2015/16
Regional Service Plan Guidelines
Amendments to the Regional Service Plan Guidelines
Page
Description
7
 Enablers – Workforce
- A new link has been provided to the Workforce Intelligence and Planning
Framework to assist DHBs (the previous link did not work).
9
 Regional Cancer Networks
- The guidance has been updated to reflect that the Cancer Health Information
Strategy will now not be released until March 2015.
March 2015
Table of Contents
Introduction to the Guidelines ................................................................................................ 3
Regional Collaboration ....................................................................................................................................3
Regional Service Plan .....................................................................................................................................3
Overview of Content Requirements ..............................................................................................................4
1: STRATEGIC POSITION ...................................................................................................... 5
1.1
Linkages ................................................................................................................................................5
2: RSP PRIORITIES ................................................................................................................ 6
2.1
Priorities.................................................................................................................................................6
2.2
Enablers ................................................................................................................................................6
2.3
Sub-regional Initiatives ........................................................................................................................7
3: REGIONAL GOVERNANCE and LEADERSHIP .............................................................. 8
3.1
Regional Governance and Decision Making ...................................................................................8
4: NETWORKS ........................................................................................................................ 9
4.1
Regional Cancer Networks.................................................................................................................9
4.2
Supporting Clinical Networks and Clinical Leadership ...................................................................9
5: HEALTH EQUITY ...............................................................................................................10
5.1
Priority Areas – Health Equity Focus ............................................................................................. 10
6: LINE OF SIGHT ..................................................................................................................11
6.1
The Planning Process Across Regional Service Plans and Annual Plans .............................. 11
7: NATIONAL ENTITIES ........................................................................................................12
7.1
Linkages ............................................................................................................................................. 12
2
Introduction to the Guidelines
Regional Collaboration
District health boards (DHBs) are expected to work together at a regional level to make the best use of
available resources, strengthen clinical and financial sustainability and increase access to services. Improving
regional collaboration between DHBs has been an evolving process over time. In the last few years, significant
progress has been made in establishing the key foundations to assist regional working and DHBs are in a good
position to continue implementing their regional and sub-regional priorities.
Regional Service Plan
The purpose of a Regional Service Plan (RSP) is to provide a mechanism for DHBs to document their regional
collaboration efforts and align service and capacity planning in a deliberate way. The RSPs include national
and local regional priorities, and outline how DHBs intend to plan, fund and implement these services at a
regional or sub-regional level. The plans have a specific focus on reducing service vulnerability, reducing costs
and improving the quality of care to patients.
High-quality health care results from the simultaneous implementation of three quality dimensions: improved
quality, safety and experience of care, improved health and equity for all populations and best value for public
health system resources. High-quality health and disability services respond to the needs and aspirations of
diverse population groups, and the health system must work to eliminate barriers to accessing high-quality
health care. Therefore, the 2015/16 RSP guidance includes a focus on health equity, which is a cross-cutting
dimension of quality. Further detail on expectations is set out in section 5: Health Equity.
In 2015/16, there is also a continued focus on improving alignment between the DHB Annual Plans (APs) and
the RSPs. The visibility of contributions by DHBs to achieve regional service priorities will be further
strengthened by expanding on the Line of Sight framework provided for the 2014/15 plans. The Line of Sight
framework is included in section 6.1 as a general guideline. A combined priorities document has also been
released that clearly articulates what is required in both the RSPs and the APs for those planning priorities
that cross both plans.
For further information regarding these guidelines please contact:
Stasha Mason
National Health Board
Ministry of Health
Wellington 6145
stasha_mason@moh.govt.nz
(04) 496 2265.
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Overview of Content Requirements
1: STRATEGIC POSITION
1.1 Linkages
2: RSP PRIORITIES
2.1 Priorities
2.2 Enablers
 Regional and national information technology
 Regional workforce
 Capital
2.3 Sub-regional Initiatives
3: REGIONAL GOVERNANCE and LEADERSHIP
3.1 Regional Governance and Decision Making
4: NETWORKS
4.1 Regional Cancer Networks
 Key actions
4.2 Supporting Clinical Networks and Clinical Leadership
5: HEALTH EQUITY
5.1 Priority Areas – Health Equity Focus
 Health Equity Tools
6: LINE OF SIGHT
6.1 The Planning Process Across Regional and Annual Plans
 Guidance framework for RSP priorities
7: NATIONAL ENTITIES
7.1 Linkages
 Health Quality and Safety Commission
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1:
STRATEGIC POSITION
In the development of the strategic section, regions should reflect on progress to date, identifying and
explaining any significant changes from earlier years, and identifying the direction of travel for 2015/16 and
future years.
1.1
Linkages
The strategic section of the RSP should also be consistent with national strategic imperatives, as well as all
trends and key outcomes outlined in:


