Following the announcement earlier in the year about major changes to New Zealand’s health system (reforms which aim to improve the quality and consistency of care for all New Zealanders by doing away with what has been known as ‘postcode’ health), last week the New Zealand Government unveiled a system that aims to complement these reforms: Health System Indicators.
So what is the purpose of the Health System Indicators framework?
The main aim is to measure how well the health and disability system serves New Zealand. As Health Minister Andrew Little explains, the framework is to help the sector “focus on the areas that most need to improve – especially for Māori and Pacific peoples.”
This new framework identifies high level indicators of performance while taking into account that every community has different health challenges. The emphasis is on continuous improvement at a local level to lift overall health system performance, rather than on achieving nationally-set performance targets.
What are the Health System Indicators replacing?
Developed by the Ministry of Health and the Health Quality & Safety Commission (HQSC), the health indicators replace the National Health Targets, which the Government describe as “outdated and ineffective.”
Andrew Little explains: “The targets have been in place since 2007 and there’s plenty of evidence – from New Zealand and other countries – that they don’t work. They are arbitrary and don’t reflect the real priorities of the health system. Even worse, they led to what can only be described as perverse outcomes, with district health boards seeking to meet, such as doing lots of small procedures instead fewer major ones so they could claim more people were being treated.”
What are the Health System Indicators?
The indicators are based on the Government’s six priorities for health: improving child wellbeing, improving mental wellbeing, improving wellbeing through preventative measures, creating a strong and equitable public health system, better primary healthcare and a financially sustainable health system.
How will the Health System Indicators framework work?
The Government have chosen an initial set of 12 high-level indicators for the framework that align with its priorities and will help the health and disability system to focus on the areas where improvement is needed the most. Local solutions for different parts of the country will be developed, measured and tracked to ensure positive change on each of the indicators.
DHBs and local providers will be supported during 2021/22 to partner with their stakeholders including Māori/Iwi partnership boards and clinicians to develop a set of local actions for each high-level indicator that will contribute to national improvement.
Results for the Health System Indicators will be published quarterly on a web-based dashboard hosted by the HQSC.
How will the new framework improve equity for Māori and Pacific people?
Data for all the high-level indicators (except financial performance) will be available by ethnicity, both nationally and (in due course) at a local level. This will help identify where more needs to be done, especially for Māori and Pacific peoples.
The local actions to improve national performance will be developed in partnership with local communities and stakeholders to ensure they are fit for purpose and will be delivered in a way that works for Māori and Pacific communities.