DHBs’ Employment Relations Strategy

Over the past year TAS has been leading development of a five-year ‘20 DHBs Employment Relations Strategy’ (ER Strategy).

“With complex health challenges and no overarching ER strategy providing context and direction, how do we know our employment arrangements enable DHBs to meet these environmental and operational challenges as they deliver health care for their communities,” reflected Peter Brown, TAS Director of Employment Relations.

Participants at the Employment Relations (ER) strategy session - 2019 ER Conference

Participants at the Employment Relations (ER) strategy session - 2019 ER Conference



To develop the strategy, TAS on behalf of DHBs held a number of consultation workshops nationally, with each workshop engaging the voices of both clinical and non-clinical employees, and union representatives. The workshops focused on the overarching objective that future employment arrangements need to deliver across the health sector and the challenges facing the sector in New Zealand.

Stephen Cummings, Victoria University of Wellington’s

Professor of Strategy and Innovation was brought in as an expert advisor to support the workshops, and team, to develop the strategy.

Stephen focused on using the ‘Growth Options Heatmap’ to help sort and prioritise feedback from the workshops. The heatmap is a unique approach to the use and interpretation of the traditional SWOT analysis and enabled the identification of five key strategic intents. Stephen’s book, Strategy Builder (Wiley, 2015) was a relevant source of information on the most effective way to develop and visualise a strategy.

The Balanced Scorecard approach was then used to develop operational strategies, goals and measures, across innovation and learning, customer, financial and internal business perspectives.


Any ER strategy needs to enable future proofed employment arrangements to address our workforce and health operating environment challenges.

Examples of these changes and challenges include:

  • the increasing complexity and expectations of the medical treatments available to diagnose and treat each patient

  • the use of artificial intelligence, robotics, automation and advanced digital and cognitive technologies disrupting health care delivery models

  • the increased use of trans disciplinary teams in the delivery of patient care

  • the continuing pressure on the funding available for health care.

“We enjoyed a high level of enthusiastic engagement with unions and health sector practitioners who all provided a realistic picture of the challenges facing DHBs and their views on strengths in the sector.”

Peter Brown, TAS Programme Director of Employment Relations


It was important that the ER Strategy Development team closely engaged with the Ministry of Health Workforce Strategy Group, in order to align the strategy, goals and measures across both strategies.

The more than 70,000 employees across our 20 DHBs account for the majority of the health expense budget. It was important to develop a pragmatic ER Strategy that recognised this and enabled achievement of our overall workforce objectives and created long-term benefits for our health operations and workforce.


The Employment Relations Strategy 2019-2024 has been signed off by all 20 DHBs. This signals their commitment to:

Develop employment arrangements across the sector which will enable effective teams to do their best work to deliver Pae Ora for our communities.

In practice, this means DHBs will:

  • Seek to think and act as one ‒ managing and delivering services, thinking and acting as one organisation and one system.

  • Tackle pay disparity ‒ lessen the gap between low and high paid staff and address pay equity.

  • Support our staff to do meaningful work ‒ leaders within DHBs commit to developing our people and ensuring the work environment supports our people to thrive.

  • Support mutual agility and innovation ‒ employment arrangements support our people to be agile and innovative in how they deliver services.

  • Be financially sustainable ‒ recognise our agreements need to be financially sustainable.

“We are confident the commitment of the DBS to the implementation of this strategy will enable employment arrangements across DHBs, which support continuously improving healthcare for all New Zealanders.”

Peter Brown, TAS Director of Employment Relations

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