DHBs’ Statements of Intent (SOIs) that articulate the ability of each DHB in the region to deliver
improved services into the future
the Strategic Intentions section of DHBs’ APs, where each DHB examines how health services can be
most effectively and efficiently co-ordinated and delivered.
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2:
RSP PRIORITIES
2.1
Priorities
The 2015/16 RSP priorities are noted below. These are mostly a continuation from 2014/15, with the
exception of Cancer Services, which has been removed as an RSP priority. However, necessary actions to
support cancer services at a regional level are outlined in section 4: Networks.








Elective Services
Cardiac Services
Mental Health and Addictions
Stroke Services
Health of Older People
Major Trauma
Information Technology
Workforce.
2.2
Enablers
The National Health IT Plan and Health Workforce Regional Work Plan outline the strategic focus for these
areas, and include key priorities and programmes that are expected to be implemented regionally by DHBs.
The regional priorities for 2015/16 for IT and Workforce are outlined in the combined priorities document.
The requirements for enablers can be incorporated into specific service priorities where applicable. Further
context on how these enablers link with regional objectives in RSPs is noted below.
2.2.1
Regional and national information technology
IT provides the platform to support improved information sharing that enables new models of care and better
decision making. Well-designed IT systems help us work smarter to reduce costs, support care pathways and
give patients better, safer treatment. Greater reliance on technology requires effective management of IT
investments, implementations and ongoing operations. Sustained investment in IT is one of the ways to
manage increasing demand with limited resources.
The regions making the greatest progress in IT enablement have identified that strong regional governance
and decision making, collaboration between DHBs, involvement of consumers and clinicians in co-design and
well-managed IT capacity and capability are essential elements for the successful delivery of IT initiatives. An
additional part of the planning information requested requires these areas to be addressed (see the planning
priorities document).
Stronger information governance will be important to ensure that health information remains in a trusted
environment as IT enables better information sharing. The development of the Health Information
Governance Framework is under way and will be consulted on in 2015. Thereafter there is an expectation
that it will be adopted by DHBs.
In the 2015/16 RSPs regions must include:

their prioritised three-year plan of all local, regional and national IT initiatives, including the applicable
critical IT priorities that are outlined in the separate planning priorities document. The following level
of information should be provided for each initiative (a, b and c are mandatory):
a. name of the initiative
b. budget allocation by DHB (capex and opex)
c. the key deliverable that will be achieved in the 2015/16 year
d. benefits, dependencies and milestones (where available).
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
strategies the region has put in place to address the following IT delivery challenges:
a. regional governance, leadership and decision making
b. regional funding and approval model(s)
c. regional capacity and capability.
2.2.2
Regional workforce
To enable a consistent approach to workforce planning, the national DHB General Managers Human
Resources (GMsHR) group and Health Workforce New Zealand have collaborated in the development of a
Workforce Intelligence and Planning Framework. The Framework aims to assist DHBs when undertaking
workforce planning at the individual DHB, regional and national level for the immediate planning horizons –
up to three years. The Framework can be accessed on the Connex website at the following link:
http://www.dhbsharedservices.health.nz/Site/ER/Workforce-Intelligence-and-Planning-Framework/WFIPHome.aspx.
The DHBs are encouraged to use the Framework, which is being tested as part of the 2015/16 DHB annual
planning process. The GMsHR Group will seek DHB feedback to ensure a consistent and robust workforce
planning process across DHBs.
To enable and sustain our future health and disability workforce, Health Workforce New Zealand will work
collaboratively with DHBs to:




actively address and progress a co-ordinated approach to 'new models of care' thinking, planning and
development
clearly define and contribute to national workforce priorities that lead to, and/or support, interventions
at a regional level
provide leadership and commitment that supports the regional training hub to deliver solutions that
deal with regional challenges
actively address national/inter-regional/intra-regional co-ordinated approaches that support individual
DHBs workforce needs, now and for the future.
To achieve this, DHBs are expected to work in close collaboration with the Regional Workforce Development
Director and the regional hub to:





