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KaiāwhinaWorkforce Action Plan:5-Year Actions 2015-2020 I Toward the 20-year Vision

Updated 13th September 2018

Kaiāwhina Workforce Action Plan:5-Year Actions 2015-2020 I Toward the 20-yearVision

A kaiāwhina workforce that adds value to the health and wellbeing of New Zealanders by being competent, adaptable and an integral part of service provision.

Consumer Focus

The Consumer Focus principles underpin implementation of the Kaiāwhina Workforce Action (the Plan)

• The relationship between kaiāwhina and the consumer, and family/whānau is based on

trust and transparency.

• Consumers are supported through systems that are enabling.

• Services support consumers and family/whānau to develop self-management skills.

• The kaiāwhina workforce understands and recognises the impact of stigma and discrimination

on the consumer/s they work with and their families/

whānau, including self-stigma.

• Diversity and the cultural values and beliefs of consumers and their family and whānau are

respected.

In addition, the Plan recognises and takes direction and guidance from other national documents

including the New Zealand Health Strategy.1

The New Zealand Health Strategy

The future we want:

The statement ‘All New Zealanders live well, stay well, get well’ is central to this strategy. We

intend it to reflect New Zealand’s distinctive health context and population needs. Within this

statement, the single word ‘all’ is important. It reflects the need for a fair and responsive health

system that improves health outcomes for key groups, including Māori, Pacific peoples and

disabled people, who are not currently gaining the same benefits from the health system as

other New Zealanders. To improve outcomes for these groups, the health system will need to

improve its understanding of different population groups, involve people in designing services

and provide a range of services that are appropriate for the people who use them.

1 Minister of Health. 2016. New Zealand Health Strategy: Future direction. Wellington: Ministry of Health.2

Te Tiriti o Waitangi Treaty of Waitangi

The Plan acknowledges that te Tiriti o Waitangi (te Tiriti) is the founding document of Aotearoa

New Zealand and recognises that a key intent of te Tiriti was to uphold relationships of mutual

benefit between the indigenous peoples of Aotearoa (tangata whenua) and all those who had

come, and were to come, to settle here (tangata tiriti).

The Plan upholds these relationships of mutual benefit, and is committed to implementation

aligned with the principles of partnership, participation and protection which underpin te Tiriti

relationship between the Government and Māori. Together these three principles have a role

in understanding health and wellbeing, the development of health and disability policy and the

delivery of health and disability services and programmes.

Central to te Tiriti relationship and implementation of te Tiriti principles, is a shared understanding that health is a taonga. Based on this understanding, the Plan supports both Māori and the Crown in their shared roles in implementing health strategies for Maori, and will engage with all stakeholders in good faith and with mutual respect, co-operation and trust.

The Plan was co-created with, and is implemented by, multiple stakeholders in the aged care,

home and community, mental health and addictions, and disability sectors across private,

NGO, district health board, and government settings who support and share this role by

working together towards the vision of a kaiāwhina workforce that adds value to the health

and wellbeing of New Zealanders by being competent, adaptable and an integral part of

service provision. The Plan intends that all stakeholders establish an enduring Tiriti relationship

which creates a future that benefits all whānau, hapū, iwi and Māori.

The Plan is committed to the kaupapa (purpose) behind the Ministry of Health’s He

Korowai Oranga: Māori Health Strategy2 which sets the overarching framework to guide

the Crown and the health and disability sector to achieve health equity for Māori.

Pae ora is the Government’s vision for Māori health and provides a holistic concept and

includes three interconnected elements, mauri ora (healthy individuals), whānau ora (healthy

families) and wai ora (healthy environments). It provides a platform for Māori to live with good

health and wellbeing in an environment that supports a good quality of life and encourages the

stakeholders in the Plan to think beyond narrow definitions of health, and to support the

development of high-quality and effective services

The four Pathways laid out in He Korowai Oranga: Development of whānau, hapū, iwi and

Māori communities; Māori participation in the health and disability sector;

Effective health and disability services; and Working across sectors; together provide

guidance and direction on how the work of the Plan will support the achievement of pae ora

and the principles of te Tiriti o Waitangi.

