Te Ranga Ora

The Ministry has committed to a five-year Te Ranga Ora learning partnership with Health New Zealand | Te Whatu Ora - Counties Manukau to understand the impact of new models of care for long-term conditions (like diabetes), and how commissioning can be used as a tool for health equity and wellbeing.

Māori and Pacific people and those living with economic hardship have some of the poorest health in New Zealand.

These inequities are most marked in long-term conditions (LTCs) like diabetes, gout, heart disease and hypertension, many of which are preventable.

In Counties Manukau, there are over 67,000 people with one or more long-term conditions¹ and over 13,000 people who are Māori, Pacific and other people living in the most economically disadvantaged areas with two or more LTCs.

Poor treatment of LTCs reduces quality of life, increases risk of complications and hospitalisations, and leads to premature death.

As well as the human cost, the current annual cost of diabetes to New Zealand is $2.1 billion.

Over the next 20 years it is predicted that the number of people with type 2 diabetes will increase by 70-90%. Of these people, Māori, Pacific and Asian will be the worst affected.

Health NZ Counties Manukau has committed new funding to support Te Ranga Ora to co-design and implement new systems of care to support people with LTCs and their whānau.

The target populations for Te Ranga Ora are Māori, Pacific peoples, people living in the most economically disadvantaged areas, and their whānau, who live in the Counties Manukau rohe and have two or more long-term conditions.

To start, the new systems of care developed through Te Ranga Ora will be implemented across five ‘prototype collectives’, that each consist of at least three providers (including at least one social service/wellbeing provider) that collectively serve at least 500 service users.

The Ministry is funding a five-year learning partnership focused on understanding how to better prevent and treat long-term conditions, and how commissioning can be used as a tool for health equity and wellbeing.

Developing a Māori Health Commissioning and Implementation Framework is a priority action in Whakamaua: Māori Health Action Plan 2020-2025 (Whakamaua).

This work is one of the seven flagship projects the Ministry is undertaking in response to the Health and Disability System Review and is built on the joint work undertaken with Te Puni Kōkiri to review whānau ora commissioning (resulting in the Te Piringa commissioning framework). 

Collaborative commissioning is also a priority action in Ola Manuia: Pacific Health and Wellbeing Action Plan 2020–2025 (Ola Manuia).

The Ministry needs to test and refine commissioning models in a mix of locations and contexts to successfully improve commissioning.

Te Ranga Ora is an opportunity to do this with a project that is already underway; uses best practice evidence; has buy in from the community, and other agencies; and aligns with the Ministry’s strategic context and operating environment.

Officials consider Te Ranga Ora to be based on the best practice principles of commissioning to improve health outcomes for Māori and Pacific people.

The evaluation learning partnership with Health NZ Counties Manukau provides the opportunity for the Ministry to:

• support action learning, innovation, continuous improvement, and transferability of insights to develop a more effective approach to LTCs treatment and prevention
• gain practical insights into the system-level changes needed to implement whānau-centred commissioning
• test and understand transferable insights on how to use commissioning as a lever for better health equity overall
• deliver on a flagship programme for the Ministry’s response to the Health and Disability System Review and priorities in both Whakamaua and Ola Manuia.
• advance understanding across the social sector on how to enact new ways of working required by the Public Sector Act 2020 and the Public Finance Act 1989 wellbeing amendment.

The Ministry will share the first interim report on the evaluation with Minister Henare in July 2021.

¹Chan WC, Winnard D, Papa D (2017) People identified with selected Long Term Conditions in CM Health in 2015. Counties Manukau Health. Unpublished.