Annual Report 2017/18

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Company Overview

TAS works with the leaders and practitioners who plan, commission and deliver health and social care.

We are a professional services organisation, providing a range of strategic, advisory and programme management services to the health sector. We bring together sector experts with data analysis and health system insights, helping our customers to make informed decisions and improve service planning and delivery.

We also help build capability in the sector through education and training. Ultimately it’s about working together to create a world class health system for Kiwis. The six Central Region District Health Boards (DHBs) are our shareholders.

 
 
 
 
 

Our Expertise

  • Growing sector collaboration

  • Data analysis, insights and strategy

  • Efficient, effective programme management

  • Building capability through education and training

  • Trusted, independent advice.

 

Our core customers are the twenty District Health Boards and the Ministry of Health. Through our work we partner and connect with a broad range of stakeholders including:

 
  • Aged residential care providers

  • Primary health organisations (PHOs)

  • Unions

  • Professional associations and clinical groups

  • Government organisations

  • Sector bodies and representatives

  • Iwi

  • Non-government organisations (NGOs)

  • Health workforce and service providers.

 
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"I’ve been working in the health sector for many years. I believe in an integrated healthcare system that gives all New Zealanders access to the services they need. TAS has a good understanding of each of the 20 DHBs and pulls all the threads together"

- Carolyn Gullery, Executive Director Planning, Funding and Decision Support, Canterbury and West Coast DHBs

 
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Key Achievements

We are proud to present key achievements from the past year that
are moving TAS towards realising our 2020 vision.

Highlights of our work

TAS is committed to enhancing value for our customers to enable them to deliver the best
healthcare they can for all New Zealanders. The following highlights of our work over the past
year profile TAS’ role as a key strategic partner and enabler to help the sector achieve its aims.

We have enabled:

Integrated Pharmacy Services Contract

  • Successful conclusion of consultation and negotiation process for the new Integrated Pharmacy Services Contract.

 

Nine multi-employer collective agreements (MECAs)

  • Development opportunities in bargaining for nine multi-employer collective agreements (MECAs). Significant support was provided to the Nurses MECA.

 

Competency assessment of 937 interRAI assessors

  • Competency assessment of 937 interRAI assessors (Community and Long Term Care Facility).

 

Combined audits

  • Collaboration with Ministry of Social Development (MSD) to enable combined audits which minimise the impact and reduce costs on customers.

DHB health system performance framework

  • Development of a DHB health system performance framework in conjunction with a broad range of sector representatives.

 

WebPAS system onboarding

  • We enabled the onboarding of three DHBs to the WebPAS system (patient administration system), a significant milestone.

 

31 interRAI quality indicators

  • Development of 31 interRAI quality indicators for aged residential care providers.

 

Front+Centre

  • Establishment of the Front+Centre meeting and collaboration venue in Wellington.

 

Organisation performance

Our key performance results reflect our continuing work to build a sustainable and high
performing organisation.

 
 

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New Investment
Funding increases or investment for new work programmes or projects

2017/18

3M

2016/17

2.8M


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Customer Advocacy
Customers who would recommend TAS

2017/18

58%

2016/17

47%


 

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Customer Satisfaction
New measure, respondents rated TAS services 7+/10
 

2017/18

79%

2016/17

-


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People Engagement
Staff Engagement Index
 

2017/18

68.3%

2016/17

68.4%


 
 
 
 

Chief Executive and Chair Report

We are pleased to present the annual report for TAS for the financial year 1 July 2017 – 30 June 2018.

 

 

At TAS we are passionate about helping our customers deliver the best healthcare they can for all New Zealanders and we believe TAS plays an important role as a strategic partner and enabler to help the sector achieve its aims.

The last twelve months have seen a number of changes and reviews initiated across the health sector and the resetting of clear priorities for health from the new Government. The sector, its workforce and its performance continue to be very much in the spotlight. The operating environment for our core customers (DHBs and MoH) and in turn for TAS remains challenging in terms of growing demand for services and the associated pressure on resources.

