TE PUAWAI
• assess needs of populations
• plan and design health services in a district at a high level, including decisions about prioritisation
• establish, set goals for, and monitor service alliances.
• identify opportunities for evolution and service development
• identify the need for work streams and service level alliances
• problem solve
How Alliances and( when required) Service Level Alliances Work Organisations sign up to an Alliance and agree that the Alliance Leadership Team( ALT) has over-arching decision making authority within the agreed scope of the Alliance. Alliances are led by the ALT and supported by alliance management teams. The ALT is predominantly clinical and the selected participants have an identified community of influence. They do not sign up to the Alliance Agreement but instead sign a Leadership Charter which binds them to participating in the decision making processes of the Alliance in a way which is consistent with the principles of the Alliance. The DHB participates as an equal member of the Alliance and is represented on the ALT in its Planning and Funding function as well as having clinical staff there as appropriate for the scope of the Alliance. However the DHB retains some reserved powers in order to reflect its statutory roles and accountabilities. The parties to the Alliance must agree to the scope of the ALT’ s decision making authority and decisions are made by consensus.
Alliances will implement the jointly agreed DHB Annual Plans which reflect the Government’ s priorities and Health Targets.
An Alliance reflects a group of organisations agreeing to work together to achieve shared outcomes and using a shared decision-making forum, the ALT, and may be able to operate without formal legal incorporation, bank accounts or staff. Alliances will need coordination and support functions. These functions will often already exist in some form within members of the Alliance( e. g. health needs analysis for a DHB, or health outcome data collection in a managed services organisation). Thus while providing these functions may require some reconfiguration of resource, it should not involve additional resources. The functions will be provided from the existing resource of all the participating organisations and professions on a secondment or co-option basis as necessary.
Service Level Alliances Service Level Alliances( SLAs) are established by the ALT as required to implement significant service change and or specific service redesign. They are decision-making forums for organising groups of related health services, including decisions on contractual mechanisms and budgets. The SLAs may, as appropriate, function for fixed periods of time. They involve the DHB and the relevant professionals, key managers and organisations which are needed to make robust decisions about service expectations, service development and redesign. This will usually involve both the professionals and organisations who deliver a given service, and those other professional groups which refer to or use the service.
In essence I read the above as a further attempt to achieve what was intended all along by the primary health strategy. When the strategy was launched many of us understood that a DHB was the entity charged with keeping its entire population
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