Primary Care Development Programme
Health New Zealand is strengthening primary and rural care, so all New Zealanders receive timely access to quality health care.
Pātiki and Waharua Kōpito patterns
It’s vital all New Zealanders have timely access to quality health care, when and where they need it.
Most New Zealanders access the health system through a primary health care provider, such as a local doctor.
Primary care sector
The primary care sector protects, promotes, and improves people’s health by delivering timely access to quality healthcare.
It plays a key role in preventing illness, treating disease early, and reducing the impact of long-term conditions.
Primary care delivers most of the services most New Zealanders need and organises access to more specialised services when needed.
The Interim New Zealand Health Plan 2022-2024 | Te Pae Tata identified the need to strengthen primary care as one of the health reform opportunities to:
- reduce the risk and burden of disease
- reduce demand for more costly and intensive specialist care
- achieve better and more equitable health and wellbeing outcomes for all New Zealanders.
Primary care services are facing severe capacity and resource constraints.
Many practices are unable to accept new patients, and waiting times are too long.
About the programme
The programme aims to address the major capacity constraints and access blocks, to the extent we can within current funding settings.
To help meet the growing demand, primary care providers, partners and stakeholders will provide input as we investigate how:
- to grow the primary care workforce (including both medical and non-medical roles)
- best to deploy roles such as paramedics, nurse practitioners, physiotherapists, pharmacists, and nurse prescribers, to provide both routine and urgent care services
- to better target capitation and other primary care funding
- to get more consistent delivery of services across Aotearoa New Zealand
- telehealth services can best support face to face providers
- best to organise networks of providers through PHOs in future.
Engagement
Key to the programme’s success will be strong engagement with, and input from, primary care providers, partners, and stakeholders.
Expected outcomes
The programme will take a progressive improvement approach; we recognise that constrained primary care capacity and resources is limiting access to care now, and that as improvements are developed they should be progressively implemented.
Over time, we aim to:
- make it easier to get a GP appointment (face to face or online)
- access x-rays or other diagnostic imaging quickly
- get additional well-connected care if you have complex needs
- use telehealth if your local health care provider is full or it's more convenient.
The programme is led by Health New Zealand’s Commissioning business group and is aligned with the Manatū Hauora - Ministry of Health policy work programme.
Work streams
- Primary care
- Urgent and afterhours care
- Rural unplanned care
Each work stream is supported by at least one expert advisory group.
A further workstream is the Telehealth Service Review that will inform a longer-term telehealth service commissioning plan.
Primary care
Primary care
Objectives
- Support the implementation of modern, secure, and interoperable Primary ICT services, and develop a primary care data repository.
- Identify the capacity needed to meet future demand for primary care services. This includes assessing different workforce models and associated models of care.
- Revise capitation rates to better reflect patient need and modernise performance frameworks.
- Develop a clear description of the future primary health care services we want to purchase from PHOs (or similar organisations).
- Develop an approach to providing primary care to populations with high and complex clinical needs (e.g., those in aged care facilities).
- Implement consistent access to community referred radiology across Aotearoa New Zealand.
Urgent and afterhours care
Urgent and afterhours care
Objectives
- Review current service and funding models.
- Develop (in collaboration with ACC) a consistent set of urgent/afterhours care service models that can be deployed to meet local needs, standardising quality, metrics, co-payments, opening hours, and service delivery level constraints.
- Identify and discuss associated risks.
- Define nationally consistent service coverage expectations.
- Assess workforce capacity and training needs for future models.
Rural unplanned care
Rural unplanned care
Objectives
Identify rural emergency health services, location and distribution of services needed.
Design future models or options for Primary Response in Medical Emergencies (PRIME), and rural emergency response delivery, by:
- developing a more integrated and responsive rural unplanned care system, that improves equity of access for rural communities
- designing a streamlined and sustainable funding mechanism, to improve rural service viability.
Read more on the Rural Unplanned Urgent Care re-design page
Timeline
The initial phases of programme will run until June 2025, after which further phases will be developed.
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By July 2024 we expect to have:
- completed a discussion document on the future functions required of PHOs (or successor entities)
- completed initial modelling of capitation reweighting to better reflect equity.
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By December 2024 we expect to have:
- reviewed the rural unplanned care system (including the PRIME contract)
- developed the workforce models
- finalised the funding options for changes to capitation and funding of urgent care.
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By July 2025 we expect to have:
- started the rollout of consistent access to radiology across New Zealand
- set out a plan for future delivery of urgent care services, including in rural New Zealand.
Get involved
We can’t do this work without input from primary care providers.
As the programme progresses, we’ll let you know how you can engage with the design activity across all workstreams.
In the meantime, if you want to know more, please email: Primary.Care@tewhatuora.govt.nz