Our people continue to deliver quality outcomes and customer service and it is pleasing to see these efforts reflected in the high customer advocacy (58%) and satisfaction scores (79%) we received in 2017/18.

The changes in our operating environment have reinforced how important it is for TAS to make sure our business is well positioned to evolve and adapt as the needs of our customers change. The financial surplus obtained this year has enabled re-investment back into our core systems, future sustainability and growth.

Our aspiration for the future is to extend our value as a proactive service based organisation, to diversify our revenue and improve resilience in our business and to help lead change to get the sector future ready. To this end we began a process in late 2017 to review our operating approach and organisational design to respond to the changing needs of DHBs while also developing new business opportunities that will benefit the health sector. This work continues into 2018/19 and reflects an exciting period ahead in the direction of the organisation.

We’d like to thank our TAS staff and Board for their support over the last twelve months.

Dr Jan White concluded her tenure as our Board Chair in June and Murray Bain took on this role.


 
Graham Smith  Chief Executive

Graham Smith
Chief Executive

Murray Bain  Chair (from 1 July 2018)

Murray Bain
Chair (from 1 July 2018)

 
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"I enjoy connecting with colleagues over shared challenges and opportunities. We’re all working together for social good."

- Rachel Haggerty, Director, Strategy, Innovation and Performance, CCDHB

 
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Key Programme Achievements

TAS core services are focused on facilitating key national and regional work programmes on behalf of New Zealand’s DHBs and the MoH. In 2017/18 we worked with our DHB and MoH partners and broader sector stakeholders to deliver key achievements across these programmes of work.

 

Workforce Services

  • Set of four strategic workforce principles developed that will drive workforce development activity across the 20 DHBs. The principles will guide national collective action and align investment in workforce development to government priorities.

  • KiwiHealthJobs website launch enabling DHBs access to other advertising mediums at no additional cost.

  • Wellbeing for Health website development and launch.

  • Partnership approach with the Health Sector Relationship Agreement (HSRA) to develop a website of tools focused on promoting and building wellbeing across the health workforce.

  • Development of the Care Capacity Demand Management (CCDM) website to make resources more readily available.

  • Allocation methodology developed across the DHBs to enable best placement of medical graduates across regions.

  • Vacancy reporting added to the suite of health workforce metrics.

  • Completion of Audiology and Occupational Therapy workforce assessments.

 
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Employment Relations

  • Development opportunities in bargaining for nine multi-employer collective

  • agreements (MECA).

  • Joint working group with Council of Trade Unions (CTU) and health sector unions

  • to deliver a process and framework for reviewing DHB payroll systems.

  • Leadership of DHB pay equity process and claims, NZ Nurses Organisation

  • Independent Panel Process (NZNO IPP) and working party with E tū to address low

  • pay as per Government Expectations.

  • 90 attendees at employment relations conference ‘Gaining the Edge’


Community Pharmacy

Contract consultation process with the Community Pharmacy sector:

  • 25 regional hui and 2 national hui held for consultation.

  • 1000+ submissions received on proposed new contract.

  • Post-consultation, DHBs and sector representatives have worked to jointly agree an evergreen Integrated Community Pharmacy Services Agreement that will be implemented 1 October 2018, which will support delivery of the Pharmacy Action Plan.


Health of Older People

  • Funding Model Review for Aged Residential Care (ARC) formally commenced in January 2018.

  • Guaranteed hours for Home and Community Support Services (HCSS) workforce implemented across home and community support.

  • 80% of employees in HCSS on guaranteed hours at 36 hours per fortnight.

  • Pay Equity funding included in aged residential care pricing in ARC contracts.

 
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Health System Performance

  • ‘Your Health System: A DHB Lens’ prepared for the DHBs’ briefing of the incoming government. This report was a comprehensive overview of the shared aspirations and challenges facing the sector from the DHBs’ perspective.

  • Two submissions produced responding to the Productivity Commission’s Inquiry on measuring state sector productivity

  • DHB Health System performance framework developed.

  • Hosted a round-table led by Professor Patrick Dunleavy (London School of Economics) and Jason Tabarias on the diffusion of innovation in the New Zealand hospital sector.

