Part 3: Connecting services for New Zealanders

Reflections from our audits: Service delivery.

Many problems that our society faces are pervasive and complex. A single organisation cannot solve them. They require public entities, and the public and private sectors, to work together purposefully to connect services.

Public entities seek to break through traditional or perceived boundaries between organisations and sectors to work together in better connected, flexible, and innovative ways. We have seen examples of this happening and where it needs to happen more.

Public sector leaders need to be good stewards of public services, looking ahead to manage and connect services between their organisations to serve people's interests and needs well.

Meeting complex needs

People have increasingly complex health needs. Our annual audits in the health sector have shown that there is a continuing push for DHBs to work more collaboratively to connect services and provide the best, most cost-effective healthcare for patients. There is a move towards more preventative action and for patients to be treated in the community more.

Some complex needs are born out of a crisis, such as the Canterbury earthquakes. The Residential Advisory Service in Canterbury is an example of organisations working together to meet need. The Canterbury Earthquake Recovery Authority (CERA), the Earthquake Commission, and the major insurers, through the Insurance Council of New Zealand, fund the Residential Advisory Service, which provides free and independent advice to Cantabrians who have problems with the Earthquake Commission or insurance claims that prevent them getting their home repaired or rebuilt.

During our work on service delivery, we found other examples where public entities needed to make better connections in delivering services.

Every day, MSD's staff work with people with complex needs. Some of those people have high needs and require co-ordinated health, education, housing, and social services to get the best outcomes for themselves and their families. Our report on MSD's use of case management highlights the need for MSD and other public entities to work together to help adults with the highest barriers to employment.

Some case-managed clients reported feeling emotionally supported. They felt that MSD had given them the confidence and support they needed to get back into the workforce.

In our report on ACC's use of case management, we recommended that ACC more actively manage the transfer of clients between it and other public entities to reduce the potential for people to miss out on services they are entitled to and to ensure that people are appropriately prepared for transfer to another public entity.

Working together

Public entities are working together and with others more and in different ways. This remains challenging for them.

There are many different approaches that can be taken to working together. In paragraphs 3.13-3.30, we discuss some examples from our work.

Public entities must choose an approach that fits the circumstances and includes appropriate incentives for working together, that they give adequate attention to managing relationships and risks effectively, and that they monitor and evaluate whether the intended outcomes from working together are being achieved. Having common purpose and clear objectives, being flexible and prepared to make trade-offs, and binding commitment and clear accountabilities are some aspects of working together effectively.

People working in partnerships

In the education and primary industries sectors, we are seeing partnerships between public entities and the private sector, such as the Primary Growth Partnership initiative (PGP), research partnerships, and Government Industry Agreements. Our work looking at PGP and the maturity of relationships between schools and whānau sheds some light on what makes partnerships effective.

Our February 2015 report Ministry for Primary Industries: Managing the Primary Growth Partnership looked at how well the Ministry for Primary Industries (MPI) was managing PGP. The objective of PGP is to encourage partnerships between the public and private sectors to increase overall investment in innovation that will ultimately lead to the economic growth and sustainability of primary sector industries. As at 30 November 2014, the Crown and industry partners had committed $680 million to PGP.

MPI took a flexible approach to setting up and managing partnerships with industry because of the diverse nature of the work and the people involved. This flexibility is appropriate. In our view, when forming new partnerships, managing new relationships in a way that fosters trust and appropriately manages risk is more important than rigidly following a set formula.

In the six PGP programmes we looked at, some partnerships appeared to work well from the beginning and others experienced difficulties. Lessons were learned along the way, some positive and some less so. The programmes showed some encouraging results. For example, a prototype fishing net had been tested that aims to harvest high-value fish in a low-fatigue, low-damage way, and seed trials led to increasing production of crops under conditions of high drought and disease stress.

Effective partnerships are founded on strong, trusting relationships. We have a programme of work to find out how well the education system supports Māori students to achieve their full potential. As part of this programme, our February 2015 report Education for Māori: Relationships between schools and whānau looked at the maturity of relationships between schools and whānau.

We surveyed 1954 Māori students/whānau and 376 primary and secondary schools to find out what they thought about their relationships. Obviously, people, not institutions, have relationships. School leaders valuing Māori, whānau, and schools working together on purposeful events, open and honest communication, and schools being aware of and considering the circumstances of whānau when contacting them and organising meetings all help to build relationships.

On the whole, school staff think that they have better relationships with whānau than whānau think they do. Many aspects affect these relationships. What people told us raised many questions – to which we do not have all the answers. Our report is a timely reminder for schools and other public entities to focus sustainably on their relationships with whānau.

People working in alliances

In our November 2013 report Effectiveness and efficiency of arrangements to repair pipes and roads in Christchurch, part of a series on the Canterbury recovery, we looked at how effectively and efficiently CERA, the New Zealand Transport Agency, and Christchurch City Council were reinstating horizontal infrastructure through SCIRT. This contract to rebuild the roads and underground water, wastewater, and stormwater pipes in Christchurch is one of the most significant and complex contracts in the Canterbury recovery.

We concluded that the choice of an alliance (a mixed team of public and private organisations working together) to reinstate the horizontal infrastructure in Christchurch was a good fit with the post-earthquake situation in Canterbury and provided a useful way to manage the risks in a suitable way.

SCIRT's design showed many of the good practice characteristics of an alliance. It had sound business systems that create operational efficiencies. Highly trained specialists came up with practical solutions, and projects were scoped well.

However, CERA, the New Zealand Transport Agency, and Christchurch City Council had no common understanding of levels of service. The public entities funding the alliance did not give enough guidance for SCIRT to know what services to deliver and where, for the most effective and efficient rebuilding and repair of infrastructure.

