What We Do
The 62-page report, The quest for integrated health and social care: A case study in Canterbury, New Zealand by Nicholas Timmins and Chris Ham from The King's Fund, highlights some of the key achievements and struggles of the Canterbury Health System since it set upon a more integrated pathway in 2007.
The report tells the story of the journey towards Canterbury's goal of providing integrated care for all. The King's Fund report confirms that Canterbury has been doing the right things and in fact rated us higher than we might have expected, comparing us very highly on the international stage.
The report provides in-depth analysis and quotes the key people involved in our journey of transformation. We invited the Kings Fund to put our system under the microscope and asked for a 'warts and all' assessment of how we are doing.
Our health system has worked incredibly hard to make it better for people: to cut waste out of the system and improve the patient journey by putting people at the centre of everything we do. The mantra 'one health system, one budget' is firmly held by everyone who delivers care, whether in the community or a hospital setting.
As the report says 'this journey of transformation is still incomplete' and it will remain a process.
Innovation, change and courage have been vital elements of our journey to date. We still have some way to go until we are a fully integrated system however, we have made exceptional progress.
The stimulus for change in Canterbury was a health system that was under pressure and beginning to look unsustainable.
Canterbury adds to the small stock of examples of organisations and systems that have made the transition from fragmented care towards integrated care with a degree of measurable success.
Creating a new system takes time - Canterbury has been working to create 'one system, one budget' for at least six years and the journey is far from complete.
It takes many people to transform a system. A small number of leaders were at the heart of Canterbury's transformation, but this leadership rapidly became collective, shared and distributed.
Listen to Karen Brown, Health Correspondent for Radio New Zealand's Morning Report talking about The King's Fund's report on integration in the Canterbury Health System.
Health Service Journal – 'Canterbury Tale – making a success of integrated care'.
The British Medical Journal article, published 12 September 2013 'Abolishing purchaser-provider split helped New Zealand scheme to cut costs, says King's Fund'.
Mike Bewick gives his response to The King's Fund's review of the Canterbury health care system in New Zealand. The review looks at how the Canterbury District Health Board has successfully implemented an integrated care system over the past few years.
'It's one thing to advocate the idea of integrated care but quite another to make it work in practice − as Canterbury District Health Board has.' Chris Ham, chief executive of The King’s Fund
Researcher Nicholas Timmins and King's Fund chief executive Chris Ham have recognised Canterbury's health system changes on the world stage. See 'On the right track? How HealthPathways are improving care in Canterbury, New Zealand'.
New Zealand Trade and Enterprise news article 'The King's Fund launches report on Canterbury's quest towards integrated care'.
The changes made to the system since 2007 mean that Canterbury now has a system in which good-quality general practice is increasingly keeping patients who do not need to be in hospital out of it; is treating them swiftly once there; and discharging them safely to good community support.
"What our experience demonstrates is that it is possible to provide better care for patients, reduce demand on the hospital and flatten, or reduce elements of the demand curve across health care by improved integration - particularly around the interface between the hospital, primary care and community services."
"I was particularly pleased to see our clinical pathways system, Health Pathways, identified in the report as "one of Canterbury's most innovative and most effective changes".
"It's also satisfying to be compared to other "stand out" health care authorities, Jonkoping County Council in Sweden and Intermountain Healthcare in the US, as leading the way." The Canterbury system has not yet been completely transformed, The King's Fund researchers Nicholas Timmins and Chris Ham say, but Canterbury is well on the way to a truly integrated system.
With our alliances, networks and collaboration, we know our success is all down to people and relationships. I'd like to acknowledge those providing treatment, care and support in, and close to, people's homes, as well as those who are providing specialist and hospital-level care.
While we're not there yet, we have set some milestones for our future direction of travel.
Our health system may be one of the biggest, but it's also one of the most nimble – and we will continue to adapt, flex and innovate to managing the changing landscape ahead.
"Canterbury is seen as a world leader and hopes it continues on this path. The three enablers have been: vision; sustained investment in staff and how they are utilised.
"Innovation and change in particular has also been an extremely important part of our journey. Incorporating information technology systems, developed collaboratively with our clinicians' input, into the way we do things is key in us making it better for the patient.
"Systems such as Healthpathways, Electronic Request Management System and Shared Care View, are all some of the major innovations to help us on this transformation."
View a presentation on the report’s findings. The presentation (below) is also available on The King's Fund website.
View a larger version of the our health system illustration
The King's Fund is an independent charity working to improve health and health care in England. They help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate.
Their vision is that the best possible care is available to all.
For more information, video interviews, presentations and commentary, view The King's Fund website.
Download a copy of the 62-page report, The quest for integrated health and social care: A case study in Canterbury, New Zealand by Nicholas Timmins and Chris Ham from The King's Fund.
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