improve recruitment, retention and distribution of the health and disability workforce
deliver on health and disability workforce priorities through increased collaboration, inter-sectoral
partnerships and regional approaches that improve productivity and economies of scale
align workforce development to meet service demand
maximise the value derived from workforce resources and reduce duplication
strengthen health workforce intelligence to provide high quality support and advice.
2.2.3
Capital
Regional service planning remains an integral part of capital investment planning. Where it is appropriate,
potential capital impacts should be identified. However, quarterly reporting on capital will not be required via
RSPs. In 2015/16, the NHB will continue to collect the regional capital plans separately. The NHB considers
this will reduce administrative workload for DHBs and focus DHBs on regional capital planning.
2.3
Sub-regional Initiatives
Current and emerging sub-regional initiatives where DHBs are working together to provide improved value to
their populations should be identified in the RSPs. Measurable and time-bound actions are required to be set
out in the AP (Annual Plan Toolkit, Module 2: Delivering on Priorities and Targets).
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3:
REGIONAL GOVERNANCE and LEADERSHIP
DHBs are expected to continue to provide effective regional governance, accountability and decision making.
DHB Chairs and Chief Executives from each region will be required to agree and sign RSPs on behalf of their
individual boards.
3.1
Regional Governance and Decision Making
RSPs should provide information about how implementation will be governed, costed, funded and managed,
including how DHBs will manage performance.
Information may include: roles and responsibilities, an outline of arrangements to provide support and
assistance to other DHBs to meet the regional and/or sub-regional performance expectations, and how
barriers and issues will be resolved.
Some regional (including sub-regional) work programmes may require specific governance and leadership
approaches with tailored membership to appropriately represent the key stakeholders and to ensure the best
outcome is achieved (eg, involvement and alignment with primary care, NGOs, patient representative groups).
DHBs may also wish to include other examples of regional collaboration, for example, cross-appointed board
members and clinicians and regular engagement between DHB boards in the region.
DHBs are expected to assist their colleagues in finding and implementing solutions to financial or clinical
issues that arise. This may include making staff with expertise available to work with the NHB to resolve the
issue. An indication of how the region will arrange this should be included.
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4:
NETWORKS
4.1
Regional Cancer Networks
Cancer networks bring together stakeholders from across the region who are working at different stages of
the cancer care continuum including DHBs, NGOs, GPs and PHOs, cancer service providers, cancer treatment
consumers and their family or whānau, hospices, and research organisations. Cancer networks work across
boundaries to improve the outcomes for patients by:


reducing the incidence and impact of cancer
increasing equity with respect to cancer.
Implementing the priorities of the National Cancer Programme remains the focus for regional planning for
cancer services. In particular to improve:



equity of access to cancer services
timeliness of services across the whole cancer pathway
the quality of cancer services delivered.
4.1.1
Key actions
The region (in conjunction with the regional cancer network) needs to identify the actions it will undertake to
improve access, timeliness and the quality of cancer services. For example:



improve the functionality and coverage of multidisciplinary meetings (MDMs) by implementing the
regionally agreed MDM priorities
implement actions that support the region to deliver on the priorities for cancer as outlined for DHB
APs in the combined planning priorities document
where appropriate, identify workforce and IT programmes of work that support the actions the region
is undertaking to improve cancer services.
Identify and progress priorities that will support the implementation of the Cancer Health Information
Strategy (to be released in March 2015).
Please note that planning guidance on endoscopy/colonoscopy is provided in the 'Improved Access to
Diagnostics' section of the AP guidance (which can be found in the planning priorities document available on
the NSFL website).
4.2
Supporting Clinical Networks and Clinical Leadership
In 2015/16, it is expected that clinical integration will continue to be visible in the development of service
priorities. RSPs are to adopt a proactive approach to strengthening clinical integration by developing and
supporting clinical networks. In particular, the RSPs are to:


identify how the region can work with clinical leaders to make better use of clinical networks to support
improved clinical and financial sustainability of services
identify services within the region that may benefit from the development of a regional clinical
network.
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5:
HEALTH EQUITY
The World Health Organization defines equity as: the absence of avoidable or remediable differences among
populations or groups defined socially, economically, demographically or geographically. Equity is not a single
component, but rather a cross-cutting dimension across all elements of quality. Focus is not just on overall
health but the gap in quality between different groups eg, ethnicity, deprivation, age, gender, disability and
location.
Strong regional collaboration is critical to achieving health equity for all New Zealanders. The Ministry expects
that achieving health equity is a focus for all regional activity. The regions are asked to outline in their RSPs at
least two activities to help improve health equity in each of the priority areas listed below.
The Ministry is not prescriptive on appropriate activities for inclusion in the plans (with the exception of Major
Trauma) as activities will vary between regions depending on their various needs. The Ministry will be looking
for evidence that the regions have worked through a process of identifying the disparities evident in each
priority area, and outlined relevant activities to reduce these disparities in order to achieve health equity.
5.1
Priority Areas – Health Equity Focus
For 2015/16, the RSPs are expected to focus on reducing disparities and achieving health equity for all New
Zealanders in the key priority areas below:






Stroke Services
Cardiac Services
Mental Health and Addictions
Health of Older People
Elective Services
Major Trauma (focus on data collection towards implementation of major trauma data registry).
5.1.1
Health Equity Tools
Regions can use the following tools, or others at their disposal, to assess and identify regional disparities and
outline activities for achieving health equity in the priority areas listed above.



Equity of Health Care for Māori: A Framework (this was recently released in July 2014).
Whānau Ora Health Impact Assessment 2007.
The Health Equity Assessment Tool: A User's Guide 2008.
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6:
LINE OF SIGHT
For 2015/16 focus remains on ensuring there is greater alignment between RSPs and APs. The RSPs are
expected to set out the regional priorities and how DHBs intend to work as a region to achieve these. The
requirements of IT, workforce and capital to implement service priorities are also expected to be incorporated
where applicable.
6.1
The Planning Process across Regional Service Plans and Annual Plans
The Line of Sight guidance framework is provided below for general use. It aims to improve linkages across
RSPs and APs and to demonstrate how individual DHB actions contribute to achieving regional priorities.
To expand further on this framework, a combined priorities document that clearly articulates what is required
in both the RSPs and the APs for those planning priorities that cross both plans has been released.
6.1.1
Guidance framework for RSP priorities
Line of sight across Regional and Annual Plans
RSP - Common Priorities and Objectives
Priorities and objectives that DHBs within a region want to achieve.
RSP - Key Actions, Milestones and Measures



Key actions to set out what the region will do to achieve its objectives (and where appropriate
significant individual DHB contributions are identified).
Key milestones required to reach regional objective.
Measures the region will use to assess actions agreed to achieve milestones, including setting of
baselines.
RSP - Inputs / Resources
The nature of inputs may vary and could include:
 costs to implement actions in order to achieve priority
 people / teams / and/or new roles required to progress actions.
RSP - Responsibilities


Accountable roles.
Organisations and/or networks required to implement priority eg, PHOs.
RSP – Requirements of Enablers to Achieve Regional Priorities

Workforce, IT and capital requirements to deliver on regional services priorities should be explicitly
identified where relevant to achieving a regional objective.

AP – Individual DHB’s Contribution to Regional Priorities
The planning priorities document sets out the DHB’s individual actions to deliver against regional priorities
and targets. This includes:
 key individual DHB actions to deliver on regional milestones and priorities (links to regional actions)
 measures to demonstrate progress on regional milestones and priorities.
 Where appropriate, budget allocation by DHB
To streamline reporting, the local actions of DHBs to deliver on regional objectives are reported quarterly
within a consolidated regional report by Shared Services Agencies on behalf of DHBs. This is intended to
streamline reporting as individual DHBs will not be required to report local actions to support regional
priorities through their local DHB quarterly reports.
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7:
NATIONAL ENTITIES
7.1
Linkages
Linkages with other work, in particular across the National Health IT Plan, Health Workforce New Zealand,
Capital, and the Health Quality and Safety Commission need to be considered.
7.1.2
Health Quality and Safety Commission
DHBs are required to incorporate Health Quality and Safety Commission programmes into their RSPs, as
outlined in the Commission’s Statement of Intent 2014-18. In particular, DHBs are encouraged to
demonstrate a structure and planned actions for regional implementation of the ‘Open for better care’
national patient safety campaign, including establishing a regional patient safety and quality improvement
governance and working arrangements. Each region is expected to:





involve consumers (patient and family)
maintain and participate in regional governance approaches that ensure regional and local leadership
of the campaign
work with the Commission to design the topic-specific approaches to the campaign
work with the Commission to implement the campaign regionally and locally
develop networks to support the campaign and build capability for improvement.
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