2 Ministry of Health. 2014. The Guide to He Korowai Oranga – Māori Health Strategy. Wellington: Ministry of Health. 3

Kaiāwhina Workforce Action Plan FAQ

There is a compelling call for action to ensure that New Zealand has a sustainable health and

disability workforce for the future given the increasing demand for services as the population

grows and ages, and as models of care move closer to home, become more integrated, and

new models emerge. A core part of this workforce will be fulfilled by kaiāwhina – the non-

regulated care and support workforce in the health and disability sector.

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Why did the Kaiāwhina Workforce Action Plan come about?

Why is the Kaiāwhina Workforce Action Plan important?

Having a well prepared, supported and fit for purpose workforce ready to respond to the

needs of people is critical for sustainable health and disability services into the future. The

wide range of roles within the kaiāwhina workforce, which represents more than a third of the

health and disability workforce, is an essential component of integrated health provision and

disability support to enable good lives. The Kaiāwhina Workforce Action Plan goal is to build

such a workforce and to have this workforce accepted and valued as an essential part of the

integrated team.

In late 2013, Health Workforce New Zealand (HWNZ) and Careerforce committed to a 20-year

vision to build a strengths-based transformational approach to advance the role and

contribution of kaiāwhina as valued members within the health and disability system:

A kaiāwhina workforce that adds value to the health and wellbeing of New Zealanders by being

competent, adaptable and an integral part of service provision.

This included the provision of learning and development pathways to ensure kaiāwhina have

the required skills, knowledge and attributes to respond to current and emerging roles, and to

also ensure opportunities are provided in an accessible manner for kaiāwhina to attain this

learning.

To achieve this vision an initial five-year plan was developed following extensive consultation.

In 2014 the Kaiāwhina Workforce Taskforce was established to provide over-arching

governance to the Plan. A Working Group and Programme team coordinate the progress of

the Plan’s actions and report through to the Taskforce.

Who is involved in the Plan?

One of the greatest strengths of the Kaiāwhina Workforce Action Plan is that it was co-created

and is being implemented, by multiple owners in the aged care, home and community, mental

health and addictions, and disability sectors across private, non-government organisations,

district health boards, and government settings.

These owners are collectively invested in progressing this workforce for the benefit of

consumers, the kaiāwhina themselves and the New Zealand health and disability system as a

whole.

What is unique about the Plan?

Kaiāwhina What’s in a name?

The role kaiāwhina is an over-arching term to describe a multitude of role titles for those health and disability sector workers who are not regulated under the Health Practitioners Competence Assurance Act 2003.

During the development of the Plan, the term “unregulated” or “non-regulated” was repeatedly raised as being demeaning and pejorative. The term kaiāwhina was suggested, socialised and officially adopted by the multiple stakeholders in the Plan.

Kaiāwhina (from the Māori language, meaning “a person who assists”) now describes all non-regulated roles in the health and disability sector. The term does not replace the specific role titles, for example: healthcare assistant, orderly, mental health support worker.

AccessThe opportunity to participate in training and learning.

Kaiāwhina have the opportunity to participate in training and learning to develop their knowledge and skills andadvance their careers. Choices regarding the range of jobs are available. Career information, workplace developmentand progression can be accessed by all. Kaiāwhina have access to and use technology in the workplace.

Outcome

1. LEARNINGAND DEVELOPMENT:

Kaiāwhina have access to participate in learning and development in their roles

2. JOBS:

The range of kaiāwhinaroles, including role progression and development, is accessible. Learning and skills development support kaiāwhina aspiring to leadership roles

3. TECHNOLOGY:

Kaiāwhina use technology applicable to their roles

Action 1 AC 1.1

Ensure learning programmesare readily available to kaiāwhina in a manner that recognises their learning style, language and culture, together with their physical location and work requirements.

AC. 2.1

Kaiāwhina have access to information on roleprogression and development within the employer organisation and the broader community.Category 1

AC 3.1

Kaiāwhina are supported to access and use organisational technology systems.Category 1

CompletedJune 2016

ProgressNovember 2017

Action 2 AC 1.2

Mechanisms exist to enable kaiāwhina on their learning journeys.