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Primary Care

Primary Care Leaders’ Forum on Urgent Care
Forum for all DB Primary Care Portfolio Managers on models of care, information technology innovations and system level measures.

Working group established with representatives from the Primary Care and Aged Care sectors, to examine ways to improve access to general practice services for residents of Aged Care facilities. Areas of focus included contract alignment, relationships, workforce and technology enablers.


New Zealand Health Innovation Network (NZHIN)

Facebook Workplace pilot launched, targeting innovators to connect up networks across the sector and encourage collaboration, facilitate information sharing, and enable virtual sharing of capability and capacity.


interRAI

 
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interRAI patient assessments completed. 
(ew and re-assessments)

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Palliative Care assessment rolled out

 
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interRAI assessors achieve competency. (Community and Long Term Care Facility)

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Data visualisation tool launched

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interRAI quality indicators developed for aged residential care providers.

 
 
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Regional Health Informatics Programme (RHIP)

  • Shared Web Patient Administration System (WebPAS) live in three DHBs

  • Regional Application Data Access (RADA) live.

  • Regional Operations Directorate created.

  • Programme move to BAU, and formal Service Delivery Partner established.

  • Signed MoU with six DHBs to formalise roles and responsibilities for regional support.

 
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Audit and Assurance

  • 65 audits completed within the Central Region.

  • Scope of all audits extended in 2017/2018 to cover the new legislation under the

    Vulnerable Children Act and the new Health and Safety Legislation.

  • Extension of audit service scope to enable TAS to award certification.

  • Growth in the number of customers within the certification audit programme.


Regional Services Plan (RSP)

  • National Expected Clinical Standards implemented by primary care as part of their management of people with acute cardiac syndrome.

  • 85% of every primary care team/practice with access to atrial fibrillation diagnostics (of the remaining 15%, these practices are within 10 minutes by car to the nearest hospital or after hours medical centre).

  • Regional collaboration strengthened the implementation of the NZ Dementia Framework and the actions specific in Improving Lives for People with Dementia.

  • Achievement of a 17% thrombolysis rate for the regional stroke service, above the expected target of 8%.


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" I’ve been to Front+Centre four times. It’s a different kind of environment to the usual – it encourages participation and discussion "

- Sha Bolivar, Registered Nurse

 
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Strategic Objectives

 
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Strategic Objective:
Delivering Value to the Sector

 

TAS has a strong focus on continuous improvement to ensure we keep adding value to our customers and the sector. 

Over the last year we’ve re-examined our value proposition to understand more about the value we bring to our customers, opportunities for the future and how we can enhance our service delivery.

Through a series of staff workshops we identified key areas of value that TAS provides to our stakeholders.  We tested these out with some key customers and stakeholders via one-on-one interviews and through our annual customer satisfaction survey. Our value attributes resonated strongly with our customer groups.

Understanding these core areas of value provides us with a more holistic framework to enhance and measure our performance as an organisation.

 

Percentage of survey respondents that ranked TAS value attributes as important or very important

 
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89%

Building sector collaboration

 

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75%

Building sector capability through training

 

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87%

Providing independent and trusted advice

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95%

Providing cost effective and efficient expertise

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97%

Delivering meaningful data insights and strategic advice

 

 

 
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Strategic Objective:
Getting Closer to our Customers

 

Partnering with our customers to enable them to reach their goals lies at the heart of our business. 

Customer Satisfaction
Each year we formally evaluate how well we are delivering against customer expectations through our annual customer satisfaction survey. Respondents to the survey were from a mix of District Health Boards, the Ministry of Health and other health sector organisations, in a variety of roles. This year’s survey examined four key areas – customer advocacy, customer satisfaction, perceptions of TAS and our value proposition. Overall the survey findings were positive. 

 
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Strategic Objective:
Innovating smart business processes

To enable us to evolve and grow we need to invest in and strengthen the foundations on which TAS sits. 

Our major business process initiative in 2017/18 was the review of our operating model and organisation design to enable flexibility, expertise and agility; be more responsive to changing customer needs; better leverage our internal capability and resources; and grow the career and skills development opportunities for our people.

