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undergraduate programme. Postgraduate study amongst the practice nurses is also encouraged and a new graduate of a few years ago is almost ready to submit her NP portfolio. Karyn Sangster Chief Nurse Advisor Primary and Integrated Care at Counties Manukau DHB told the group about significant practice change spurred on by GP Dr Tim Hou’s observation that the traditional primary care model wasn’t working well for people with long term health conditions. In order to better meet the needs a planned, proactive care programme has been developed. The programme is overseen by a clinical governance board with nurses, allied health and doctors supported to provide more purposeful assessment, care planning and care coordination to over 21,300 people with long term conditions. All the people in the programme now have an electronic shared care plan visible across the health system. by NZ nurses to assist in the journey of change. A strategic nursing leadership narrative would align itself with the vision of the NZHS. I imagine the call to action will be every place is the right place, for responding to the health needs of people. A substantial shift will be required away from traditional places of care (hospitals) to care closer to peoples home and as directed by their needs. Corresponding shifts in nursing education and in models of care, alongside ongoing removal of any barriers to innovation will need to occur. I look forward to sharing the early draft of a strategic narrative with you early in the New Year. In the meantime I want to thank you all for the remarkable work you do in primary and community care for New Zealanders, I wish you a very safe and happy Christmas and a wonderful 2017. A strategic narrative for change A recent discussion with a senior primary care nurse has motivated me to consider further developing, with the sector, a strategic nursing leadership narrative for guidance, use and adaptation December 2016 L.O.G.I.C 5