Speech from Virginia Hope, Bob Francis and Peter Glensor

Beginning for Hutt Valley
Good afternoon and welcome. I am Virginia Hope, chair of Capital & Coast and Hutt Valley DHBs. In the Wairarapa Bob Francis, chair of Wairarapa and a board member of Capital & Coast DHB are simultaneously making this same presentation to Wairarapa DHB staff, and Peter Glensor, deputy chair of Capital & Coast and Chief Executive Mary Bonner are doing the same in Wellington.

Alternative beginning for Capital Coast
Good afternoon and welcome. I am Peter Glensor, Deputy Chair of Capital & Coast Board.  With me is Mary Bonner, Chief Executive.  Simultaneously Virginia Hope, Chair of Capital & Coast and Hutt Valley DHBs is delivering the same presentation to Hutt Valley DHB staff.  In the Wairarapa Bob Francis, chair of Wairarapa and a board member on Capital & Coast DHB is doing the same for Wairarapa DHB staff.

Alternative beginning for Wairarapa
Good afternoon and welcome. I am Bob Francis, chair of Wairarapa DHB and with me is [name] a board member from Capital &Coast. In the Hutt Valley, Virginia Hope, chair of Capital & Coast and Hutt Valley DHBs is simultaneously making this same presentation to Hutt Valley DHB staff and in Wellington, Peter Glensor, Deputy Chair of Capital & Coast and Chief Executive Mary Bonner are doing the same for staff at Wellington and Kenepuru hospitals.)

The purpose of today's presentation is to speak with you about a programme developed by the boards of the three DHBs - Wairarapa, Hutt Valley and Capital & Coast - together with the Sub-regional Clinical Leadership Group, to more closely integrate the operations and delivery of health care by the three DHBs.

I will give you a brief introduction which will be followed by a powerpoint containing a little more detail, followed by questions.  The whole process will take less than an hour.
For some time the three boards of the region have seen that there are significant benefits to be gained from a closer working relationship at all levels between the three DHBs.  Partnership activity amongst the three DHBs is not new.  For the last two years, the group of clinical leaders and managers from the three DHBs, the Sub-regional Clinical Leadership Group, has progressed partnership activity in a number of specialties including ENT, Gastroenterology, Child Health and Palliative Care.  Known as the 3DHB Programme, the intention is to advance integration in these services and accelerate integration across many of the other specialties.

Done right, all three boards firmly believe that greater integration will remove many of the artificial boundaries and barriers that hamper effectiveness and at times frustrate patients and clinical staff alike.  It would lead to better use of human resources in the form of our experienced and capable staff and help ease the financial pressures we are all experiencing.  In particular, we would want it to make a material difference to fundamentals such as reducing waiting times and providing better and equitable access to diagnostic and elective services.

To capture the benefits and avoid loss of identity of any of the DHBs, we have adopted the term "partnership" to characterise the future relationship between the DHBs.  The "partnership" idea appeals to the boards because it recognises the dual requirement to work closely together whilst recognising the continuing role of the individual DHBs - their facilities and the services they provide.  Partnership means that from now on decisions will be made in the collective interest of the three DHBs.

The boards are also mindful of the challenges ahead of us.  We have the prospect of ageing patients supported by an ageing workforce.  We recognise that to join DHBs together is not enough and that a "whole system" view will take time to evolve.  We would want this to happen as quickly as possible.  We also recognise the dangers of a large organisation losing focus on the patient and we would want a strong patient-centred culture emerging from these changes.

To be truly effective the partnership idea needs to extend beyond the clinical level to support and management services such as IT, and HR, in fact, right through to the senior management teams.

The three boards concluded that now is the time to accelerate this aspect of the partnership process.  As a result they commissioned an analysis by independent consultants which has helped define the corporate, clinical and support measures required to move the 3DHB Programme forward at pace.  From this exercise it was decided that a gradual approach should be taken with improvements in integration made as opportunities arise.  However, it was felt that the programme required some initial impetus and accordingly some early changes will be made.

These will be outlined in detail in the powerpoint presentation, but an important early step will be the amalgamation of the senior management teams of Wairarapa and Hutt Valley and the appointment of one chief executive for the two DHBs.  At the same time the pace will pick up on clinical integration.  The pace for this will be largely set by the Clinical Leadership Group together with management.

While the management of Hutt Valley and Wairarapa will integrate, their boards will remain separate.  This is quite deliberate.  Boards represent a level of local control, local focus and local voice.  We want to retain that.  The boards also oversee local accountabilities and this will be an important role in a large delivery organisation.  The shared membership between the three boards will be retained to ensure alignment between them.

Many of you may be asking yourself the question how will this impact on me.  While there will be more immediate impacts on the management teams of Wairarapa and Hutt Valley, the vast majority of staff will not be immediately affected and perhaps notice little change.  Gradually over the next two years and as services join-up across the three DHBs and staff move around more to provide service, then there will be impacts.  Support services will integrate and projects will need to be set up to do this involving staff.  This announcement provides the high level direction in which the boards intend to move in the next few years, but the actual implementation of these plans will need to pass through the usual design and consultation processes.

In conclusion I would like to reiterate the point that increased size alone will not achieve the gains we are seeking.  Thinking of the region as one population and potential access to the breadth of skill and expertise across the region will create new opportunities but real progress will come as we continue to work together across our three DHBs.  The three boards are excited by the opportunity.  We have been inspired by the leadership and commitment from the Clinical Leadership Group.  We are constantly humbled by the sheer will to do well and perform to higher and higher standards that exists throughout these three DHBs.  On the basis of that we are confident these incremental gains are achievable and when they are brought together and focused on patient care they will certainly be worth having.

Thank you.