Embed shared vision and values
Elements we are building from
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What we need to achieve
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A transition time can be difficult in terms of vision and values. People will naturally look to Health NZ and the MHA for guidance. Yet these organisations are still being developed and it may take some time to roll out a comprehensive vision across the health system. There is a risk that organisations and leaders look inward and become defensive in a time of transition.
The Southern system will make the most progress if leaders look at this transition time as one of opportunity and work proactively together to take new ideas and opportunities forward into the new structure.
A new level of collaboration and collective thinking is required. The tasks of establishing locality networks, enabling Māori leadership, focusing on equity and joining up clinical leadership all require leaders from across the system to engage with shared values that will lead to positive and enduring relationships.
The key values developed by the Southern DHB remain relevant to guiding relationships and behaviours, between organisations, within and across professional groups and with communities and consumers during this time of transition. These values are:
The Southern system will make the most progress if leaders look at this transition time as one of opportunity and work proactively together to take new ideas and opportunities forward into the new structure.
A new level of collaboration and collective thinking is required. The tasks of establishing locality networks, enabling Māori leadership, focusing on equity and joining up clinical leadership all require leaders from across the system to engage with shared values that will lead to positive and enduring relationships.
The key values developed by the Southern DHB remain relevant to guiding relationships and behaviours, between organisations, within and across professional groups and with communities and consumers during this time of transition. These values are:
However, more is needed to recognise and reinforce Māori leadership within the Southern system.
How the sector engages with Māori should reference the Pae Ora framework, developed by the Ministry of Health, which describes the Te Tiriti o Waitangi in the context of the health and disability system.
Pae ora also provides guidance on ‘How we apply Te Tiriti in the modern world, which is influenced by the Wai 2575 report, and includes:
The Pae Ora framework should be used as a tool to guide how Māori leadership is recognised in the Southern Health system. |
An aligned vision and values is immensely powerful within a system as is creates the lubricant for relationships and helps give people at all levels the confidence to move forward and make decisions.
The reality is that an effective vision and values do not live on bits of paper or websites. They exist in internalised principles and behaviours and influence how people think and act every day.
One focus of this strategic briefing has been to encourage and empower people across the system to take up leadership and to reach out, build connections, and develop local ideas around how we reframe our health system in line with the health reform agenda.
As organisations and professional groups work together in a more connected way, they will need to develop and agree their own values that underpin who they are and how they work together.
Don’t wait – create your own local vision and values and graft these on to the guidance from Health NZ and the Māori Health Authority.
Proposed leaders for action in this area: Leaders across the health system.
Secure Sustainable workforce
Elements we are building from
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What we need to achieve
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The Southern District has ongoing challenges in attracting and retaining workforce for the current service models – especially in Southland. This is being exacerbated by the effects of Covid-19, with ongoing border closures affecting the usual workforce supply and competition within the health sector for staff. There continue to be shortages within primary care teams (further exacerbated by an ageing GP workforce) and what has been described as a workforce crisis in aged residential care. Attracting and retaining staff continues to be an issue within rural settings across a range of professions.
At present the approach to the perennial workforce supply issues is fragmented. The current Southern Workforce Strategy looks to address key issues identified by the DHB and WellSouth PHO.
What is needed is a regional commitment to a joint workforce plan that includes not only the DHB and PHO but also the rural hospitals, aged residential care, allied health and NGO and community providers.
These organisations often compete for the same staff. For example, rural hospitals and aged residential care facilities are left to recruit independently and compete for scarce skills.
In the short term, there needs to be an action plan to assess and respond to the impact of Covid-19 on the workforce across the system. In the medium term what is required is a joined-up ‘Southern system workforce plan’, that is future focused, and data driven, and sets out an approach to supply, recruitment, retention and on-the-job training and development.
The system, working in a connected way, will have a better chance to recruit and retain the workforce that is required to deliver tomorrow’s health system. Elements that are important to support the ‘rebalanced’ health system include:
At present the approach to the perennial workforce supply issues is fragmented. The current Southern Workforce Strategy looks to address key issues identified by the DHB and WellSouth PHO.
What is needed is a regional commitment to a joint workforce plan that includes not only the DHB and PHO but also the rural hospitals, aged residential care, allied health and NGO and community providers.
