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.

Pages from Whakakotahi Project Charter 2017   Final

Whakakotahi driver diagram - click to open PDF (268 KB)

Whakakotahi - a new quality improvement programme

The Commission’s increased focus on primary care has, in the first instance, involved partnerships with primary care teams to work on small-scale improvement projects through a quality improvement initiative called Whakakotahi (te reo Māori for ‘to be as one’).

Whakakotahi 2017 started the programme. It involves primary care teams working on a quality improvement project, of their choice, to address an area of patient care they wish to improve. The second round, Whakakotahi 2018, is now underway. Leading the third and final round (for the first phase of this approach and to allow a pause and review of the programme) will be an expression of interest to invite applications for Whakakotahi 2019, from 25 June 2018.

Whakakotahi is run by the primary care programme team within the Commission, who support and mentor the participating primary care teams through site visits and group learning events.

Whakakotahi is acting as a catalyst for starting valuable discussions with primary care, raising the sector’s capability to use improvement science to effect 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, with the following objectives:

  • build collaborative partnerships between the Commission and primary care to improve primary care quality and the Commission’s understanding of it
  • improve one or more health outcomes with associated improvements in equity, integration and consumer engagement
  • support sector-led improvement projects to build and spread improvement science expertise and skills in the primary care sector
  • identify improvement projects/initiatives that are suitable for implementing at a local, regional or national level (as appropriate)
  • support 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.

For more information on Whakakotahi read the most recent expression of interest documents for Whakakotahi 2018 or view the Whakakotahi project charter.

For any questions about the Commission’s work in primary care, please email us at

Other quality improvement work in primary care

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 08/02/2019