EARLY STRAWMAN DRAFT Integrated Quality and Incentive Framework
Quality
Level
Practice
Infrastructure
Incentive
Capacity
Integrated range of services
(both clinical and support).
Inter-professional model.
Highly responsive to patient
experience feedback.
Seamless vertical and horizontal
integration in place.
Practice has suite of eShared
Care applications in place
including:

eClinical Pathways

eBenchmarking

eHospital Portal

eCase Management

ePatient Experience
Workforce operating at top of
scope including:

All GPs VR

Proficient /Expert level RNs

May include NP

PM Dip level (or equiv)
Comprehensive CQI plan
implemented including patient
satisfaction.
Delegated funding for a
comprehensive range of services
linked to outcomes measures
such as:
“Partnership” agreement using
the Alliance Agreement in place
with DHB. Development of an
Alliance Plan which includes the
following requirements:
Achievement of national and
agreed local targets.
Able to demonstrate sustained
and significant contribution to
health system through locally
agreed targets, eg. reduction in
ED attendances and unplanned
admissions.
Able to demonstrate effective
clinical leadership including
management of unexplained
variation.
100% practices “Advanced”.
% practices “Excellence”.
Enabling platform for vertical and
horizontal integration.
100% practices have a suite of
eShared Care applications in
place including:

eBenchmarking (Atlas of
Variation)

eHospital Portal

eCase Management

ePatient Experience
Advanced business support
capability in place including:

Info Mgmt Platform

Advanced Population
Health management

Predictive Risk modelling
Network wide CQI plan
implemented including patient
satisfaction.
Advanced workforce plans
implemented.
Eligible for comprehensive FFP
based on nationally consistent
formulae for community based or
potentially community based
preventative, LTC and acute care
management services. These
service models will be outlined in
the Alliance Plan and could
include:
Extended patient access
available.
Mix of short and extended
consults.
% Multi-modal consults (video,
phone, email).
Interdisciplinary practice with
appropriate utilisation of
nursing services.
Extended team eg. clinical
pharmacist, Health Care
Assistant (HCA), Nurse
Practitioner (NP).
Clinical partnership with
community pharmacy.
Practice has suite of eTransfer of
Care applications in place
including:

eEnrolment

eClinical Audit

eDS

eReferral

NZ ePS

ePatient Portal

eProvider View
Workforce development plan
implemented including:

VR GPs (or on pathway)

RNs in PDRP

PM in CPD programme
CQI plan developed including
level of patient satisfaction.
Service plan and outcome targets
agreed.
Bundled practice level SIA, HP, CP
that can be utilised to achieve
best patient outcomes (agreed
service plan).
Direct access to a range of
services such as:
Alliance framework and signed
Alliance Agreement in place with
DHB. Development of an
Alliance Plan which includes the
following requirements:
100% practices “Entry Level”.
% practices “Advanced”.
% valid enrolment.
Demonstrable ability to manage
unexplained variation through
evidence informed best practice.
Achievement of agreed outcome
measures within FFP and
additional contracts.
Health information sharing
agreement and protocols in
place.
Multidisciplinary Clinical
Leadership.
Community engagement.
Workforce development
programmes in place.
Suite of eTransfer of Care
applications in place including:

eEnrolment

eClinical Audit

eReferral, eDS

NZ ePS

ePatient Portal

eProvider View

eClinical Pathway
Health service management and
reporting.
Comprehensive business
capability in place.
Network wide workforce plan
developed.
Network wide CQI plan
developed including patient
satisfaction.
Agreement in place for afterhours care (until 10pm).
Arrangement in place for
overnight care (10pm to 8am).
Practice has eHealth solutions in
place including:

Electronic PMS

Healthlink (or equiv) for
secure messaging

GP2GP

eLab / eRad order

ePrescribe
Annual workforce and patient
satisfaction surveys undertaken.
Eligible for:

B2B contract with PHO

FFS for SIA, HP, CP

FFS for GMS, ACC, Imms,
Mat

PPP (national targets)
Receive network business and
clinical support services.
100% practices “Entry Level” or
on Entry Level pathway.
Meets minimum PHO
requirements.
Has the support of clinicians with
demonstrable clinical leadership
in place.
Network level reporting on
agreed health targets.
Annual network workforce
survey undertaken.
CBF compliant.
Clinical Audit capability.
Payments management.
Basic Population Health.
Business and clinical support
capability (for practices).
Patient Satisfaction Surveys.
Entry Level
Nov 28
DHB
Model of Care
Excellence
Advanced
PHO/Network
Strawman Draft


bundled Elective FSA and
follow up.
contracts for extended
scope services.

Advanced Diagnostics

Community Radiology

Retinal Screening

Community Podiatry

Community Nursing
Direct access to care “packages”
such as:

Acute care
Infrastructure
Incentive
Capacity
Benefit
“Partnership” agreement in place
with the network , using the
Alliance Agreement. Development
of an Alliance Plan which includes:
an enhanced FFP (based on
nationally consistent funding
formulae) for a comprehensive
range of services with agreed
outcome measures.
seamless vertical and horizontal
integration in place.
eShared Care interface in place
including:

eBenchmarking (Atlas of
Variation)

eHospital Portal

eCase Management

eSelf Care
Unity of purpose between DHBs and
networks to develop a sustainable
health system which delivers on the
Government’s priorities.
Safe and affordable care delivered at
the right time, right place with the
right provider.
Increased value for health funds
invested.
Clinicians (and others) with a high
level of productivity and professional
satisfaction.
Improved patient satisfaction.
Eligible for FFP (SIA, HP, CP) with
mutually agreed outcome level
reporting.
Eligible for fully funded PPP with
outcome level reporting.
Eligible for additional service
agreements funded by nationally
consistent formulae. These
service models will be outlined in
an Alliance Plan and could
include:

Community Radiology

Advanced diagnostics

Acute Care management

Retinal Screening

Community Podiatry

Community Nursing
Alliance framework and signed
Alliance Agreement is in place.
Development of an Alliance Plan
which includes:
FFP and PPP with mutually agreed
outcome reporting
Additional service agreements
funded by nationally consistent
formulae
Health information sharing
agreement and protocols in place.
Seamless eTransfer of Care
interface of Hospital and
community systems in place:

eReferral, eDS

eLab, Pharm, Rad

eClinical Pathway

ePatient Vitals View
Clinical pathways developed,
agreed and implemented for
additional service agreements.
High level of service integration
resulting in:

Improved productivity, safety,
value and health outcomes

Shorter wait times for service /
treatment

Improved patient experience of
care

More care delivered closer to
home

Sustainable team-based
workforce
Timely and comprehensive health
information to inform QI and health
service planning activity.
Eligible for DHB-PHO Agreement.
DHB-PHO Agreement negotiated
and in place.
Meso-level clinical/ business
coordination/ support in place for
community delivered care.
Engagement and contracting with
one entity (as opposed to multiple
providers).
Demographic profile of enrolled
population.
Universal access to FLS and targeted
high needs care.





Community Nursing
Services
Child Health Services
Palliative Care Services
Elective FSA and follow up
Referred Services (Lab,
Pharm, Rad)