31/03/2023
As heralded last week, the process of organisational change within Te Whatu Ora has commenced.
Below are links to the following change documents:
1. Commissioning (used to be called planning and funding),
3. Innovation (an entirely new function we recommend you have a look at), and
We have also attached a document with the Te Whatu Ora structure, the divisions undergoing change this week are highlighted in green.
Remember that importantly, clinical leadership, P&C (new term for HR), and Hospital and Health Services are still to come amongst others!
This has been circulated to all Te Whatu Ora members as well as those in NGOs, PHOs, and other primary care organisations, and those subject to the commissioning arm (labs, explore, breast screening, etc) given your specific interest in the commissioning function, but maybe others as well.
Your reps have had advance notice of these documents (in confidence) and have been advised on how to set up meetings, gather feedback, and generally “manage” the feedback process. Te Whatu Ora is adamant they don’t know it all and do expect to adapt what is proposed on the basis of feedback. So how do you do that:
- You can combine your thoughts with colleagues and send to us. We will provide a collective response.
- We would also encourage you to make individual submissions. Te Whatu Ora has set up a platform called “what say you” (https://tewhatuora.wsy.nz/) which we understand to be interactive. We advise you all to login in if you haven’t already (it was used for the pre-employment vaccination policy) and keep an eye on what is being said. Any difficulties with this, let us know.
We have 4 weeks within which to submit these documents, however, remember we still have 6 more to go and they will overlap the periods for these ones: a bit of a rolling maul!
Kia kaha,
Dr Deborah Powell
National Secretary
06/04/2023
How are you going with the 4 documents you received last week? We have had a few complaints about managers not allowing you time during the working day to read and consider the documents delegates in particular and have escalated that concern to senior management for action as well as taking the matter up locally. It is important delegates in particular get time to look at the documents: they are not easy readings, and we are relying on them to assist the rest of the membership drill down on what is and is not important to you. Any further issues please let us know.
Good news; the original timetable of documents every week for 4 weeks, has been adjusted. At the end of next week, 4 more documents will arrive:
- Pacific
- Procurement and supply chain (that is the Te Whatu Ora division, not the division that is internal to Hospital and Health Services. More on this below)
- Digital and Data – a lot of you will be interested in this one we suspect!
- Office of the CE. This one is interesting if only for the “power” that will be based here, however it also gives us a single point of accountability which under 20 DHBs we had no success at nailing down!
Hospital and Specialist Services (HSS) is undergoing a rethink about their model whilst still having to run services. So they are moving ahead to appoint some positions whilst continuing to develop their proposed model:
- The Regional District Directors are in position, but the hospital managers (old COOs now called interim district directors) have their fixed term contracts expiring 30/6, so some decisions do need to be made. They will be consulting on these positions shortly with a view to moving to appoint permanently to commence 1 July.
- System Leadership and Performance (Jo Gibbs {Tier 3} is the manager in charge of this division of HSS) needs managers in place to focus on immediate issues such as patient flow, planned care, etc so will also move to permanent appointments at tier 4 for these roles.
- Strategy, planning, and purchasing ((Rachael Haggerty {also Tier 3} is the manager in charge of this division of HSS) need a strategic plan in each region to garner opportunities for clinical networks, etc to optimise service delivery, so they will also be moving on this front.
- And then there are the internal to HSS commissioning people. They are currently in role in the (old) DHBs and have been hard to identify; first put under the Commissioning function, they are now seen as sitting under HSS so are being mapped over to this division at the moment.
Clinical Leadership is intimately connected to HSS. A Chief Clinical Leader (a 2nd tier role i.e. reports directly to the CE – Margie Apa) is currently being sought and below them, we will have the same structure the DHBs had: a Director of Nursing (DoM) Chief Medical Officer (CMO), Director of Midwifery and a Chief Allied Scientific and Technical (DAH). Below them is where it will probably get interesting especially in the AST space – more to come on this. The Position Descriptions for these 4 tier 3 roles are to be provided to the Unions for input prior to them going out to be advertised and filled. All the 20 CMOs, DAHs, DoNs, etc will remain in place.
Are you still with us?
In summary:
- We need to respond to the 4 documents you already have by the end of April so look to getting what feedback you have to us later next week or at the latest the week after.