AC 3.2

Service related technologyneeds are identified andkaiāwhina are supported to develop their skills. Technology is used as a service enabler.Category 2

CompletedApril 2016

Action 3 AC 1.3

Experienced kaiāwhina havetheir competencies assessed as the first step in their learning and development programme.

CompletedFebruary 2016

ProgressNovember

2017

ProgressNovember 2017

CompletedFebruary 2016

ProgressNovember 2017

6

Career DevelopmentCareer progression for kaiāwhina workers is clear and easily navigated.

An easily navigated career pathway helps current and future kaiāwhina make choices about training and roles topursue. The pathway enables new workers to enter the sector, progress to leadership roles and to the regulatedworkforce. Skills and knowledge will be transferable and recognised within the NZ qualifications framework.

Outcome

1. PATHWAYS:

Career Development options support continuity for individuals andorganisations

2. LEADERSHIP:

Learning and skills developmentsupport kaiāwhina aspiring to leadership roles

3. TRANSFERABLE SKILLS:

Alongside formal qualifications, transferable skills and experience are recognised

Action 1 CD 1.1

Knowledge and tools are provided to organisations to embed achievable careerpathways that are sustainable and recognised in their development plans.

CD. 2.1

Provide tools and knowledge to organisations to recognise and embed achievable leadership and management pathways that are sustainableand recognised in their workforce development plans.

CD 3.1

Knowledge and tools will be provided to employers to identify skills and experiences that are transferable into other roles and/or opportunities.

CompletedFebruary 2016

Action 2 CD 1.2

Develop a vocational pathway programme that provides secondary school students with the values, knowledge and skills required to enter the health and wellbeing workforce.

CD 2.2

Develop relevant and accessible programmes that support the development of leaders within organisations that lead to the award of New Zealand qualifications.

Action 3 CD 1.3

Develop accessible programmes and appropriate apprenticeships that incorporate competency standards for the kaiāwhina workforce.

Action 4 CD 1.4

Develop the NZQA listed health and disability New Zealand qualifications which provide pathways for school leavers, informal carers and employees from levels 2 to 6 and into the regulated workforce.

Action 5 CD 1.5

Provide opportunities for relevant formal and informal prior learning to be credited towards qualifications.

CompletedFebruary2016

CompletedMay 2016

CompletedMay2016

CompletedJuly2016

CompletedAugust 2017

CompletedAugust 2017

CompletedAugust2016

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Workforce RecognitionKaiāwhina are respected and acknowledged for the work they do.

The kaiāwhina contribution to health and disability teams is valued by employers, other professionals, consumers andthe community. This will also be reflected in fair and equitable policies and practices.

Outcome

1. VALUED:

Kaiāwhina are recognised as a valued workforce

2. FAIR:

The guiding principle of fairness is embedded in employment relationships with the kaiāwhina worker

3. EQUITABLE:

Employment terms and conditions have parity with other workers in comparable positions

Action 1 WR 1.1

Policy, approaches and expectations that raise the profile of the work of kaiāwhina across the spectrum of health and disability settings are put in place.Category 2

WR. 2.1

A system is implemented which covers the wages, the time spent travelling and the vehicle costs incurred by kaiāwhina as they provide services to people.

WR 3.1

Mechanism is developed to outline and recognise the required skill, training and qualification level of the kaiāwhina workforce.Category 1

CompletedMay 2016

Action 2 WR 1.2

At all levels of the system, kaiāwhina are treated with respect and their skills and contribution to the total health and disability service team is acknowledged in practical ways, including, but not limited to, through inclusion, employment conditions and the language used.Category 2

WR 2.2

The kaiāwhina workforce is primarily a regularised workforce whereby the majority of workers have guaranteed hours of work, are paid an equitable wage and have manageable workloads.

