Our People

He whakapapa, he mokopuna, he tamariki, he mātua, he tūpuna. He aha te mea nui. He tāngata, he tāngata, he tāngata.

Our people are central to all we do. Our people are what drive our organisational culture. The five organisational Values are what we pride ourselves on. They are the foundation of our culture that we continue to build on.

Demographics

Leadership, Accountability and Culture

Northland DHB strives to provide an organisational culture that has strong leadership and accountability. A culture where everyone can contribute to the way the organisation develops, improves and adapts to change. Northland DHB is committed to meeting its statutory, legal and ethical obligations to be a good employer.

Collaboration and leadership is encouraged across services, occupational groups and supported at all levels of the organisation. This multi-disciplinary approach contributes significantly to staff engagement, innovation and a sense of belonging. As our people are our most valuable resource, staff safety, health and wellbeing is paramount.

A key focus and priority for Northland DHB is achieving equity within the New Zealand health system. We require our workforce to be mindful of this. Evidence shows patient outcomes improve when they are treated with a higher level of cultural safety, and cared for by a skilled workforce that reflects the community we serve.

This year the Board and Executive Leadership Team acknowledged the misinterpretation of the agreement recorded in Te Tiriti o Waitangi. Since 2014, the Waitangi Tribunal has upheld their claim that the treaty their ancestors signed, confirmed and guaranteed their tino rangatiratanga and that no cession of sovereignty had taken place for Māori of Te Tai Tokerau.
Therefore Northland DHB now uses Te Tiriti and/or Te Tiriti o Waitangi to replace and dispel any further use of The Treaty of Waitangi. Use of Te Tiriti and/or Te Tiriti o Waitangi replaces the ‘principles’ with the original four articles in the Tiriti document itself.

The DHB’s positive relationship with its union partners remains. A Bi-Partite Forum meets regularly and remains integral to maintaining a cooperative working environment. The objective of the forum is for on-going constructive engagement between Northland DHB and the unions that represent its employees.

Northland DHB continues its commitment to its sustainability responsibilities whereby there is continuous focus on reducing carbon emissions from operations.

A further commitment for 2020 has seen the Chief Executive and Executive Leadership Team sign up to the national Accessibility Tick programme. This programme is designed to support the organisation to become more accessible and inclusive employer. The programme has been designed in consultation with a broad range of New Zealand employers and disability sector experts.

Achievements in 2020-21 include:

- There were 20 leadership initiatives with 116 attendees over the last 12 months
- A series of education interventions have been developed to feed into the ‘achieving equity’ programme of work:

• 78 hiring managers attended the ‘Achieving Equity’ workshop
• 221 participants completed the online ‘Achieving Equity’
  module
• 70 staff attended the Revisiting Te Tiriti and Disrupting
  Institutional Racism delivered by Associate Professor Jacquie
  Kidd and Dr Heather Came
• A regular 10 week ‘Journey into Te Reo’ course which has
  been oversubscribed.

A number of initiatives have been put in place to reduce carbon emissions:

• Contributed to organising the Sustainable Healthcare conference in Wellington
• First benchmarking of carbon emissions across 12 DHBs
• Letter to Hon. Andrew Little on behalf of the Sustainable Health Sector National Network requesting for integration of the climate change programme in Health NZ. Have subsequently been asked to join the Transition unit on climate change
• Reprocessing of Hovermatts on Surgical Wards to avoid waste going to landfill, reduce transport emissions and strengthen supply chain
• Introduction of 150 Electric Vehicles into the fleet
• Nominee for the Northland Regional Council Environmental awards
• Newly created annual minor works budget to fund sustainability initiatives within our facilities.

Recruitment, Selection and Induction

Northland DHB remains committed to supporting more Māori into Northland DHB’s workforce. Northland DHB is committed to encouraging more Māori into health and disability fields. This applies particularly to areas where Māori are under-represented as health professionals and over-represented in their health needs. Our objective to grow the capacity and capability of our Māori workforce’ has led to a number of development projects which have been implemented with much success.

