To head towards wellness

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Te Tumu Waiora - Te Reo for to head towards wellness - is a new way of delivering wellbeing, mental health and addictions support through general practice.

The model puts mental health and wellbeing at the heart of general practice with focused roles, Health Improvement Practitioners and Health Coaches, working as part of the general practice team. This model allows for a 'warm handover' which means that a GP or nurse in the general practice can offer someone who is experiencing mental distress or addiction issues the option of seeing the HIP in the same location quickly – often immediately.

The HIPs and Health Coaches provide advice and support based on individualised goals, promoting self-management and work closely with local community NGO support workers to ensure people can access the full range of help they need.

Late in 2019, The Ministry of Health released a Request for Proposal (RFP) for Integrated Primary Mental Health and Addictions Services across New Zealand. 

This proposal was part of the government’s Wellbeing Budget 2019 announcement and focused on one element of a new mental health pathway. This proposal included:

  • peer/cultural health coaches
  • health improvement practitioners 
  • support for general practice
  • seamless access to cultural and social supports, and 
  • effective links and coordination between primary and secondary mental health and addiction services. 

The ministry sought collaborative responses to deliver the service to the enrolled population of selected general practices within a defined geographical area. 

Canterbury Clinical Network facilitated the development of the Canterbury response. Development of this response included the establishment of a sponsorship group of the three PHOs, Navigate Waitaha and the CDHB. This group was supported by the discussions and decisions put forward by a technical advisory group (TAG). 

A co-design workshop was held 6 September and the key themes from that were incorporated into Canterbury's proposal. The Te Tumu Waiora model, recently piloted both nationally and regionally, was referenced in the design of a Canterbury response

Latest News

Pioneering mental health specialist visits Canterbury

20 Dec, 2021 | Return|

Dr Patti Robinson, co-founder of the Primary Care Behavioural Health model and Focused Acceptance and Commitment Therapy (FACT), has been involved with the New Zealand health system since 2017 when she was approached to provide advice on a new integrated way to provide mental health, addiction, and wellbeing support in general practice. 

During her visit to Canterbury, Patti hosted a question-and-answer session for general practice teams to give a brief overview of the Primary Care Behavioural Health model and offered examples demonstrating ways that General Practitioners, nurses, and Te Tumu Waiora roles, including Health Improvement Practitioners (HIPs), Health Coaches (HCs) and Support Workers can work together to address patient needs.  

She also hosted a full-day workshop for HIPs and Brief Intervention Talking Therapists (BITT) around the FACT methodology, which is the model used by HIPs and BITTs and uses acceptance and mindfulness strategies to help their patients.  

At the general practice session Patti indicated a person’s environment can prompt the type of complaint they have. 

“Often the clinical setting of a general practice can prompt a physical symptom such as sore tummy or headache rather than considering what may be causing it, such as anxiety or stress," says Patti.

“When you have a HIP or HC down the corridor, they can often see a patient straight away via warm handover.  This provides much better access, with most people seen on same day.”

Patti confirmed that across the globe where the model is used, they’ve noticed higher client satisfaction, a reduction in medication and an 85% improvement over all after one visit (duke score - measure of a person’s health and wellbeing). In New Zealand, there is feedback that this approach results in higher satisfaction rates from Māori.

“Many of these people wouldn’t have accessed this care if a HIP or HC wasn’t at their practice. Any time with a patient is precious and often the only chance to make a difference. If an opportunity is missed, they may not come back.” 

Patti noted that when the HIP, HC or Support Worker works with the patient on a behavioural plan, it is particularly effective. The plan is also accessible by the practice team as they are fully integrated and part of the team on site. 

Te Tumu Waiora Clinical Implementation Lead Shelley McCabe says we were delighted to be able to host Patti and draw from her wealth of knowledge and experience with the primary behavioural health model. 

“The GP teams particularly valued the analogy Patti presented about the ‘landmines’ that need to be avoided and the ‘trampolines’ pursued in their work with HIPs HCs and Support Workers, such as understanding the scope of each of the roles, and how best to utilise them to meet the needs of their patients, as well as ensuring that they are well integrated members of the practice team,” says Shelley.  

Above left: Dr Patti Robinson (second from right) with members of the Canterbury Te Tumu Waiora team, from left Lurita Kurene, Stacy Belser, Brendan Sillifant, Deb Bradshaw, Hiedee Harris, Shelley McCabe and Jackie Moore. 
Above right: Jane McGregor (HIP, Pegasus Health) and Sue Louter (HIP, Waitaha Primary Health).

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Useful resources

Te Tumu Waiora website

A new website explaining TTW for our community.

Information flyer

Information about Te Tumu Waiora Canterbury for practices and patients.

HIP and HC posters

Posters for practices to display explaining what HIP and HC roles.

VIDEO - Overview of TTW

Video describing the role of HIPS and Health Coaches.

Video - HIP role

Tara Mueller, a Health Improvement Practitioner, talks about her role.

Video - Health Coach role

Health Coaches in Aotearoa New Zealand