we can be more responsive to health needs. 

This is about providing health care services that are accessible, affordable, and appropriate for all communities, whilst giving local communities a stronger say in health services through iwi partnerships and local networks. 

It will include the establishment of comprehensive primary and community care teams to contribute collectively to the aspirations and health needs of people in their community – with a focus on wellness, prioritising Māori (including early detection and intervention), hospital avoidance and supported discharge.  

To find out more about the introduction, funding, decision-making, and implementation of these new roles within primary and community care teams, click the link below.  

Comprehensive Primary and Community Care teams  

By implementing a nationally consistent programme for acute care, planned care and community-based radiology, we can support whānau to access more care in their community.  

This will involve supporting and training the health workforce to extend the care that they are currently providing within their communities - particularly for rural, high Māori, Pacific and Tāngata Whaikaha (disabled) populations. 

These changes will mean better access to services that are closer to home, with a view to reducing pressure on hospitals, particular for those regions who are experiencing the highest pressures (Whangarei, Middlemore, Auckland, Tauranga, Palmerston North, Wellington, Christchurch and Invercargill).

To do this, primary and community care providers will be resourced to grow the range of services they can offer and whānau will have more choice of providers - including Pacific and hauora Māori partners.

Health Pathways allow clinicians access to evidence-based local guidance and support to make the right decisions together with their patients.  

Currently there are eleven different community Health Pathway programmes and two separate hospital programmes across the country.   This priority area will work towards bringing together Health Pathways into one national programme to deliver consistent, evidence based and equity focused care, regardless of where people live.

Commissioners will work closely with the Health Pathways team as National Pathways are developed to ensure each locality has access to a range of providers aligned to the evidence-based pathway.

While a national approach is being developed, direct links with local communities will be paramount to ensure the pathways remain relevant to those teams on the front line.

This is about supporting our wider health workforce in the community and hospital settings, to access standardised guidance for how they deliver care, in the most efficient way possible. 

Te Aka Whai Ora will lead the prioritisation of the national pathways and ensure a strong equity, Te Tiriti and wellness approach is applied across the development of all pathways. 

Timeframes for these changes will range from urgent through to July 2023 and July 2024.   

We are currently working through the options for change, new investments required and how we can support implementation.   

We’ve compiled a list of the most asked questions and answers that are relevant for people interested in this mahi.  Got another question?  Feel free to email us at earlyactionsprogramme@health.govt.nz.