DISTRICT ALLIANCE AGREEMENT

WAITEMATA AND AUCKLAND DISTRICTS

PART A Parties

  1. The Parties to this Agreement are:

AUCKLAND DISTRICT HEALTH BOARD, a Crown Entity established by section 19 of the New Zealand Public Health and Disability Act 2000, of Auckland (“ADHB”).

WAITEMATA DISTRICT HEALTH BOARD, a Crown Entity established by section 19 of the New Zealand Public Health and Disability Act 2000, of Auckland (“WDHB”).

PROCARE NETWORKS LIMITED, a registered NZ limited company, of Auckland (“PNL”).

AUCKLAND PHO LIMITED, a registered NZ limited company, of Auckland (“APHO”).

ALLIANCE HEALTH PLUS TRUST, a registered charitable trust, of Auckland (“Alliance Health Plus”).

NATIONAL HAUORA COALITION INCORPORATED, an incorporated society, of Auckland (“National Hauora Coalition”).

TOTAL HEALTHCARE CHARITABLE TRUST, a registered charitable trust, of Auckland (“Total Healthcare”).

WAITEMATA PHO LTD, a registered NZ limited company, of Auckland (“WPHO”).

TE RUNUNGA O NGATI WHATUA, a registered charitable trust, of Auckland (“Ngati Whatua”).

TE WHANAU O WAIPAREIRA, a registered charitable trust, of Auckland (“Waipareira”)

  1. The Parties are not collectively established as a legal entity.
  2. Commencement date and term of Agreement

This Agreement commences on 1 April June 2014 and continues until all our Alliance Activities expire or our Agreement is ends on 30 June 2019 unless terminated according to the terms and conditions of this Agreement.

  1. Execution
    By our respective authorised signatories signing below, all Parties agree to comply with and be bound by the terms and conditions of this Agreement

Executed as an Agreement

Executed by Auckland District Health Board

in the presence of

Director/Authorised Signatory
Director/Authorised Signatory
Witness signature
Full name
Occupation
Address

Executed by Waitemata District Health Board

in the presence of

Director/Authorised Signatory
Director/Authorised Signatory
Witness signature
Full name
Occupation
Address

Executed byProcare Networks Limited

in the presence of

Director/Authorised Signatory
Director/Authorised Signatory
Witness signature
Full name
Occupation
Address

Executed by Auckland PHO Limited

in the presence of

Director/Authorised Signatory
Director/Authorised Signatory
Witness signature
Full name
Occupation
Address

Executed by Alliance Health Plus Trust

in the presence of

Director/Authorised Signatory
Director/Authorised Signatory
Witness signature
Full name
Occupation
Address

Executed by National Hauora Coalition Incorporated

in the presence of

Director/Authorised Signatory
Director/Authorised Signatory
Witness signature
Full name
Occupation
Address

Executed by Total Healthcare Charitable Trust

in the presence of

Director/Authorised Signatory
Director/Authorised Signatory
Witness signature
Full name
Occupation
Address

Executed by Waitemata PHO Limited

in the presence of

Director/Authorised Signatory
Director/Authorised Signatory
Witness signature
Full name
Occupation
Address

Executed by Te Rununga O Ngati Whatua

in the presence of

Director/Authorised Signatory
Director/Authorised Signatory
Witness signature
Full name
Occupation
Address

Executed by Te Whanau O Waipareira

in the presence of

Director/Authorised Signatory
Director/Authorised Signatory
Witness signature
Full name
Occupation
Address