Northland DHB is the Northern regional lead for the national Māori Health Workforce Development programme – Kia Ora Hauora (KOH). The northern region encompasses Counties Manukau DHB, Auckland and Waitematā DHBs and is the highest performing region in the country. Thirty-nine percent of the KOH northern membership lies within Northland DHB. As at 30 June 2021 the KOH national membership was sitting at 4,282. The Northern region makes up thirty-four percent of the total membership with 1447 members and maintains the largest database across the country at this time.
Sixty percent of the northern regions’ membership are made up of people aged 25 years and under and sixty-eight of the members are in tertiary education settings.

Kia Ora Hauora regions have three targets that they must meet quarterly and/or annually. These are:

1. Annually recruit 160 new Māori into the health career pathway programme. As at 30 June 2021 the northern region has recruited 377 new Māori to the programme
2. Support 40 Māori to transition into tertiary level health studies annually. As at the 30 June 2021 the northern region has supported 183 members to transition to tertiary education
3. Support 40 Māori to transition into health sector employment. As at 30 June 2021 the northern region has supported 40 members to transition to employment. In addition, we have offered $16,000.00 to Māori experiencing financial barriers to transitioning to employment. For example, final exam fees, national registration fees, tools for the trade, further training.

Our longstanding arrangement with the University of Auckland witnessed another cohort of 23 Year 5 and 6 medical students’ progress through our Pūkawakawa programme. The programme theme this year was Engaging effectively with Māori. Students were given opportunities to experience, explore, define and create their own interpretation of Māori advancement in the context of health. Emphasis was placed on a Kaupapa Māori approach to health and Māori perspectives on health. This will be achieved through dynamic and authentic learning experiences.

Attract, recruit and develop a talented workforce strategic objective underpins our commitment to future-proofing our service delivery. This has led to a number of initiatives in the recruitment improvement project to streamline the staffing process.

Achievements in 2020-21 include:

• Kia Ora Hauora have launched the KOH Connect portal. The concept and design for the KOH Connect Portal was developed by Kia Ora Hauora and sponsored by Tumu Whakarae (GM Māori network) as a response to the national workforce strategies to increase Māori capacity in the health and disability sector. The portal was launched in Christchurch, February 2020 by the Honourable Minister, Peeni Henare and will enable national DHB access. The portal holds a number of KOH qualified and near graduation Māori profiles. These members have been supported throughout their study to achieve qualification and employment. Hiring Managers can register with the KOH portal to actively recruit Māori
• The annual Pihirau Scholarship opens in March and this year we had 31 applicants with 27 of those being successful. These scholarships support tertiary retention with the fee paid directly to the tertiary provider against their annual programme fees. A total of $55,000.00 was awarded this financial year
• KOH northern also provides tertiary support packages. The intention is to reduce barriers for Māori accessing tertiary study and receiving qualification. Packages include laptops, travel assistance and accommodation grants (if staying in tertiary accommodation). KOH northern provided 10 laptops, $2,320 in travel assistance, and $4,000.00 in accommodation support
• Pūkawakawa Wānanga – successfully delivered noho marae with 23 Year 5th and 6th year student doctors
• In 2021, the Executive Leadership Team and Board committed to supporting Project SEARCH initiative in Whangārei and Te Tai Tokerau for the rollout of the first cohort to be launched in February 2022
  • Project SEARCH is a programme aiming to break down barriers for disabled New Zealanders who want to enter the workforce. The programme directly encourages a collaborative, partnership approach to the transition from school through industry-based vocational training that leads to employment
  • The programme is an employer led one-year internship programme for students with learning disabilities in their final year of school (18-22 years). It is targeted to students whose goal is competitive employment utilising the skills they learned during the programme.
• 575 new employees have been welcomed through the online learning module Getting Started at Northland DHB. The purpose of this module is to support a smooth transition into the organisation with a focus on our Values, population and overview of where to go for key information. This flexible approach fits well in our current uncertain COVID-19 world
• Recruitment Improvement Project
  
