There is national and international agreement that the primary care sector plays a crucial role in the future health of all people. It contributes to addressing health inequities, escalating costs and managing demand on secondary services and the wider health system.

Primary care services, the largest part of our health system, can have a significant impact on the health of all New Zealanders.

An increasing focus on primary care

In 2014, the Health Quality & Safety Commission hosted a workshop with primary care opinion leaders to identify important quality and safety issues, and how we can make a difference.

This led to the primary care expert advisory group (EAG) being established in 2015. The primary care EAG supports the Commission’s engagement with primary care providers, and advises on many of the Commission’s activities that touch primary care.

In response to the EAG’s advice, the Commission agreed to a stronger focus on primary care and community services, aged residential care and disability services.

The Commission supports the PHO quality improvement network, also established in 2015, to enhance communication between PHO quality improvement staff, and share knowledge, professional development and networking.

Other primary care work within the Commission includes the primary care patient experience survey and aspects of the Atlas of healthcare variation.

Whakakotahi quality improvement programme

The Commission’s increased focus on primary care includes partnerships with primary care teams to work on small-scale improvement projects through its quality improvement programme, Whakakotahi (te reo Māori for ‘to be as one’).

The aim of Whakakotahi is to increase quality improvement capability in primary care. Successful providers are supported by the Commission to implement quality improvement projects about an area of patient care they want to improve that is important to their patients/community and to them as providers of care.

The Commission’s primary care programme team supports and mentors participating primary care teams through site visits and group learning events. 

To enhance the learning experience, a member of each project team is offered a position on the primary care quality improvement facilitator course delivered by Ko Awatea and the Commission's primary care and capability programmes.

Whakakotahi is acting as a catalyst for starting valuable discussions with primary care, raising the sector’s capability to use improvement science to achieve better patient care and outcomes, and laying important foundations for future improvement work in primary care.

More specifically, the aim of Whakakotahi is to increase quality improvement capability in primary care by:

  • building collaborative partnerships between the Commission and primary care to improve primary care quality and the Commission’s understanding of it
  • improving one or more health outcomes with associated improvements in equity, integration and consumer engagement
  • supporting sector-led improvement projects to build and spread improvement science expertise and skills in the primary care sector
  • identifying improvement projects/initiatives that are suitable for implementing at a local, regional or national level (as appropriate)
  • supporting the implementation of the System Level Measures Framework, by linking improvement projects to the framework and raising improvement science capability in the primary care setting.

Cultural guidance to ensure improved health outcomes for Māori patients and communities is provided to Whakakotahi by Te Tihi. This organisation represents an alliance of nine iwi, hapū, and Māori organisations that works collectively to deliver whānau-centred services for Māori health.

As part of our commitment to quality improvement principles, we have structured our programme and theory of change in a ‘driver diagram’. This helps to maintain focus and direction. It is an iterative document that responds to the changing needs of the population and sector we are working with.

In the Auckland region, Ko Awatea carries out quality improvement work in primary care through its Safety in Practice (SiP) programme. SiP is entering its fourth year. The programme aims to create a consistent approach to enhancing quality improvement capability in general practice and community pharmacy by focusing on patient safety. Safety in Practice has developed many helpful and freely available resources (available at the bottom of this page). These may be of interest to health professionals wishing to identify quality improvement opportunities and plan and run quality improvement projects of their own.

Many other organisations and individuals also carry out quality improvement work in primary care in New Zealand. Are you or your organisation currently doing this? Would you like to? The primary care programme team would love to hear from you, learn about your quality improvement work, and discuss how we may be able to work together. Please email us at

Last updated 18/10/2019