Sharing services

Sharing services, including "back office" services, is one way public entities seek to be effective and efficient. Some of the drivers for sharing services include sharing and building expertise, removing duplication, increasing efficiency, and reducing costs. Defining the expected benefits and evaluating whether they are achieved is important in sharing services successfully.

Our annual audits in the health sector have shown a significant increase in collaborative working and shared service arrangements in recent years, reflecting increasing financial pressures and an emphasis on efficiencies. For example, healthAlliance N.Z. Limited (healthAlliance) was originally set up in 2000 by Counties Manukau District Health Board and Waitemata District Health Board to provide back-office functions (including procurement, supply chain, finance, information systems, and payroll processing) to release funding for frontline patient care. The scale of healthAlliance's operations has now expanded.

Our November 2013 report Regional services planning in the health sector showed that the health sector needs to work more collaboratively to deliver services. In 2011, changes were introduced to encourage regional services planning. DHBs were expected to plan to deliver services together to reduce service vulnerability, reduce costs, and improve the quality of care. We found some signs of success, but not as much progress as expected. Collaboration in and between district health boards worked best where there was a combination of trust, good leadership, financial incentives, and a strong common cause. Our recommendations included that the Ministry of Health and district health boards work together to prepare an evaluation framework and use it to work out whether regional services planning is having the intended effects.

In our annual audits of local authorities, we see examples of local authorities sharing services. For example, the various local authorities in Wellington are combining their respective economic development budgets to fund a Wellington Regional Economic Development Agency. The objective is to provide a more consistent and co-ordinated focus on economic development in the region.

Wellington Water, the council-controlled organisation that maintains the infrastructural assets of Hutt City Council and Wellington City Council, has been reformed and is broadening its role to provide asset management planning services to the local authorities. It has extended its geographical coverage to the Porirua, Upper Hutt, and Greater Wellington councils.

In June 2014, we issued Setting up Central Agencies Shared Services. Central Agencies Shared Services (CASS) was set up to provide internal human resources, information management, information technology, and financial services to the Treasury, the State Services Commission, and the Department of the Prime Minister and Cabinet.

Important aspects of the change were not done well. CASS had benefited the Department of the Prime Minister and Cabinet in particular, through some important improvements in services, but CASS was not yet consistently providing services that users expected. CASS needed to work further to provide more effective services and find a balance between standardised services and being flexible enough to appropriately accommodate the differences between the central agencies.

Not enough baseline data was collected at the outset to inform the change management plans and measure the performance of CASS. This is a useful lesson for public entities.

Leading good stewardship

Leaders of public entities have an important role in purposefully connecting services together to meet complex needs seamlessly and sustainably. They are the stewards of public services and need to look outward, beyond organisation boundaries, and over the long term to serve people well.

Some changes to encourage connections between public entities have been introduced throughout government.

Although we have not audited them, we are aware of examples of stewardship between public entities in the justice sector.

The Justice Sector Leadership Board, set up in 2011, is responsible for improving performance throughout the justice system, co-ordinating the major change programmes under way, and collectively planning to modernise the sector, to reduce costs, to improve services, and to further enhance public safety. The Secretary for Justice chairs the Justice Sector Leadership Board, which comprises the chief executives of the New Zealand Police, the Ministry of Justice, and the Department of Corrections and is supported by a Sector Group in the Ministry of Justice.

The Hutt Valley Innovation Project is an example of the justice sector working together in an effort to reduce the frequency and effects of crime. Between September 2012 and December 2013, frontline service providers collaborated on 10 initiatives. In its 2013/14 Annual Report, the Ministry of Justice reported that, since June 2011, total recorded crime in the Hutt Valley had dropped, prison sentences had decreased, and the District Courts were managing fewer cases and reducing the time needed to resolve cases.

The Ministry of Justice also reported that the project has since been rolled out to three locations: the East Coast, Papakura, and Hamilton. Justice sector agencies in each area were working together, and with other social sector public entities, to find local solutions to address problems such as alcohol abuse and family violence.

We have also reported on examples of stewardship improving in public entities' planning for long-term management of services and assets. In our November 2014 report Water and roads: Funding and management challenges, which looked at local authorities' management of infrastructure assets, we were pleased to note a greater focus on long-term planning in central and local government. Examples include the National Infrastructure Unit in the Treasury preparing a National Infrastructure Plan and Local Government New Zealand's Three Waters project work.

In our report on MSD's use of case management, we found that a more outward and cross-agency perspective was needed. We recommended that MSD use its role on the Social Sector Board to encourage the development of an inter-agency response to help working-age adults with the greatest complex needs into work.

For our part, we have for many years supported Auditors-General from Pacific countries. Recently, they have worked co-operatively to audit environmental problems facing their countries. This work has highlighted the importance of working together to tackle such complex, long-term problems. The most recent co-operative audit looks at strategies for tackling climate change impacts.

The countries of the Pacific are among the most vulnerable to the effects of climate change. Rising sea-levels, cyclones, tsunamis, food security, and coastal erosion are real threats. Although all countries in the Pacific are exposed to the threats of climate change, their vulnerabilities are not uniform – one size does not fit all.

The regional overview report from the co-operative audit found that, overall, the audited Pacific Island governments do not have adequately funded or planned responses to adapt to the short-term and long-term negative effects of climate change. Co-ordination between the many public entities responsible for climate change adaptation policies and actions, including funding co-ordination through national financial management systems, is fragmented. Some countries are addressing the findings of the audits. For example, the state of Kosrae in the Federated States of Micronesia has finalised a disaster and preparedness plan.

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