PART B. OUR PARTNERSHIP

  1. Introduction.
  2. Our Alliance are the parties to this Agreement who are
  3. The Auckland and Waitemata District Health Boards and;
  4. Primary Health Organisations that haveprovider members withenrolled populationsin the Waitemata and Auckland District Health Boards geographic areas and;
  5. Mana Whenua partners as determined by the District Health Boards to enable obligations under clause 23.1 and;
  6. Mataawaka partners as determined by the District Health Boards to enable obligations under clause 23.1..
  7. We wish to create a future health system and design services across the Waitemata and Auckland districts as an Alliance of district health boards, primary health care partners, Mana Whenua and Mataawaka partners. This strategic approach will be focussed around patient and whanau determined care and designed and delivered using a locality framework.
  8. The Alliance will be used for agreed initiatives and will include a broad range of activities including strategic planning, implementation planning and delivery, monitoring and improvement.
  9. The scope of our Alliance is determined by our Alliance Activities. Our Alliance, in carrying out its Alliance Activities, may not be involved in all healthcare services in our District.
  10. The foundation of our Agreement is a commitment to act in good faith and to reach consensus decisions on the planning and delivery of services to benefit the people of our communities and our wider health system.
  11. The Alliance agrees to work together in an innovative and open manner to create the future health system with due regard to the feedback from our communities, clinical leadership, the evidence and information available to us.
  12. Relationship of Alliance with others
  13. Our Alliance is not a legal entity and services are not funded through the Alliance.
  14. Relevant services will be contracted for between funders and individual providers in a way that supports and enables the delivery of services as agreed by the Alliance.
  15. PHO Parties are funded for PHO services through a national PHO agreement that requires an alliance approach to the planning, design, delivery and improvement in services across a district.
  16. Our Alliance enables the relevant Parties in the Waitemata and Auckland districts to give effect to the PHO agreement.
  17. Our Alliance is across two districts that have the same boundaries as the Waitemata and Auckland District Health Boards described in the New Zealand Public Health and Disability Act 2000.
  18. Where services are also impacted on by the activities of other alliances the Parties are party to, due regard will be given to the activities of the other alliances in the planning and delivery of services by the Alliance.
  19. Our Alliance will support the recommendations and advice of clinical governance groups where appropriate within the scope of our alliance activities.
  20. Where the strategic direction of other alliances or groups is inconsistent with that of the Alliance, the AllianceSystem Leadership Group will take responsibility to address any Alliance issues with other groups.
  21. Scope of Our Alliance
  22. Our Agreement describes how we will work together in a collective and cooperative way to plan and deliver health services that support the needs of our communities and localities. This will include accountability, the sharing of information and resources so that we are collectively responsible for performance and the best use of resources.
  23. Our Purpose
  24. Our Alliance partners are individually responsible for the performance of their own organisations and the services they deliver but are collectively responsible for improving outcomes for theAuckland and Waitemata population.
  25. The scope of our Alliance is determined by our Alliance Activities. Our Alliance, in carrying out its Alliance Activities, may not be involved in all healthcare services in our District. It is expected that the Alliance Activities will be extended as achievements are attained and the capability of the Alliance to work collectively is demonstrated.
  26. Our Alliance also has specific Alliance Objectives that we expect to meet and exceed as part of our Alliance Activities.
  27. The scope of our Alliance, our Alliance Activities and our Alliance Objectives are set out in Schedule 1.
  28. Our Alliance work programme will describe how the activities are to be achieved, who is responsible, how the activities are to be resourced and measures of success.
  29. Our Goals

We wish to develop a more cohesive, accessible, efficient, effective, safe, and sustainable health system for our community by:

7.3.1.Creating the conditions for patient and whanau determined care through the locality approach and thereby empowering individuals to make informed decisions about their healthcare eg greater flexibility in the way services are provided or in what providers do.

7.3.2.Increased integration of community, primary care, secondary care health services and social services through locality development and a whole of system approach for our future health system.

7.3.3.Building capability and capacity across the sector by increasing the scope of primary care.

7.3.4.Supporting, where appropriate, infrastructure development within primary care.

7.3.5.Reducing health inequalities through a reorientation of the sector so that individuals and communities are supported to improve their own lives.

7.3.6.Supporting clinical governance through engagement with clinicians and design of services and change processes that enable the achievement of desired outcomes.

7.3.7.Driving performance through quality improvement, transparent reporting and effective mechanisms for public accountability from the Alliance.

7.4.Patient and Whanau Determined Care

7.4.1.Patient and whanau determined care is the fundamental approach to achieving our goals and will be the basis for our planning and delivery. The final form of patient and whanau determined care is not yet agreed and will take time to complete. Many stakeholders need to be engaged in this process. We need to work in a way that supports the people of Auckland and Waitemata to maximise their health and well being and in so doing reform the way we go about our business. Moving towards this approach will be a radical change for patients and health providers alike. It will affect all aspects of relationships across the system and the contract between the public and the care givers. This is a long term commitment.

