School Based Health Services – Health New Zealand

About SBHS

Improving the wellbeing and resilience of young people will give them a better sense of connection and help to ensure they are ready to learn and more likely to achieve at secondary school.

Young people need to be supported to develop confidence to reach out for help and support when they need it.

School Based Health Services (SBHS) takes a holistic approach to supporting young people. The most common presentations include, but are not limited to:

trauma-based health impacts particularly family harm
mental health
addictions
sexual and reproductive health.

SBHS nurses provide free and confidential clinical primary health care and referrals on to required services. They also support health promotion campaigns within the secondary school community.

Students can request to see the nurse, or the nurse may reach out to offer support.

Available to around 115,000 students in 300 secondary schools across Aotearoa New Zealand, covering:

lower decile (decile 1 to 5) secondary schools
Teen Parent Units (TPUs)
Activity Centres and Alternative Education sites (AE).

School health services may also be available in other schools, for example, where:

schools pay for their own nurse
the district or primary health organisation has chosen to supplement services with a GP
primary and intermediate schools.

Our focus

SBHS has a focus on populations currently not well served by the system, including:

rangatahi Māori
Pacific young people
rainbow young people
care-experienced young people
young people with disability.

Our work

SBHS’s work programme includes:

Partnership and communications.
Embedding Te Ūkaipō.
Workforce development.
Data and information.
Commissioning and funding.
Puna ako.

Who we're working with

We work with a range of partners, including young people and the youth health sector. Our partnership includes:

Te Tatau Kitenga | Youth Health Sector Advisory Group
Māngai Whakatipu | Youth Advisory Group
Te Rōpū Mātanga o Rangatahi | Māori Youth Health Sector Advisory Group
Malatest International – Evaluation
Society of Youth Health Professionals Aotearoa New Zealand (SYHPANZ) – Workforce Development
Deloitte –Te Ūkaipō Wānanga Programme
Hauora Māori Services
Ministry of Education
Manatū Hauora.

Te Ūkaipō: Our vision and values framework

“Te hoki atu ki te wāhi i ahu mai koe, te wāhi i whāngaitia e koe hei oranga mōu mō te rerenga ki mua”

To return to the place of your origin, the place where you can be nourished to sustain you for the journey ahead.

Te Ūkaipō includes nine interconnected kaupapa Māori whanonga pono (values) with corresponding whakataukī.

Together these values form a strong and sturdy kōhanga (nest), a safe space for rangatahi to come into, ask questions, grow and develop.

Te Ūkaipō is the model of care for SBHS, in the way we work, the mahi we do and the outcomes for young people. It is the foundation for all the workstreams and enhancements to SBHS.

Te Ūkaipō was developed by Te Rōpū Mātanga o Rangatahi as an expression of Te Ao Māori , Mātauranga Māori and Te Tiriti o Waitangi principles.

Te Rōpū Mātanga o Rangatahi are the kaitiaki of Te Ūkaipō. The Te Ūkaipō Vision and Values Framework is available in the Documents section below alongside a compliation video and podcasts.

Compliation video (90 seconds).
Overarching podcast: An overview and introduction to Te Ūkaipō including the whakapapa.
Youth Related podcast: Two rangatahi (Devontae and Aorangi) speak about what Te Ūkaipō means to them.
Nurses podcast: Nurses speak to what Te Ūkaipō means to them and their practice in SBHS.
Training for Providers podcast: Discussion on how Te Ūkaipō can help to enhance the practice of SBHS kaimahi and how providers can support its use.
Commissioner podcast: Focused on the role of commissioning in embedding Te Ūkaipō and equitable health outcomes for rangatahi.
Te Reo Māori podcast: An overview and introduction to Te Ūkaipō including the whakapapa all in Te Reo Māori.

Embedding Te Ūkaipō

Te Ūkaipō shapes and influences practice, commissioning, and delivery of SBHS by enabling a Māori-centric approach to enhance the experience of young people in SBHS.

As we apply Te Ūkaipō we consider the relationship with whānau and the partnerships between services as these are essential to the wellbeing of whānau and their ability to access and engage with services easily.

The Te Ūkaipō Wānanga Programme enables SBHS health practitioners, planners and funders to:

understand the Māori-centred approach to service delivery
apply Te Ūkaipō in their practice as the model of care
enhance the experience of rangatahi in SBHS.

The Programme is for anyone practising in SBHS, including nurses, doctors, counsellors, funders and planners.

Resources include e-learning on the LearnOnline platform, and kanohi ki te kanohi wānanga.

The programme runs until June 2025.

Resources are available to download and print to promote Te Ūkaipō in the Te Ūkaipō framework resources section.

Te Tatau Kitenga | Youth Health Sector Advisory Group

Te Tatau Kitenga was established in February 2020 through a partnership between the Ministry of Health and the Society of Youth Health Professionals Aotearoa New Zealand (SYHPANZ).

The name was gifted by the SYHPANZ Kaumatua, translating as ‘The Doorway to Foresight’ in recognition of the group’s strategic vision for young people and their function as door holders for others.

Te Tatau Kitenga provides expert advice and recommendations to Te Whatu Ora on youth-related topics and services, especially for SBHS priority groups.

See Te Tatau Membership List in Documents section below.