The senior leadership team led the organisation through a process which examined our value proposition, existing ways of working, our current and desired culture and opportunities to extend our value. We also sought our customers’ perspectives to ensure we were aligning our future pathway with their expectations and needs.  

We agreed a number of ‘shifts’ that we believe will enable us to fulfill the potential of TAS and realise our 2020 Vision aspirations. These shifts are positioned around the framework below:

Evolving our core services
"Optimising how we work across service lines to deliver greater impact"

Growing new business
"Developing new products and services that benefit the health sector"

Strengthening our foundations
"Investing in our people, systems and processes to achieve a customer centric culture and unified TAS way of working"

To implement the changes we need to make, we are embarking on a transition programme for the organisation in 2018/9. Our intial focus will be on investment in our tools, systems, people and processes and optimising how we work across our customer service lines. 


 
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Strategic Objective:
Growing our People

We’re committed to growing innovative, trusted, expert advisors, who love what they do to make a difference.

 
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Our TAS Values

Our values of aspiration, integrity, courage and professionalism are a core part of how we approach our work at TAS. In 2017/18 we developed how we were sharing these values with our people. Visual representation of the values were created and we refined how we described them based on input from our teams. 

We also launched a new Living the Values award to encourage and recognise staff who are role modelling the values.

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Building our culture

As part of the operating model review we held workshops with our teams to explore the current and desired TAS culture. This helped us understand the parts of our organisation culture that we value and want to carry forward into the future, and identified elements that our people wanted to develop for future.

Elements for development:

  • Customer focused

  • Shared and unified TAS approach to work

  • Accountable and transparent about our efforts

  • Valuing and encouraging diversity

  • Working as partners with our stakeholders and customers

  • Strong sense of community and connectedness – friendly and caring

  • Supporting innovation, learning and growth and celebrating success.


Health, Safety and Wellness

Our health, safety and wellness committee is made up of representatives from each business unit. They meet regularly to monitor health and safety processes and initiatives in the organisation.

Risks
The main risks for TAS staff are discomfort, pain or injury from computer use, risks around working alone for our remote staff and managing contractor risks.

Key achievements over the last year

  • A SafePlus Assessment

  • First Aid Course run on site for staff

  • Purchase of a defibrillator (it is also included on the defib app)

  • Events organised to encourage activity - Active April and Step’tember

  • Proactive health initiatives such as free flu vaccinations

  • Ergonomic workstation set ups and assessments.

The SafePlus report made a number of recommendations which TAS is incorporating into a more comprehensive health, safety and wellness strategy.


 
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Setting a good example: extending a maternal mental health model to eating disorders

It’s been a big year in the Mental Health and Addiction sector. A national enquiry into mental health, new Substance Addiction legislation and renewed media and public attention, meant staff worked extra hard to deliver projects, on top of their everyday work. One project in the central region, reviewing a clinical network approach in maternal mental health, led to thinking about how this could be applied to other areas, including helping people with the experience of eating disorders. 

Project members John Zonnevylle, Jade Walker, Tracey McIntyre and Emma Thompson (pictured left to right)

Project members John Zonnevylle, Jade Walker, Tracey McIntyre and Emma Thompson (pictured left to right)

John Zonnevylle, Operations Manager responsible for the maternal mental health team and central region eating disorder team, says the team wanted to improve service delivery for people with the experience of eating disorders. ‘We knew the maternal mental health care model was similar, in that we support regional partner DHBs, who in turn support women and babies in their local area. We wanted to take those learnings, and apply them in a different way. Our aim is for people experiencing eating disorders to get the best possible treatment in their local area, and only need to use the tertiary service in Wellington when absolutely required.’

’The great work done by Jade Walker, Tracey McIntyre and the Specialist Maternal Mental Health Team has provided us with a good template to guide further developments.’

A regional co-ordinator had been put in place for the specialist maternal mental health service, to provide education and training to local services, improving and enhancing care for mothers before and after giving birth. Where a mother had a high level of distress, the central region opted to keep services in her own home and community.

