Te Ara Ako - Mei 2023

MAY 2023

International study tour sharing of findings Nā Irihapeti Mahuika

Te Ara Ako - May 2023

Overall Summary I would like to mihi to Collaborative Aotearoa for the facilitation and organisation of this Study Tour The tour included visiting pertinent places including Alberta to learn more about their primary and community integration; as well as visiting The Tamarack Institute, Greater Hamilton Health Team, North York Health Team and the Ontario Indigenous Primary Health Care Council; where we can take a deep dive into the Ontario Health Networks, the use of Collective Impact and Field Catalyst approach and Indigenous Primary /Community Health Models of Care. We were also privileged to be hosted by the indigenous healthcare leaders across Canada.

The tour the flew into London to visit a number of Integrated Care Systems, which are similar to our New Zealand model of Localities but are much further down the track in terms of maturity; so there were great opportunities to explore the concept of localities.

The tour finished with the opportunity to attend The 23rd International Conference on Integrated Care (ICIC23) in partnership with the Flanders Agency for Health and Care - ICIC23 – 23rd International Conference on Integrated Care (integratedcarefoundation.org).

We co-presented the Collective Action ki Aotearoa kaupapa alongside Healthy families team.

This was an amazing experience for us and great exposure on an international stage.

Te Ara Ako - May 2023

Te Ara Ako o Collaborative Aotearoa 2023 The study tour learnings will support our leaders in Aotearoa, New Zealand in the redesign of our primary and community care systems. Specifically aiming to deliver on the vision of achieving Hauora, health and wellbeing for all New Zealanders. We'll gain fresh perspectives and experiences that support the health reforms and multi sector collaboration that delivers real community change.

Taonga we created and took overseas to gift to the places we visited

Key Objectives Strategies and activities around indigenous leadership and improving equity of outcomes for priority populations Using innovative workforce models and comprehensive primary and community-based care models to support transformational change How to leverage community assets and community voice to plan and extend the reach of services How to use population health data to effectively understand the needs of our priority population How primary and community services integrate to provide holistic care (including primary mental health care) Using extended care teams to the top of their scope to address the widersocial determinants of health

Te Ara Ako - May 2023

CANADA Alberta Health (Edmonton, Canada) Alberta Health presented an overview of their system, the model seems broken and upon further understanding there are many flaws in the funding and design of Primary care. There is little or no investment in community care and many community care providers run off next to nothing. Alberta Health presented their system, they acknowledged the Canterbury health system as the inspiration ... proud moment right there. It is affirming to know that we are leading the way in terms of primary care.

Radius Community Health and Healing Centre

There are amazing people, doing amazing work for the most highneeds population. They do this with mana, and compassion. The team at Radius Community Health and Healing received our first mauri stone. It was an amazing moment where we were able connect and share our trauma journey. In an area of homelessness, it was confronting and clearly a high needs area, there were the most at risk, vulnerable community being served by the most amazing clinicians and support workers.

Opportunities for us: to partner with NGOs which are supporting our homeless and most at risk communities and whānau. How can we support them and ensure that they have everything they need?

Indigenous Wellness Clinic The Indigenous Wellness Centre in Alberta is an Indigenous led and run “Indigenous Health in Indigenous hands”

Te Ara Ako - May 2023

Key takeaways from this first part of the journey First Nations journeys are similar to ours in Aotearoa.

We are a part of the international journey of colonization.

There are the same intergenerational traumas that we share and we honor these journeys, together, as indigenous peoples.

We need to bring a ground swell of indigenous leadership together to be able to make progress in partnership, internationally.

Four directions learning

The basis for many of the teaching of the first national communities are based on the four directions. All aspects of being and wellbeing connects to these four aspects. They are all inter-connected. There is a strong connection of between this whakapapa of knowledge and the same foundation of knowledge here in Aotearoa.

Anishawbe Health Toronto and Indigenous Healthcare Council There is a collective of Indigenous leaders who are leading the way for their communities as advocates for the way in which the health system responds to the needs of their people. They provide education and support, grow indigenous workforce in health care, offer appropriate Indigenous healthcare in a supported and integrated way as well as support the creation of indigenous health resources.

Wisdom weavers are the opportunities to come together and share the narratives of our people to ensure they are not lost.

Resources: Effective Engagement Toolkit Indigenous Health Systems Transformation Booklet

Te Ara Ako - May 2023

Greater Hamilton Family Health Network (Hamilton, Canada) Tamarak Institute

North York Toronto Health Partners Waterloo Health Centre

North York Family Health Team

Key findings

These both had a strong focus on integrated care. There were highlights of how services can be brought together for the betterment of the communities they serve.

These visits all focused on the community first and then bringing together the appropriate services that these communities need. They are often co-located and share space so that they can best meet the needs of the people they work for. The needs of communities are paramount in the design of collaboration and services.

Te Ara Ako - May 2023

LONDON City and Hackney Place Based Partnership and Health Innovation Network (South London) Hackney and City Locality

All Localities in London had a strong partnership with local council and worked hard to consider innovative approaches that required resources and connections outside of health in order to make them work.

There are additional resources that are provided which provide additional roles into family practices (general practices). These roles are wellbeing based and provide the opportunity for clinicians to collaborate with to address and support the holistic needs of the communities they serve.

There were some interesting examples of services that were thinking of specific ways of working for particular communities of people.

Eg: there was an innovative approach to mental health care service that are offered in a very real and responsive way to their clients.

Bristol Intergrated Care Board South Bristol Locality (Innovation and Community connector roles) Brisol About Us - NHS BNSSG ICB

Long standing localities with learnings that were able to be shared with us as we enter into our journey of locality design. These included the need to resource localities properly, the structural and systemic design of localities and the importance of Leadership and guidance from other sectors such as local government and the social sector. The focus on a Health issue is responded to, not only by the Health system, but in collaboration with other sectors such as social services.

Te Ara Ako - May 2023

ANTWERP, BELGIUM International Intergrated Care Conference

Highlights

Co-designing of Mental Health models of care. The importance of lived experience voice in the codesigning of the model of care as well as the need to consider the Design of models of care should come from a systemic Collaborative approach. Eg: Over 104 different cultures in Antwerp, how do we ensure that everyone gets a voice?

An opportunity to explore the models of care which are people-focused? The closest we have here is to ensure that our TTW and other CSV models of care align with these principles.

There is a strong need to always explore and consider from a wider viewpoint, how communities can be grown to support themselves.

Consumer input into service design

I am an expert in being someone who lives with my condition When we understand what it feels like to be a consumer it makes us better clinicians We must work with partners and create networks Have clear aims and ensure there are lots of different ways to engage.

Opportunities for us: be a part of the growth and development of the practices around lived experiences. There is a national movement to honor lived experience voice, we should be a part of this.

Network example

Te Ara Ako - May 2023

Panel Discussion about Population Health approach

Panel member included John Eastwood.

(Medical Officer of Health, National Public Health Service – Southern, Te Whatu Ora – Health New Zealand, Dunedin, New Zealand).

An exploration of a population health approach...what are the influencers? What is the definition of this approach? What data informs these approaches? Canterbury was again highlighted.

Opportunities for us: ensure our understanding of what a population health approach is is clear and consistent. Ask the questions which will ensure we are all working towards a population health approach Finally, I co-presented with Collaborative Aotearoa about the kaupapa of Collective Action and the National Healthy Families team. Click here to view the presentation.