These organisations often compete for the same staff. For example, rural hospitals and aged residential care facilities are left to recruit independently and compete for scarce skills.
In the short term, there needs to be an action plan to assess and respond to the impact of Covid-19 on the workforce across the system. In the medium term what is required is a joined-up ‘Southern system workforce plan’, that is future focused, and data driven, and sets out an approach to supply, recruitment, retention and on-the-job training and development.
The system, working in a connected way, will have a better chance to recruit and retain the workforce that is required to deliver tomorrow’s health system. Elements that are important to support the ‘rebalanced’ health system include:
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Proposed leadership for action in this area: Southern DHB, working with stakeholders across the system
Proposed leadership for action in this area: Southern DHB, working with stakeholders across the system
REALISE SYNERGIES WITH LOCAL TRAINING INSTITUTIONS
Elements we are building from
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What we need to achieve
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Otago and Southland healthcare institutions operate alongside major workforce training institutions, which include the University of Otago, Otago Polytechnic, and the Southern Institute of Technology. These academic and training institutions have strong workforce and operational links to the health sector, training a large proportion of the medical and allied health workforces.
The health sector has had variable alignment with these institutions over the last 20 years which has largely been dependent on the quality of individual relationships. Currently the potential for these relationships is not being fully realised around contributing to equity, the sustainability of the local health workforce, supporting ongoing training for the region’s health workforce and supporting applied research and innovation.
There is an opportunity to build the strategic relationships between health and training/research institutions in the South with advantages to all parties. This should result in an agreement for an ongoing forum that explores and aligns strategic interests.
The health sector has had variable alignment with these institutions over the last 20 years which has largely been dependent on the quality of individual relationships. Currently the potential for these relationships is not being fully realised around contributing to equity, the sustainability of the local health workforce, supporting ongoing training for the region’s health workforce and supporting applied research and innovation.
There is an opportunity to build the strategic relationships between health and training/research institutions in the South with advantages to all parties. This should result in an agreement for an ongoing forum that explores and aligns strategic interests.
Some initial areas of focus for action include:
1. Equity
Developing an agreed approach to train, place, retain and on-the-job upskill a workforce where improved equity is a priority. This will include a proactive focus on the Māori and Pacific workforce. The Iwi Māori Partnership Board should be part of this dialogue. The approach should be one with clear short, medium and long term goals in terms of creating a workforce that is matched to the population. 2. Sustainability and rural placements Training institutions can contribute to workforce sustainability through ensuring skills match what the system needs. For example, building a workforce of rural generalists (across professions) working at top of scope is a key part of the workforce needs for the rural South. The University of Otago Medical school indicates that 30% of their current students identify that they want to be generalists in the future. This could be better supported through further expanding rural immersion placements in the Southern District, which needs to be a partnership between the university and the health system. Less than 10% of students participate in the formal rural immersion programme. Rural placements are important to expose young trainees to the benefits of rural life and provides opportunities for employers to encourage them to pursue a career in the country. Southern training institutions attract people from across cultures and backgrounds. There is a real benefit if those students decide to stay in the South. |
3. On-the-job upskilling (earn and learn)
The Health and Disability system Review identified increasing on-the-job or earn-and-learn training as an important part of the future workforce training mix. The Southern system has an opportunity to be leaders in this approach by moving proactively to identify the future skill mix of the workforce and developing training approaches that are effective in an earn-and-learn context. This may mean that there needs to be explicit agreements between major health employers and training institutions to align employment packages and upskilling opportunities. 4. Research, innovation and change As the health system moves forward with structural reform and changes to systems of care, it will need support from applied research across a range of areas to inform on issues such as population health approaches, connected care, equity, data infrastructure, use of technology, leadership models and workforce development. There is a real potential for health organisations and research institutions to identify areas of interest where both will gain and where both have a strategic interest in supporting research and evaluation that delivers academic and service delivery rewards. Examples of research collaboration exist with Health Research South, which was set up as a research partnership between the Otago Medical School and Southern District Health Board. Through this the University has made available a range of skills including:
This type of relationship should be expanded to include multiple institutions and focused on insight that will be of most value as the health service continues its rapid evolution. |
Proposed leadership for action in this area: Southern DHB and the University and Polytechnics.