- Late next week expect the 4 documents above to arrive and the same process as for the first 4 kicks off.
- HHS will be making some permanent appointments to ensure Business As Usual continues and is reconsidering their model, so we won’t see that for a while yet; and
- Clinical Leadership likewise will be making tier 2 and 3 appointments however the next layer is probably where we will want to get excited! Watch this space on that one.
We will be in touch again on this process next week.
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Kia kaha,
Dr. Deborah Powell
APEX National Secretary
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17/04/2023
We now have the second round of Te Whatu Ora change for your consideration. In this tranche, we have:
- Procurement and Supply Chain (P&SC).
- Data and Digital.
- Office of the CE.
- Pacific Health.
Procurement and Supply Chain
Some things to focus on here depending on who you are:
- We made a preliminary submission to support good clinical input into this function. They seem to have heard us with a number of positions with a role in this space;
- Under GM Strategy and Engagement is a Tier 5 role entitled “National Clinical Lead” who is responsible for providing strategic and engagement support to P&SC as well as ensuring the customer lens is applied to the refinement of the clinical engagement model (page 14).
- Clinical Product Management has 5 divisions (page 8&9)
- Surgery and Labs
- Medical and Interventional
- Wards and ambulatory
- Clinical Product Liaison
- Clinical Product Innovation and Strategy
– is it enough?
- Equipment management is a role at Tier 4 to ensure the upkeep and management of health technologies.
- Pharmacy members; there are repeated references to your area in this document; page 4, 6 (Vaccinations), and 9 (pharmac) for starters.
- Labs and Xray bottom of page 4.
Data & Digital (D&D)
All of us should be interested in this one given the improvement of these services will help us all achieve our goals better. The most relevant pages for you are probably 16 and 17 – Clinical Informatics where the engagement with clinicians seems to lie. However, it is really hard to read. We have done a “what we think it says” which is attached. When we get a reply from Te Whatu Ora, we will let you know what they say.
Office of the CE
Many of you won’t care, but…. This new structure is where the single point of accountability will lie. One of the “benefits” of Te Whatu Ora is a single point – as opposed to the 20 points under 20 DHBs plus NZBS, etc. It was hard to hold any senior management to account in that system! This office:
- Supports the Board and Executive Leadership Team (ELT).
- Has a role to support the needs of those in the disability sector.
- Has government services included – Official Information Act requests, supporting parliamentary processes etc.
- Championing sustainability lies here.
- Strategy, planning, and performance as well as strategic issues and coordination.
- Legal and closely related privacy responsibilities
- Principal Legal – Employment sits here, away from People and Culture! As does legal – clinical folk. Is this appropriate?
- By Contrast, media is sitting with People and Culture (that document still to come) Again is this appropriate? Dividing media from OIA and legal feels like a way to avoid answering the media….. – or are we just overly suspicious?
Pacific Health
The role of this division of Te Whatu Ora speaks for itself. Bringing functions previously carried out by the Ministry and various DHBs they seek to work closely with other Te Whatu Ora divisions including Public Health, Innovation and Commissioning to improve equity for Pacific peoples.
As with the first tranche, you can go to “what say you” or let us know what you think to add to our submissions. |
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Kia kaha,
Dr. Deborah Powell
APEX National Secretary |
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29/05/2023
The Health Charter is a document that started as a worker’s charter but has morphed over time in its drafting. The first draft was “on hold” for over a year as it was felt inappropriate to release it to the workforce for consultation with Te Whatu Ora being so new. However, last week, we were formally asked to start the consultation process with you.
We appreciate you have had a lot of consultations over the last few months, however, this one we encourage you to take some time to read and think about. It is short in the sense that there are:
- A document (3 pages) explaining what the Charter is; and
- A PowerPoint presentation of the Charter itself.
We ask that you do take a minute or two to have a look at the attached and then – importantly – give us your feedback. We have designed a quick survey – only 7 questions – for you to complete. If you want to send us an email rather than answer the survey all good as well, whatever works best for you. We need to have your feedback to decide what we do next, so again please, take a moment for this one!
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Kia kaha,
Dr. Deborah Powell
APEX National Secretary
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