Case Study 4 - Transformational Change

Sector: Health 

Client Type: Health Authority 

Challenge/Opportunity

In the 1990s, New Zealand’s national health funder inherited an entitlements-based system for disability support services. It contracted agencies (NASCs) across the country to assess needs and allocate services then funded those services centrally through a national contract management system and payment system. By the mid 2000s, it spent $450 Million per year on services through NASCs. The national health funder managed contracts with service providers but most client data rested in individual systems and paper files held by the NASCs. Over time, issues arose with disparate services, uneven funding levels, regional service level disparities and a lack of flexibility to fund newly identified conditions, new therapies etc. There was also a growing push for people with disabilities to have more autonomy over their lives, their support services and the funding and management of those services. These matters ultimately led to the Health Minister at the time asking for a better approach to managing funding and services.

Value Delivered

The value delivered in this programme of work ultimately arose from the goodwill and commitment of stakeholders across the sector. Hague’s role in facilitating this value creation included:

• Developing the initial concept from a centralised funding system to a system that enabled and supported all the participating agencies to provide more value directly to their clients

• Building trust across stakeholders that this ambitious programme could actually succeed by confronting the biggest concerns head-on from the outset and collaboratively working towards solutions – this approach turned the biggest critics into the staunchest supporters

• Communicating and supporting change through direct and open communication and engagement throughout the programme – with stakeholders and the Project Board

• Developing a new disability services data standard based on existing health data standards,  managing the consultation process for that data standard and helping agencies to implement it.

• Actively assisting 18 organisations for over 18 months to cleanse and standardise their data in 18 different databases through multiple iterations leading up to migration.

• Managing an integrated programme of work to create systems and processes to manage over $450 million of services annually.

• Successful on-time and on-budget integration with Health Oracle-based payment systems: Client Claims Processing System (CCPS) and Contract Management System (CMS)

Hague’s Approach

Hague set up and managed a Programme Management Office and test lab at Hague's offices in Wellington. We managed all stakeholder management across concurrent projects, major business process change, data cleansing, database consolidation, process standardisation and new data standards. This work involved 19 diverse organisations ranging from Invercargill to Whangarei and including a Ministry, DHBs, Charitable Trusts and private companies. We also worked closely with HealthPAC - now Sector Operations which provides a variety of payment-related services for Health providers including maintenance and distribution of entitlements payment schedules, receipt, capture, validation and processing of entitlements, registers, claims and invoices and payment processing.

Outcome/Result

The Socrates programme created common processes and systems for national delivery of disability support services. This was the first national database of disability support services in New Zealand, and possibly the first in the world. The programme was a redesign of business processes and created visibility of all clients and services for the first time. It also provided for better approaches to service delivery and supported greater recognition that disability services are not entitlements to be doled out but tailored supports for the independence of people with disabilities. This project was one of three successful NZ health payments systems projects by Hague Consulting - on scope, on time, on budget and meeting quality criteria.