Localities

E kore tēnei whakaoranga e huri ki tua o aku mokopuna.
Our mokopuna shall inherit a better place than I inherited.

Since 1 July changes have been made to the New Zealand health system. Localities is a new national approach to improve how healthcare is delivered in communities.

Localities is place-based planning for health and wellbeing services which will focus on helping whānau stay well; give iwi and communities a strong voice in deciding what’s needed in their local area; and get different health and wellbeing organisations working together better to improve people’s healthcare experience.

Localities focus on much more than health services.  They focus on achieving pae ora (healthy futures) for whānau.  They will do this by improving the environment people live in, how they live, and the opportunities they have to thrive, provide for their whānau and contribute to their communities.

Localities will better connect service providers, iwi and other stakeholders to collectively improve community health and wellbeing outcomes.

A locality is a geographical area that is home to a community with their own specific health and social needs and aspirations that the system will plan and arrange services to meet. They give iwi, mana whenua, hāpori Māori and communities a strong voice in deciding what’s needed in their local area and enable different health and wellbeing organisations to work together better to improve people’s experiences of healthcare.

The geographic boundaries for the localities will be determined through a national process that will include consultation with communities, Iwi Māori Partnership Boards, and local authorities.

The locality model brings everyone together with a common understanding of challenges, a shared vision, and a joint approach to solutions that go beyond health.

A locality plan will be developed for each locality in collaboration with the locality partnership, Iwi Māori Partnership Boards, Te Whatu Ora and Te Aka Whai Ora. These locality plans will detail hauora (health and wellbeing) priorities and aspirations of whānau Māori and the community in each locality.

Locality plans will help shape the services provided in each locality. Everyone in Aotearoa can contribute to identifying priorities and hauora (health and wellbeing) aspirations and outcomes for their community.

For people living in a locality this will mean:

• a greater focus on wellness.
• more say in local service design and delivery.
• joined up care and support services.
• services delivered closer to home.

By July 2024, every community in Aotearoa will be part of a locality.

Empowering people to have meaningful say in the services they receive.

Localities give consumers and whānau an opportunity to have a strong voice in identifying and designing the services that are important for their hauora (health and wellbeing). This consumer voice will be channelled through locality groups, Iwi-Māori Partnership Boards, and a new consumer voice framework.

Planning at a local level will also enable service providers to share their local insights and expertise about what can be improved or developed to respond to the consumer and whānau voice.

Localities connect service providers, iwi, and other stakeholders to collectively improve our community health and wellbeing outcomes

A population health approach focuses on supporting whānau to stay well in their communities. It is built on the understanding that a whole range of different things can impact a person’s wellbeing.

Communities have a big influence on the lifestyle choices people make. Creating better connections across health and social care agencies can lift the health outcomes of entire communities. The population health approach will focus on wai ora (healthy settings, environments), mauri ora (healthy lifestyles) and whānau ora (collaborating to impact on social determinants of health).

Iwi Māori Partnership Boards will act as a vehicle for rangatiratanga and mana motuhake.

Iwi Māori Partnership Boards will exercise tino rangatiratanga in planning around the health needs, aspirations, and priorities of whānau, hapū, iwi and hāpori Māori within their rohe or coverage area. They will be supported by Te Aka Whai Ora to undertake their functions.

Iwi Māori Partnership Boards will make sure the voices of whānau Māori, including tangata whaikaha | disabled people, are uplifted and made visible within the health system. Iwi Māori Partnership Boards will have a key role in determining locality priorities and embedding mātauranga Māori within locality plans. Locality plans will influence and inform regional and national planning.

The role of iwi Māori Partnership Boards includes:

• engaging with whānau and hapū, and sharing the resulting insights and perspectives;
  
• understanding the current state of hauora Māori in their locality or localities and identifying local priorities for improving hauora Māori;
  
• working with Te Whatu Ora and Te Aka Whai Ora to negotiate strategic Māori health outcomes and priorities, service-level priorities, unique or significant local issues, and broader observations on wellbeing and social determinants of health in the locality;
  
• monitoring the performance of the health system for whānau Māori in their locality or localities, including against the locality plan;
  
• engaging with Te Aka Whai Ora to support its national stewardship of hauora Māori and its priorities for kaupapa Māori investment; and
  
• reporting on the Iwi Māori Partnership Boards activities to whānau and hāpori Māori in each locality.

Coordinated and better networked providers will support the delivery of services in response to each locality plan.

Through the locality approach, networks of providers will be encouraged to work together to ensure a more coordinated care experience for people in each locality. This will help people get the care they need when they need from the right organisations.

Where available, networks of providers must include Kaupapa Māori and Pacific providers to ensure mana motuhake and choice for whānau. Networks will also include comprehensive primary and community care teams, hospital services and other community providers.

Individual providers will remain accountable for their own performance but will also share more information and work together to make services more convenient and to provide coordinated care for people with complex needs. Providers will be expected to collaborate to fill gaps and continually improve service provision.

Building the future of the locality approach.

The first twelve areas to start implementing the locality approach are:

• Te Hiku o Te Ika
• Ōtara / Papatoetoe
• Hauraki
• Eastern Bay of Plenty
• Tairawhiti
• Taupō / Turangi
• Wairoa
• Whanganui
• Horowhenua
• Porirua
• West Coast
• Hokonui

The first localities have been building and testing new models and ways of working to inform how the locality approach can be rolled out across the motu.

Localities will be centrally supported, digitally enabled, and nationally connected to learn, grow and flourish

Locality central support

Te Whatu Ora is responsible for supporting each locality.  This function will be shaped over time by the needs of locality members and networks of providers.   The progress of the first localities is being monitored to inform the further development of locality support functions.

Locality digital collaboration hub

Te Whatu Ora’s national locality team have developed a locality collaboration hub for the localities to work in, connect through, share experiences and find information, tools and resources.

The learning and insights programme

Te Whatu Ora have commissioned an external agency to undertake a three-year Learning and Insights Programme with the first nine locality prototypes during the early years of operation. The learning and insights programme will allow us to learn as we implement the locality approach.

 The work from this programme will be used to enhance outcomes, provide learnings for implementation, and support providers and communities. This will enable key lessons to be shared early and inform other localities as they develop.

The locality learning collaborative

The locality learning collaborative is a national learning space created to support shared learning about this new way of working across the sector.

The intention of the locality learning collaborative is to support localities to be successful.

Activities include formal and informal networking opportunities, sharing understanding and experiences of collective impact, and agile learning to amplify the benefits achieved through innovation.