WR 3.2

The kaiāwhina workforce is paid at a wage rate commensurate with the required skill, training and qualification level.Category 1

CompletedSeptember 2017

Action 3 WR 1.3

Roles and competencies of kaiāwhina are clarified and articulated.Category 3

WR 2.3

Commissioners and employers uphold the principles of fairness to ensure that funding increases and pay provisions are visible, negotiable, appropriately and fairly allocated, and sufficient to support regulatory and agreed workforce initiatives.Category 2

WR 3.3

Terms and conditions of employment are explored that will maintain a skilled and stable kaiāwhina workforce.

ProgressFebruary 2018

Action 4 WR 2.4

Terms and conditions of employment are achieved through applying the principles of good faith as required by the Employment Relations Act.

CompletedMay 2018

CompletedMay 2018

ProgressFebruary

2018

ProgressFebruary2018

CompletedSeptember 2017

CompletedFebruary 2016

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Consumer FocusThe consumer is at the centre of the development and provision of health and disability services.

The needs, expectations and goals of the consumer and their family/whānau are central – a strengths-based approach.They have the right to culturally appropriate effective services, and to be informed of choices and participate indecision-making about their support and/or treatment. Population data is used to identify health trends.

Outcome

1. NEEDS:

Services provided meet the needs of the consumer.

2. CHOICES AND EXPECTATIONS:

The consumer receives safe, effective and responsive services.

3. PROFILE:

A demographic profile of consumers informs service providers. The profile utilizes data in sector planning.

Action 1 CF 1.1

Policy, approaches and expectations that raise the profile of the work of kaiāwhina across the spectrum of health and disability settings are put in place.Category 3

The Consumer Focus principles underpin implementation of the Plan:

• The relationship between kaiāwhina and the consumer and family/whānau is based on trust and transparency.

• Consumers are supported through systems that are enabling.

• Services support consumers and family/whānau to develop self-management skills.

• The kaiāwhina workforce understands and recognises the impact of stigma and discrimination on the consumer/s they work with and their families/ whānau, including self-stigma.

• Diversity and the cultural values and beliefs of consumers and their family and whānau are respected.

ProgressMay 2018

Action 2 CF 1.2

At all levels of the system, kaiāwhina are treated with respect and their skills and contribution to the total health and disability service team is acknowledged in practical ways, including, but not limited to, through inclusion, employment conditions and the language used.Category 3

Action 3 CF 1.3

Roles and competencies of kaiāwhina are clarified and articulated.Category 3

The New Zealand Health StrategyThe future we want:

The statement ‘All New Zealanders live well, stay well, get well’ is central to this strategy. We intend it to reflect New Zealand’sdistinctive health context and population needs. Within this statement, the single word ‘all’ is important. It reflects the need for a fair and responsive health system that improves health outcomes for key groups, including Māori, Pacific peoples anddisabled people, who are not currently gaining the same benefits from the health system as other New Zealanders. To improve outcomes for these groups, the health system will need to improve its understanding of different population groups, involve people in designing services and provide a range of services that are appropriate for the people who use them.

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Quality and SafetyServices provided to consumers meet quality and safety requirements.

Consumers have the right to receive services from a skilled, integrated team. Kaiāwhina are competent, adaptableand work to the required standards. They reflect on their and the wider team’s practice. This workforce is trained toenhance personal and consumer safety. Management/infrastructures support this.

Outcome

1. INTEGRATING:

Kaiāwhina are recognised andsupported to work in integrated models

2. COMPETENT:

The workforce is skilled and competent, to appropriately respond to consumers and family/whānau

3. STANDARDS:

Kaiāwhina meet service standards and legislative requirements

Action 1 QS 1.1

There is mutual respect for the role of all team members which includesacknowledgement of the skills, knowledge and experience kaiāwhina bring to integrated and holistic service delivery.Category 1

QS. 2.1

Education and training programmes are competency based with consumer safety and service qualityunderpinning all programmes.