Te Rōpū Mātanga o Rangatahi | Māori Youth Health Sector Advisory Group

Te Rōpū Mātanga o Rangatahi was established in August 2020 as an advisory rōpū that sits within Te Tatau Kitenga. The name was also gifted by the SYHPANZ kaumatua, meaning ‘The Watchmen of Rangatahi’.

Te Rōpū Mātanga o Rangatahi provides leadership and advice to ensure that the work of Te Tatau Kitenga upholds Te Tiriti o Waitangi and is focused on equity.

Members of Te Rōpū Mātanga o Rangatahi are also part of Te Tatau Kitenga, recognising the partnership required to embed te Tiriti o Waitangi and equity in this mahi.

Māngai Whakatipu | Youth Advisory Group

In 2021, Te Tatau Kitenga supported a youth advisory group, known as the National Youth Committee for School Based Health Services (NYC) to develop a report that captured the voice of young people in SBHS.

The NYC report identified these priorities:

a supportive culture around accessing SBHS so services are accessible without barriers
all rangatahi youth in Aotearoa NZ, no matter what education they’re receiving, or their background have access to all health services
the environment which rangatahi receive SBHS should be safe and comforting
a system that caters to all and isn’t a “One-Size doesn’t Fit All” approach.

Māngai Whakatipu | Youth Advisory Group was formally established in 2022 to focus on quality improvement and enhancement activities for SBHS.

The name was developed by the group supported by the Pou Tikanga for the Family and Community Health group. It reflects their vision to be representatives of the descendants, voices for generations to come and voices of the future.

Our partnership with young people through Māngai Whakatipu means they can be involved in all stages of design, equal with adults.

It brings youth voice, perspectives, knowledge, and experience into the enhancements programme and advises the programme partners on tailored communications material and channels for young people.

See National Youth Committee Report on SBHS 2021 in Documents section below.

Te Tatau Kitenga discussion document

Te Tatau Kitenga provided a discussion document for Health NZ with advice and recommendations for improving SBHS (the discussion document).

The discussion document identified six priorities for the enhancement of SBHS:

improving equity
aligning SBHS to te Ao Māori values and principles
building young people’s engagement and leadership
developing the workforce
embedding Te Ūkaipō in SBHS service standards
measuring the hard to measure, but important, needs and outcomes.

See link to the Discussion Document in the Documents section below.

SBHS evaluation

The objectives of the SBHS evaluation are to:

ensure that SBHS contributes to achieving equity and improving outcomes for young people
set the standard for equitable, effective, and efficient SBHS
drive quality improvement
further build the evidence base for investment in and implementation of SBHS
inform any expansion of SBHS.

SBHS evaluation framework

The evaluation team worked closely with Te Rōpū Mātanga o Rangatahi to ensure the SBHS evaluation frameworks are based on Te Ūkaipō and reflect how Te Ūkaipō creates change in the SBHS programme.

This change in turn leads to rangatahi experiencing and achieving Te Ūkaipō outcomes.

The SBHS evaluation framework shows how those outcomes link to the outcomes of the Child and Youth Wellbeing Strategy.

It includes the evaluation questions and indicators for measuring the changes within SBHS, and the impact of those changes for rangatahi.

See link to the SBHS evaluation frameworks in the Documents section below.

Formative evaluation

The evaluation team completed a formative evaluation of SBHS in 2021 to form a baseline for further evaluation of SBHS as the enhancements come into effect.

The formative evaluation describes the current state of SBHS, focusing on:

rangatahi voice and leadership
care delivery
workforce
rangatahi-centred service
connections with other staff and services.

See link to the formative evaluation in the Documents section below.

In 2022, the focus was on improving reporting and monitoring and ensuring youth voice informs quality improvement activities.

The evaluation team continued to support reporting and monitoring and rangatahi voice during 2023.

The team provided evaluation support for the Te Ūkaipō Wānanga Programme and the workforce development project.

Workforce Development project

This project aims to develop, support and grow the SBHS workforce, so it:

can provide a consistently high standard of healthcare delivery, particularly for our priority groups
contributes to equitable access and outcomes
reflects the diversity of the rangatahi it serves
is sustainable
is ‘fit for purpose’
can deliver the new model of care.

The first stage of the project was to gather and review information to describe the current state, including hearing the workforce voice, and form a stocktake and analysis of the characteristics of the existing SBHS workforce.

The second stage of the project was to prepare a desired state report. This report brings through the rangatahi voice and the kaimahi voice on where workforce transformation is needed and how to achieve that.

These will inform the development of SBHS Workforce Development Plan.

See link to the current and desired workforce development reports in the Documents section below.

Model of Care project (MoC)

MoC is one of the workstreams in the enhancements programme.

The aim of the project was to develop a MoC based on positive models of youth health and development, that works from a holistic perspective, is grounded in Te Ūkaipō and can be embedded in the context of a young person’s life and relationships.

The project focused on the existing Year 9 Health Assessment within SBHS to address the issues with the current check around quality, capacity and outcomes.

The first stage was to gather and review information to describe the current state, focusing on the voice of our priority groups.

Then we wanted to hear the voices of the priority groups and make recommendations for the MoC. The report recommends that the MoC should support an interaction that: