Integrated care in New Zealand

BACKGROUND: New Zealand’s health system has long been seen as providing highly fragmented, poorly co-ordinated services to service users. A continuing policy challenge has been how to reduce such fragmentation and achieve more ‘integrated’ care, that is, ‘co-ordinated’ care that provides a ‘smooth and continuous’ transition between services, and a ‘seamless’ journey as service users receive health, support, and social welfare services from a range of health and other professionals. DESCRIPTION OF POLICY PRACTICE: The paper takes as its starting point the view that achieving integrated care needs to be supported by a “coherent set of methods and models on the funding, administrative, organisational, service delivery and clinical levels” [1]. The paper considers how fragmentation in financing, planning, funding, and service delivery have contributed to poorly co-ordinated care in New Zealand; discusses how integrated care was to be supported by recent major reforms to the health system and whether such reforms have succeeded or not in achieving more integrated care for service users; and discusses the challenges New Zealand still faces in achieving more integrated care over the next few years. DISCUSSION AND CONCLUSION: The paper concludes that although key financing, planning, funding and service delivery reforms aimed at delivering more integrated care to service users have succeeded in integrating planning and funding functions, few changes have occurred in the ways in which services are provided to users. It is only now that significant attention is being paid to changing how services are actually delivered in order to achieve more integrated care, but even then, change appears to be slow, and significant challenges to integrating care in New Zealand remain to be resolved.