QS 3.1

The code of rights, service standards, legislation and regulations that apply to the work of kaiāwhina are identified and available for kaiāwhina to access.Category 2

CompletedMay 2016

Action 2 QS 1.2

Tools are provided to support kaiāwhina service improvement activity.Category 1

QS 2.2

Establish a system wherebykaiāwhina can demonstrate initial and on-going competence and that enables and encourages continuous professional development.Category 3

QS 3.2

Education about thestandards and legislation/ regulations that apply to kaiāwhina is available in a form that is accessible and supports delivery of safe and quality services; and enables the participation of kaiāwhina.Category 2

Action 3 QS 1.3

Knowledge and tools are available to supportorganisations to develop a culture of consumer safety that identifies challenges and opportunities forimprovement.Category 1

QS 3.3

Systems and practices are in place that supports the health and safety of kaiāwhina as they fulfil their role. These are regularly reviewed.Category 3

ProgressFebruary2018

ProgressFebruary2016

ProgressAugust 2017

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Workforce IntelligenceData and information about the health and disability workforce is available.

Comprehensive workforce data captures kaiāwhina numbers, demographics, qualifications and roles. Role descriptionsand job titles are included in standard NZ workforce data. Plans are developed to ensure sufficient kaiāwhina areavailable to meet future workforce demands and models of service delivery.

Outcome

1. DATA:

A workforce database informs sector planning

2. ROLE CLARITY:

A database of kaiāwhina roles informs sector planning

3. PLANNING:

Consumer demographicand workforce information is available to support service delivery decisions

Action 1 WI 1.1

Develop overarching, whole of sector, data sharing and access protocols, through building on existing documents and engagement with sector stakeholders.Category 2

WI 2.1

Relevant categories of ANZSCO codes are identified and the reasons why they might be useful for different contexts and purposes.Category 2

WI 3.1

Based on consumer needs and demographics, develop and test alternative scenarios ofhealth and disability service expectations and service delivery models.Category 3

ProgressMay 2018

Action 2 WI 1.2

Identify a key set of data requirements to be captured, and identify incentives for NGOs and PHOs to supply this data.Category 2

WI 2.2

Advice is available about how to use the ANZSCO codes andlevels.Category 2

WI 3.2

Identify workforce requirements to meet health and disability service expectations, service delivery models and consumer needs, and the anticipated demand generated by these.

Action 3 WI 1.3

Advice is available about what workforce data is required and why it is important.Category 2

WI 2.3

Advocate to Statistics New Zealand for changes to the ANZSCO codes and levels. Category 2

WI 3.3

Model future workforce capability and capacity under a range of scenarios, and identify workforce gaps, including consequential training requirements.Category 3

Action 4 WI 1.4

Build a centralised and accessible repository of other relevant workforce data, research and other information sources to drawupon, e.g., Statistics NZ, MBIE, training organisations, health associations etc.Category 2

WI 2.4

Advice is available aboutthe role and contribution of providers to strategic workforce planning.Category 2

ProgressApril 2018

ProgressMay 2018

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SustainabilityThere are sufficient kaiāwhina available to meet workforce demand needs.

Flexibility across kaiāwhina roles is encouraged and supported by funding structures. Workplace conditions and humanresource systems support staff, provide job security and system stability. As new models of service delivery emerge thecontribution of kaiāwhina is integrated.

Outcome

1. FUNDING STRUCTURES :

Kaiāwhina roles are acknowledged and enabled throughflexible fundingstructures

2. STABILITY:

Employmentconditions support job security andretention

3. SERVICE MODELS:

Kaiāwhina roles are included in the design of new service models

Action 1 ST 1.1

Funding mechanisms are developed that support kaiāwhina roles and the competencies required to implement emerging models of care. There is cross- sector support for the development of these mechanisms including funders, providers and kaiāwhina representatives. Category 3

ST. 1.1

Understand the range of terms and conditions, including regularised hours of work, pay rates & rewards to inform key performance indicators (KPIs) to improve job security and retention.Category 1

ST 3.1

Planners and policy makers assess and include the roles and contribution of kaiāwhina as emergingmodels of care aredeveloped.Category 1

ProgressNovember 2016

Action 2 ST 1.2

The funding mechanisms and decisions promote the role of kaiāwhina and are transparent. Category 1

ST2.1

The health professional workforce understands and values the role of kaiāwhina as a member of an integrated team.Category 1

ST 3.2

Kaiāwhina workforce planning is an integral part of service design and future health service planning for kaiāwhina working across the full range of roles.Category 3

Action 3 ST 1.3

Current terms and conditions for kaiāwhina roles are transparent and variation between roles of like-skill is minimised.Category2

ProgressAugust 2017

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CompletionCompletion means that the action is implemented to the point that it has become embedded as part of business as usual, or that the mechanism/system has been developed and is available for uptake by providers and/or kaiāwhina.