A group of clinical leads and service leads supported by TAS, identified that the Central Region Eating Disorders service (CREDS) could benefit from a similar solution.

Josh Palmer, Planning and Improvement Manager at TAS says ‘The maternal mental health service gave us a template, so now we’re able to perform a clear gap analysis. We can see what we need, and where we need to go. We know that CREDS could benefit from having another staff member skilled in education co-ordination, and facilitating connections across the region.’

John Zonnevylle reiterates this. ‘Unless you carve out time for education and support, people in clinical roles struggle to do it. Having a dedicated role has been one of the keys to success for the specialist maternal team.’

John says ‘TAS’ support was integral to driving forward the project. TAS staff highlighted the opportunity to use our learning, and were a sounding board for defining our thinking. They gave us their full support. Time remained a challenge throughout the process, and we needed simple determination and perseverance to move to success.’

TAS staff highlighted the opportunity to use our learning, and were a sounding board for defining our thinking. They gave us their full support.

John Zonnevylle

 
 

Caring for older people: A case for better data

A series of workshops around the country are bringing together key players in the Aged Residential Care sector, and helping aged care facilities learn more about their residents.

Aged residential care managers at a workshop use interRAI data to learn more about their residents.

Aged residential care managers at a workshop use interRAI data to learn more about their residents.

John McDougall, Data Analyst at the New Zealand Aged Care Association (NZACA), is an advocate of bringing people together to learn more about interRAI – assessments that take place to fully understand an older person needs and plan their care.

interRAI assessors, often Registered Nurses, complete a comprehensive clinical assessment with an older person. This forms the basis of a care plan to support someone in their own home or when they need to go into residential care.

John says Given that NZACA was supportive of the introduction of interRAI (which became mandatory for aged care facilities in 2015), we were dismayed that many of our members were finding it a burden. We wanted to ensure aged care facility managers understood how to use interRAI more efficiently, and get through the assessment process quickly.’ 

The NZACA was keen to collaborate with TAS in delivering a series of workshops for aged residential care staff.

‘The workshops are a joint venture between TAS and the NZACA. interRAI educators – a service provided by TAS - do the training and teaching at the workshops. I’m involved as an NZACA representative,’ John says.TAS facilitators deliver the presentation, working through how health professionals can maximise the value from interRAI, make better use of interRAI data and learn more about their residents. interRAI data provides a picture of the individual person’s needs and where services could improve function, slow rate of decline or help symptoms. The workshops bring together people who have the common goal of caring for older people, and allow them to put a face to a name, and establish new points of contact.

Sandra Deegan, Facility care manager/Registered Nurse at Cottage Rest Home in Opunake says the workshops helped her feel part of something bigger. ‘It was great to network with others, and realise you’re not alone – you’re not the only one going through something.’

‘At the workshop I learned that interRAI reports can be printed off monthly. I now spend one day a month downloading the reports and giving the information to the trust who governs our rest home.’ 

We wanted to ensure aged care facility managers understood how to use interRAI more efficiently, and get through the assessment process quickly.

John McDougall

 
 
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New contract for pharmacy services centres on people

A new contract for community pharmacy services marks a turning point in providing integrated pharmacy services to our communities.

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The new contract will support delivery of a key government health strategy – the Pharmacy Action Plan. It puts people at the centre of services, and envisions a healthcare system where pharmacists are skilled medicine advisors, working with other health professionals to achieve the best health outcomes for people.

To get the contract over the line, TAS supported DHBs in extensive consultation and engagement with community pharmacy owners, pharmacy sector groups, health and consumer groups. Carolyn Gullery, Lead GM Planning and Funding for Pharmacy, says ‘TAS was there every step of the way. TAS worked with legal advisors, provided meeting secretariat support and liaised with sector representatives.'

 

The road to success

The genesis of the new contract was in 2015, when DHBs wanted to take a different approach to pharmacy, in line with the New Zealand Health Strategy and Pharmacy Action Plan.

The consultation process began in 2017. DHBs held roadshows across the country from March to April 2018 along with two national hui. People shared their views via an online survey, and TAS grouped feedback from 1100 valid consultation survey responses.