7.4.2.Patient and whanau determined care will enable:

7.4.2.1.Better support for people to take more control over their health and wellbeing to maximize their quality of life

7.4.2.2.People to achieve the outcomes they want for themselves, their families and their communities

7.4.2.3.The delivery of safe, high quality, evidence-based services

7.4.2.4.The best return on investment in health

  1. Our Alliance Principles
  2. We will conduct ourselves and undertake our Alliance Activities in a manner consistent with our Alliance Principles and will take all reasonable steps to ensure that our employees, contractors and agents do likewise.
  3. We agree that every part of this Agreement must be read in such a way as to be consistent with, and ensure the integrity of, our commitments to our Alliance Principles.
  4. Our Alliance Principles.
    Our Alliance is founded on the following principles:
  5. we will support clinical governance and leadership and, in particular, clinically-led service development;
  6. we will adopt a patient-centred, whole-of-system approach, and make decisions on a Best for System basis;
  7. we will conduct ourselves with honesty and integrity, and develop a high degree of trust;
  8. we will promote an environment of high quality, performance and accountability, and low bureaucracy;
  9. we will strive to resolve disagreements co-operatively and, wherever possible, achieve consensus;
  10. we will seek to make the best use of finite resources in planning and delivering health services to achieve improved health outcomes for our populations;
  11. we will adopt and foster an open and transparent approach to sharing information;
  12. we will monitor and report on our Alliance’s achievements, including public reporting on resource allocation, service access and utilisation and where possible, benefits and outcomes;
  13. We will engage our communities in our performance, consider feedback and adviceto continuously improve our services;
  14. we will be collectively responsible for all decisions and outcomes of our Alliance;
  15. we will operate as a unified team providing mutual support, appreciation and encouragement;
  16. we will conduct ourselves in accordance with Best Practice;
  17. we will support professional behaviour and leadership;
  18. we will remain flexible and responsive to support an evolving health environment;
  19. we will incorporate whanau ora approaches where appropriate;
  20. we will develop, encourage and reward innovation and challenge our status quo;
  21. we will actively support and build on our successes; and
  22. we commit to fully exploring the collective sharing and management of the risks and benefits arising from our Alliance Activities. Where we cannot manage risk collectively, our principle is to allocate responsibility for each risk to those of us who can best manage it.

PART C. HOW WE WILL SUCCEED

  1. Commitments
  2. Shared Decision Making:
  3. Each of us is fully committed to our Alliance and carrying out our Alliance Activities to achieve our Alliance Objectives. We acknowledge that this commitment is fundamental to our Alliance’s success.
  4. We will work as one team, in an innovative and open manner, to produce outstanding results.
  5. We will work on an Open Book basis to help achieve the best results from our Alliance Activities.
  6. Shared Responsibility
  7. We all take responsibility for our Alliance’s success.
  8. We all take responsibility for achieving consensus decisions within our Alliance.
  9. We all take responsibility for addressing all potential disputes within our Alliance.
  10. We will establish and maintain an environment within our Alliance that encourages open, honest and timely sharing of information. We will discuss all matters openly including any conflicts of interest or limitations on mandates so that the Alliance is aware of all caveats, restrictions or where further authority is required.
  11. We have shared responsibilities and will actively address any duties or activities in a timely manner according to each of our responsibilities within the Alliance. Our collective work programme will specify our responsibilities and how we measure success.
  12. Shared Accountability: We are all responsible collectively for identifying, managing and mitigating all risks associated with our Alliance Activities.
  13. Commitment to Good Faith: We will, at all times:
  14. Act in good faith and be fair, honest and ethical in our dealings with each other;
  15. Make all decisions on a Best for System basis and, when making such decisions, will give predominate weight to the interests of our Alliance over our own self interest;
  16. Do everything that is reasonably necessary to enable each of us to undertake our Alliance Activities and perform our obligations under this Agreement;
  17. Not act in a manner that impedes or restricts each other’s performance of our Alliance Activities and the performance of our obligations under this Agreement; and
  18. Do all things that are, or may reasonably be, expected of us so as to give effect to the spirit and intent of this Agreement and our Alliance.
  19. Commitment to Consultation: We recognise that some of us may, in the course of undertaking our Alliance Activities and otherwise meeting our commitments under this Agreement, be required to consult with others who do not form part of our Alliance. We will provide those of us who are subject to such a requirement with a reasonable opportunity to do so in a prudent and timely manner.
  1. Service Alliances and Working Groups
  2. Service Alliances: Where our Alliance identifies a service within the scope of our Alliance Activities that requires transformational change, our System Alliance Leadership Group may establish a Service Alliance to:
  3. recommend how the service should be delivered within the scope of our Alliance;
  4. monitor and report on the performance of a service within the scope of our Alliance.
  5. Our Alliance may establish any other Working Groups that it considers necessary to advise it on any aspect of our Alliance Activities.
  6. Scope and Conditions: A Service Alliance or other Working Group will operate according to any directions, conditions or restrictions established by our System Alliance Leadership Group. This may include a direction to work collaboratively with other alliances.

