Ministry of Health
Refresh of rheumatic fever
prevention plans: Supplementary
guiding information for high
incidence District Health Boards –
Stakeholder engagement
July 2015
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Introduction
This document provides high incidence District Health Boards (DHBs) with supplementary
guidance on engaging with key stakeholders when refreshing their rheumatic fever
prevention plans. The document also provides information on how DHBs can access a oneoff assistance payment of $25,000 to enhance engagement with local priority populations, in
particular with local Māori in the development and implementation of the refreshed plans.
The one-off payment will be given to DHBs after the refreshed plans have been approved,
provided criteria specified in this guidance document for stakeholder engagement have been
met.
Background
The guidance document released in June 2015 outlined expectations on stakeholder
engagement and involvement in the refresh of the high incidence DHB rheumatic fever
prevention plans.
Increasing stakeholders’ understanding of rheumatic fever prevention and encouraging their
active involvement and ownership of local solutions is important in a sustainable plan to
reduce rheumatic fever. It is expected that focus will be given to Māori and Pacific
stakeholders such as DHB Māori Health teams, local iwi and community groups.
The minimum requirements identified in the June 2015 guidance document for the
stakeholder engagement section of the refreshed plan are:
1.
Evidence that the DHB has worked and actively engaged with local Māori and, where
relevant, Pacific communities and obtained active involvement and ownership of
sustainable actions to achieve low levels of rheumatic fever.
2.
Evidence that the DHB has worked with other local stakeholders (including primary
health organisations, Māori and Pacific health and social organisations, health and
social sector providers and other agencies) to obtain active involvement and ownership
of local solutions to achieve and maintain low levels of rheumatic fever.
The focus of this guidance document is how to effectively engage with Māori stakeholders.
However, the principles outlined can also be applied to Pacific stakeholders.
The document also outlines the criteria that need to be met for the $25,000 payment to be
recompensed to DHBs after the plans are approved.
Engaging with Māori
He Korowai Oranga: Māori Health Strategy sets the overarching framework to guide the
Government and the health and disability sector to achieve the best health outcomes for
Māori. Implementing He Korowai Oranga is the responsibility of the whole of the health and
disability sector.
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DHBs in particular should consider He Korowai Oranga in their planning, and in meeting
their statutory objectives and functions for Māori health. He Korowai Oranga assists Māori
providers and communities, and other providers when planning their own strategic
development. This means DHBs should be considering the four elements of He Korowai
Oranga when implementing policy, these are: Pae Ora – Healthy Futures, Mauri Ora –
Healthy Individuals, Whānau Ora – Healthy Families and Wai Ora – Healthy Environments.
As He Korowai Oranga states:
“The Government is committed to making the health system work for all New
Zealanders. A significant portion of the annual budget is allocated to Vote Health for
this purpose and 20 DHBs, established under the New Zealand Public Health and
Disability Act 2000, have been set up with this clear expectation.
As part of working well for everyone, the health system needs to demonstrate that it
is achieving as much for its Māori population as it is for everyone else. For example,
among the responsibilities of DHBs are to reduce disparities between population
groups, improve Māori health and ensure Māori are involved in both decision-making
and service delivery.”1
Under the New Zealand Public Health and Disability Act 2000 DHBs have the following
mandatory requirements:
Section 23:
(d) to establish and maintain processes to enable Māori to participate in, and
contribute to, strategies for Māori health improvement:
(e) to continue to foster the development of Māori capacity for participating in the
health and disability sector and for providing for the needs of Māori:
(f) to provide relevant information to Māori for the purposes of paragraphs (d) and (e).
Furthermore, the Health and Disability Commissioner Code of Health and Disability Services
Consumers' Rights Regulation 1996 ensures:
“Every consumer has the right to be provided with services that take into account the
needs, values, and beliefs of different cultural, religious, social, and ethnic groups,
including the needs, values, and beliefs of Māori.”