Rachel McKay, Community Pharmacy Services Programme Director at TAS, says a turning point in the process was the decision to use Buddle Findlay as the legal advisors for the contract.

‘Buddle Findlay have worked on other significant DHB service contracts, meaning our stakeholders had confidence that the pharmacy contract could work in practice. Having the same legal advisors working across contracts also supports developing integrated services in the future’.

 

What’s changed?

The new contract, called the Integrated Community Pharmacy Services Agreement, is a step towards pharmacists working in more integrated ways with other healthcare providers, like GPs.

‘As well as working in community pharmacies, pharmacists could be working alongside other health professionals in local communities to deliver more integrated services for consumers, in health care centres, on marae, or even in people’s homes. We want to make the dispensing function more efficient, and enable pharmacists to spend more time talking with patients, and make more use of their clinical expertise in medicines management,’ Rachel says.

 

What’s next?

While parts of the contract are nationally consistent, it also allows for more localised services, and for pharmacists to work with other health professionals to better respond to local community needs. Carolyn Gullery says that TAS will continue to provide support to DHBs, and be instrumental in sharing learnings across DHBs, going forward. The new contract will take effect from 1 October 2018.

As well as working in community pharmacies, pharmacists could be working alongside other health professionals in local communities to deliver more integrated services for consumers, in health care centres, on marae, or even in people’s homes.

Rachel McKay

 
 
 

Attracting the right kind of talent: Kiwi Health Jobs

Every month, around 30,000 people visit kiwihealthjobs.co.nz to look for their next health role. Introduced in 2011, Kiwi Health Jobs is a key recruitment tool for the 20 DHBs and the NZ Blood Service - and it is paying dividends through cheaper advertising and a growing pool of talent applying for health sector roles. The website also has a critical role to play in finding candidates for hard-to-fill roles, like midwifery. 

Kiwi Health Jobs is a key recruitment tool for DHBs to source health professionals.

Kiwi Health Jobs is a key recruitment tool for DHBs to source health professionals.

Martin Price, National Chairperson on behalf of the General Managers, Human Resources (GMs HR), says that collaboration is key to the success of Kiwi Health Jobs. ‘Each of the 20 DHBs pool their resources and act in unison. It only costs $26.00 on average to place a recruitment ad on the Kiwi Health Jobs website, in contrast to $150.00 on average for a job ad on a commercial job website.’ 

Over the past year, TAS co-ordinated continuous improvements to Kiwi Health Jobs, collaborating with DHB recruitment representatives and general managers of HR to keep the site fresh and relevant. One of these improvement initiatives was to integrate the website with existing job feeds.

Kiwi Health Jobs now has direct linkage with leading commercial job sites and is working to develop a link with jobs.govt.nz, saving recruiters time and money.

‘We’re able to take our advertisements even further than before,’ Martin Price says. ‘Through the direct link with other job boards, we’re growing Kiwi Health Jobs’ reach. To run a successful jobs website, you need to be big, and get lots of relevant candidates to come and see you. The more job adverts you have, the more candidates you attract. It’s a virtuous circle.’ 

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Fifty-seven percent of visitors access the site from New Zealand, but Kiwis aren’t the only ones looking for health sector roles. Twenty-three percent of site visitors come from the UK, US and Australia. 

‘The programme team identified at-risk occupations in New Zealand and globally, where there are significant skills shortages,’ Martin says. ‘These roles – such as sonographers, midwives and psychiatrists – are hard to fill and will be for years to come.’

The programme team is taking a proactive approach to recruit people in these roles.

‘In the UK, we’re piloting advertising to reach potential candidates in hard-to-fill roles, and attract them to come to New Zealand. It’s a long-term process, too – it starts right back at university level, when people decide to go into these careers.’

Martin and the team have high hopes for the future. ‘If Kiwi Health Jobs continues to be a success, we’ll be able to significantly expand our international presence, and help fill these at-risk roles. This will have flow-on effects and will benefit the New Zealand health system.’

Each of the 20 DHBs pool their resources and act in unison. We’re able to take our advertisements even further than before.

Martin Price

 
 
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