The importance of our community and people was at the heart of kōrero at a hui held to discuss challenges around access, capacity and demand across the Canterbury health system. 

The hui facilitated by the Canterbury Clinical Network (CCN) last month was attended by approximately 70 system and community leaders, who shared their views on system challenges and considered where to focus their collective effort to improve access and sustain our system. 

Senior Project Facilitator Koral Fitzgerald from the CCN who lead the coordination of the workshop said we worked quickly to organise the hui and appreciate the commitment people made to attend at such short notice and at such a busy time.

"I feel privileged to work alongside my CCN and CDHB colleagues who at short notice facilitated the workshop discussions and promptly gathered the feedback and themes,” says Koral. 

“There was a real sense of teamwork and commitment to open and frank conversations about how we can better look after our community and our people’s wellbeing through improving current capacity pressures on our system and access to care.”

The themes have been presented to the CCN Alliance Leadership Team, which include:

• Our community/whānau at the centre – keep the needs and wants of the community at the centre of any future steps and an equity lens applied everywhere.
• Build more trust – our system is used to working in a way where the people who deliver the service and recipients of care are part of the governance, working groups and implementation opportunities. 
• Heart – value our people, their contribution and skill.
• Teamwork – work as a team to find efficiencies in priority actions moving forward. 
• Upskill people in areas that matter most – cultural competency, Whānau Ora models, Partnership in Design framework.
• Look for opportunities to grow the workforce. 
• Great people – consider ways to collaborate and align recruitment processes and packages across the system.
• Grow technology use – balance this with the inequity of access.
• Value wider partners of care – consider involving housing, NGOs, community groups. 
• Communicate to the community – increase visibility of the services offered across Canterbury.
• Mental health needs are immense – our people and community need increased support.
• Be courageous – become agnostic, stop duplication, remove competition, keep equity front-of mind. 
• Waitlists are wasteful – consider how we stop using waitlists, without changing the eligibility criteria. 
• Mobilise services – support models to provide mobility / mobile service delivery into communities. 
• An increase in across-system relationships and trust is needed:  
  System Flow Governance Group requires a broader lens of contributors, specifically:
  o    Māori (Manawhenua ki Waitaha engagement), 
  o    on-the-ground clinicians, 
  o    equity lens,
  o    gather perspectives that were under-served or missing at the hui.
• Funding structures – the complexity of funding structures must be acknowledged to move past them. 

Feedback from the hui has prompted a refresh of the Making Our System Flow programme of work and standing up priority areas of work within CCN to respond to pressure points and opportunities identified at the hui. This includes exploring improvements to demand on community services, supporting people to navigate to the right place in our system and general practice capacity. A rethink of the governance of the System Flow work will also reflect a broadening of this work. 

The hui also identified further opportunities to use the Partnership in Design framework to enhance input into system flow design and improvement and looking beyond the health system to provide some of the answers including in education, Kainga Ora, Ministry of Social Development and others.