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New report identifies health system learning opportunities for how COVID-19 care is provided in Aotearoa New Zealand...

System safety
17 April 2023

Te Tāhū Hauora Health Quality & Safety Commission (Te Tāhū Hauora) has released a report looking at how four COVID-19 Care in the Community (CCitC) hubs in Auckland and Southland, (hubs were identified by Manatū Hauora | Ministry of Health), have functioned during the first half of 2022 and identified a series of system level learning opportunities.

Te Tāhū Hauora completed this important piece of work through a collaborative process with the four CCitC hubs. The review also highlighted the different ways that Māori and Pacific hubs provided care, shaped by the cultural lens they brought to providing care.

Te Tāhū Hauora clinical lead for system safety, Dr Carl Horsley, says, ‘The report identifies CCitC as an excellent example of a resilient system. Adaptation was central both to meeting the different needs of those with COVID-19, as well as being able to reconfigure the health care response to meet dynamic system demands.’

The CCitC response highlighted the different realities and health needs that exist within Aotearoa New Zealand. Rather than a single response, multiple responses were required to deliver safe care that met the differentiated needs of people. These responses were built on the existing relationships that the CCitC hubs had with their communities.

The report also aimed to understand both the enablers and challenges to care delivery and use these for future improvement work. Dr Horsley says, ‘This review has identified system improvement opportunities that can further inform and strengthen the existing national and regional health care system to support those providing care. These include improvement opportunities in the areas of safety learning, information technology (IT), commissioning of care, workforce development, and supporting consumer and whānau-centred care.

Other important points have been highlighted in the report:

  • Differing contexts meant that there was no ‘one size fits all’ approach. There was a need to work relationally to understand the contexts and find solutions that met these diverse needs.
  • Decentralised responses were needed to respond rapidly to the changing needs of communities yet these were dependent on centralised resourcing and strategic direction. This local-central interdependence created challenges to coordination.
  • The historical system structures, priorities and funding models conditioned and constrained the way the response unfolded. Issues of power and voice were central to challenging these and finding new ways of working.
  • The formal safety systems captured certain kinds of harm but were blind to many significant risks being managed by staff.
  • The response relied on reprioritisation of care and redeployment of staff. The capability to respond effectively to future waves cannot be assumed.

Dr Horsley says, ‘On behalf of Te Tāhū Hauora, we would like to express our sincere appreciation to all contributors to this report for their work, dedication and contributions to our communities during the continued uncertain times of the COVID-19 pandemic.’

You can learn more about the review by reading the full report here.