PART D. HOW WE WILL WORK TOGETHER

  1. Our leadership structure.
  2. General Structure:
  3. Our Alliance will be directed and lead by our System Alliance Leadership Group.
  4. The day-to-day affairs of our Alliance will be co-ordinated by our Alliance Support Team.
  5. Service Alliances: Our Service Alliances will be led and directed by a Service Alliance Leadership Team, acting within a scope of authority delegated by our System Alliance Leadership Group.
  6. System Alliance Leadership Group
  7. Our System Alliance Leadership Group: We agree that we will have anSystem Alliance Leadership Group whose primary function will be to lead us with respect to our Alliance Activities and our Alliance, in accordance with this Agreement.
  8. Duties of Our System Alliance Leadership Group: The duties of our System Alliance Leadership Group include:
  9. providing a vision, strategic leadership and direction for our Alliance;
  10. supporting clinical governance within the vision and strategic direction and providing clinical leadership across the Waitemata and Auckland districts;
  11. establishing principles and setting challenging objectives;
  12. maintaining a coherent set of policies and procedures as necessary to undertake its duties;
  13. agreeing with the DHB:
  14. our Key Results Areas and Alliance Objectives, including the systems and key performance indicators for assessing achievement of these;
  15. the work, activity and services to be provided to meet our Alliance Objectives within the Key Result Areas;
  16. establishing Service Alliances and other Working Groups as necessary to oversee the development and delivery of services that fall within the scope of our Alliance Activities;
  17. providing high level support and stakeholder interface;
  18. monitoring and encouraging inter-Party relationships;
  19. agreeing and adopting transparent governance and accountability structures for our Alliance; and
  20. mentoring and championing our Alliance and its Parties as reasonably required.
  21. System Alliance Leadership Group membership.
  22. All appointments to the System Alliance Leadership Group will be for a fixed term of 36 months.
  23. TheAlliance Leadership Group membership positions and appointmentsof the System Leadership Groupto themwill be reviewed every 3624 months after establishment to ensure it is reflective of our Alliance principles and continues to develop as a result of working together and build on our achievements.
  24. Membership positions will comprise:
  25. A DHB Chief Executive
  26. PHO Chief Executives
  27. PHO Clinical Directors (maximum of one from each)
  28. A DHB Medical Director
  29. A DHB Nursing Director
  30. A DHB Primary Nursing Director
  31. A DHB Allied Health Director
  32. A DHB Planning or Funding Director
  33. A representative of Te Rununga O Ngati Whatua
  34. A representative of Te Whanau O Waipareira
  35. Our System Alliance Leadership Group may, by agreement, add or remove a member from our System Alliance Leadership Group.
  36. We confirm that each System Alliance Leadership Group member may not appoint any alternate to attend our System Alliance Leadership Group, but may nominate another member to act by proxy in relation to any decision to be made by the System Alliance Leadership Group.
  37. Chairperson of the System Alliance Leadership Group.
  38. A chairperson and a deputy chairperson will be elected by the Alliance membership.
  39. If an elected chair is not able to be agreed, an independent chair will be appointed by the Alliance. The costs of an independent chair will be shared by the Alliance Parties according to an agreed methodology.
  40. Consensus Decision-Making: Unless all of us agree otherwise, every decision, determination and resolution of our System Alliance Leadership Group must be made by consensus of those present, whether in person, by telephone or videoconference, or by proxy, at the relevant meeting, on a Best for System basis.
  41. Implementing Decisions: We will implement all decisions and directions of our System Alliance Leadership Group concerning our Alliance and this Agreement
  42. Public Accountability