As a result DHBs are already required to engage with Māori on the local response to
preventing rheumatic fever. While the Ministry understands engagement is taking place, the
Ministry recognises that increasing community stakeholders’ understanding of rheumatic
fever prevention and encouraging their active involvement and ownership of local solutions
is important in developing a sustainable plan to reduce rheumatic fever.
1
He Korowai Oranga can be found here - http://www.health.govt.nz/publication/guide-he-korowaioranga-maori-health-strategy
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Criteria for financial assistance – requirements for funding
stakeholder engagement
Stakeholder engagement will have the following objectives:
1. To have Māori and, where appropriate, Pacific representatives approve the plan.
2. To obtain active involvement and ownership of local solutions to achieve and
maintain low levels of rheumatic fever.
3. To have ongoing and active engagement with local priority populations on the local
response to preventing rheumatic fever.
A one-off assistance payment of $25,000 is being made available for each high incidence
DHB to ensure that local priority populations (Māori, and where appropriate, Pacific peoples)
are actively engaged in developing the refreshed plan.
The one-off payment will be given to DHBs after the refreshed plans have been approved if
the following criteria are met:
1. Governance signoff – the DHB should ensure the plan has been agreed to by the Māori
governance structure the DHB uses to fulfil their Māori participation legislative
requirements under the NZPHDA 2000.2 The agreeing group(s) should also be given the
opportunity to engage throughout the development of the plan, including providing
feedback to draft versions of the plan. This agreement could come via the co-signing of
the plan or via letters of support. In addition, the agreeing group(s) should be provided
with evidence that the following action points (2-6) have been completed prior to their
supporting of the plan.
2. Provider Contribution - the DHB will provide all Māori and Pacific health and disability
providers contracted for services aimed at preventing rheumatic fever, the opportunity to
provide input into the plan. This contribution will be facilitated at an appropriate level3 and
must include the ability to input into draft versions of the plan at least four weeks before
sign off.
3. Primary Health Organisation (PHO) inclusion - all PHOs will be included in the
development of the plan, including providing input into draft versions of the plan at least
four weeks before sign off. This contribution will be facilitated at an appropriate level.
4. Cross-agency engagement - a draft version of the refreshed plan should be provided to
other relevant agencies at least two weeks prior to sign-off for comment. These agencies
should include but are not limited to: Te Puni Kōkiri, the Ministry of Social Development
and Housing New Zealand. This engagement should take place at an appropriate level.4
5. Ongoing engagement tool - the refreshed plan should contain mechanisms the DHB
will continue to use to ensure ongoing engagement with local priority populations, with
This may be in the form of a Māori Partnership Board co-signing the plan, or via local Iwi co-signing
the plan. The variability depends on how each DHB manifests their legislative requirement.
3 An example of an appropriate level interaction could be for an invitation to comment being sent at a
Chief Executive to Chief Executive level with an organisational level response following.
4 After consultation with other agencies it was determined an appropriate level was at the regional
office level. Please note an invitation should still be sent at a regional Chief Executive level to ensure
appropriate process is followed.
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regards to the prevention of rheumatic fever. This should include the communication
tools they will use to ensure ongoing engagement with local iwi, relevant Pacific groups,
Māori health and disability providers and PHOs regarding future rheumatic fever
prevention policy. This engagement should continue to be upheld at appropriate levels.
6. Feedback tool – the revised plan should contain information on the avenue the relevant
bodies listed in point 5 can use in the future to share their ideas and local solutions with
the DHB. For example, this could take place in the form of a yearly hui.
7. Oversight - the DHB should maintain a record of feedback received from consultation
and engagement with those bodies mentioned in points 1, 2 and 3, which can be
accessed if required.
DHBs need to include evidence that the above criteria have been met within their plans or in
a cover letter. The one-off payment will be approved as part of the approval process of the
rheumatic fever prevention plans, provided the criteria specified in this guidance document
for stakeholder engagement have been met.
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