Completion Monitor Completion approved by Taskforce with conditions for monitoring.

Progress Work is underway and progress has been reported to Taskforce/Working Group.

Kaiāwhina Workforce Action Plan:5-Year Actions 2015-2020 I Toward the 20-year Vision

A Kaiāwhina workforce that adds value to the health and wellbeing of New Zealanders by being competent, adaptable and an integral part of service provision.

Category One Work is underway, there is an owner/accountable lead entity for the work, there are deliverables and a timeline.

Category Two Work is underway, there is a potential owner/ lead entity, there are no clear deliverables and/or notimeline.

Category Three There is work happening within the Health and Disability sector that will have an influence on thisaction.

Purple These are part of the principles that underpin implementation of the plan. Actions will consider how they support a person-centred and consumer-focused approach.

Pink Other Government legislation will drive this outcome, e.g. new H & S legislation.

Turquoise Kaiāwhina Workforce Taskforce/Kaiāwhina Working Group/All stakeholders contribute to work.

Blue Led/owned by central agencies, eg. Ministry of Health; Health Quality and Safety Commission work; or Health Workforce New Zealand.

Brown Two or more partners contribute to work, ie: clinical networks; private sector entities; unions; DHBs.

Green Careerforce led/owned – Careerforce will enable the outcome, but cannot enforce it.

Yellow Careerforce contribute to/initiate work but results are longer term and require the support oforganisations.

Orange The outcome will occur as a result of other actions.

Action Matrix Icons

Progress Status

Action Ownership

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Kaiāwhina Workforce Action Plan Landscape

The Landscape is a diagram outlining the external influencers impacting the Kaiāwhina roles and career pathways. It describes the complex environment in which Kaiāwhina work, showing the interface with informal carers, family, consumer/service users, community networks and the regulated workforce. It also indicates by use of the dotted line how roles may develop into specialist co-ordinators and leaders, who have greater levels of responsibility and accountability.

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A kaiāwhina workforce that adds value to the health and wellbeing of New Zealanders by being competent, adaptable and an integral part of service provision.

Key Messages

Kaiāwhina is the over-arching term to describe non-regulated roles in the health and disability sector. The term does not replace the specific role titles, for example: healthcare assistant, orderly, mental health support worker.

Health Workforce New Zealand (HWNZ) and Careerforce are working together, in partnership, to facilitate and support the Kaiāwhina Workforce Action Plan (the Plan)

The Plan framework provides a holistic overview of the work or areas to build a vibrant and sustainable workforce for this sector. These are: Consumer Focus, Quality & Safety, Access, Workforce Intelligence, Career Development, Workforce Recognition, and Sustainability

Actions are underpinned by the Consumer Focus principles which inform the implementation of the plan.

The Plan was co-created with multiple key stakeholders from across the health and disability sectors, with many organisations supporting the Plan. Actions are implemented by identified owners from throughout the health and disability sectors

The Plan recognises that actions to support workforce development are occurring in many settings in the health and disability sectors and these contribute to the five-year actions

The Plan aims to ensure kaiāwhina are recognised as a valued workforce, supported and enabled on their learning journey to develop their skills and knowledge, to better support consumers of service

There is systematic progress towards the agreed 20-year vision through the five-year action plan which commenced July 2015

The Kaiāwhina Workforce Action Plan is a living document which is largely web-based to enable flexibility, adaptability and responsiveness in a fast changing environment

You can visit the website https://www.workforceinaction.org.nz for more information

Kaiāwhina Workforce Action Plan:5-Year Actions 2015-2020 I Toward the 20-yearVision

15

Contact us at kaiāwhina @careerforce.org.nz

or visit the website for further information

https://www.workforceinaction.org.nz