  • Reviewed and replaced the approval process required to raise a vacancy and obtain approval to appoint to a new or replacement role
  • Restructured recruitment model in order to shift to a Recruitment Partnering Model allowing the Recruitment team to bring the following functions in-house:
    • Advertising (including obtaining job briefings, drafting advertisments and sourcing strategies)
    • Candidate screening.
  • Developed Candidate tracking system and reporting function within the SMO team to improve transparency and visibility of candidate journey
  • Completed review of current Recruitment ATS (Applicant Tracking System). Supporting transition onto a new platform supported by TAS (via Kiwihealth jobs)
  • Reviewed and updated content for the Recruitment Toolkit for both General Recruitment and SMO recruitment. The content is currently under review by key Stakeholders and will provide guidance for hiring Managers covering the end-to-end recruitment process
  • Collaborated with key stakeholders to re-design the interview template (currently in testing phase). This has been a key driver to support the Objectives of Achieving Equity and commitment to increase the number of Māori employees within Northland DHB.

Employee Development, Promotion and Exit

We support staff to participate in various internal and external training courses, conferences, workshops, and other developmental opportunities to build capability and support career and personal development objectives. We provide medical staff with continuing medical education (CME) support and nursing and midwifery staff with professional development recognition programmes. Health Workforce NZ funding continues to be provided for postgraduate study for nursing and midwifery and the non-regulated workforce. The Workforce Development & Wellbeing department offers a range of professional and personal development training opportunities.

Northland DHB has put ‘Achieving Equity’ front and centre and has undertaken several moves that demonstrate accountability to
this kaupapa, especially under employee development. For example, Te Kaupapa Whakaruruhau / The Māori Health Cultural Quality Programme provides opportunities to gain cultural competencies. Northland DHB has also committed to implementing an equity lens overall organisational training.

E-learning development and implementation continued to enable greater access to our primary healthcare and community partners to share learning, communication, knowledge transfer and skill development. This supports best practices across Northland DHB and the wider health sector.

Northland DHB’s turnover has increased from 9.9 percent to 10.6 percent. The national average is 12.4 percent.

An improved Exit Survey was implemented, enabling more accessible access for staff to provide feedback when leaving the organisation or transferring to another department.

Since implementation, the survey has been updated to include ethnicity, which will provide analysis regarding leaving reasons and enable the DHB to action solutions to retain our staff where possible.

Achievements in 2020-21 include: 

• 65 internal organisational course events in 2020/21 were provided, seeing 2,393 overall attendances. Courses included cultural, leadership and communication skills. These courses are also open to Hospice and our PHE partners
• 66 e-learning courses specifically for the Northland workforce, these range from clinical and non-clinical
• 8 national e-Learning courses that we are utilising
• With 12,139 completions over the last 12 months. The Northland workforce has wider access to other DHB e-learning courses within the Ko Awatea network
• Tū Tira (meaning Stand Together) is a professional development opportunity where Kaimahi Māori can come together to share aspirations, achievements, successes and build on current capabilities. The annual Symposium planned and delivered by Tū Tira was supported and sponsored by Te Poutokomanawa, Māori Health Directorate.
  
  • This year's programme of presenters and breakout sessions aimed to build on the success of last year's inaugural event. Tū Tira's focus on building the capability of our Māori workforce was reinforced by this year's theme "Home Grown"
  • The kaupapa Māori event is important as it recognises the organisation's commitment to Te Tiriti. It builds on the organisation's cultural capacity and acknowledges Kaimahi Māori are essential to improving health outcomes within our rohe.
• Review of Te Kaupapa Whakaruruhau and redesign of mandatory workshops ‘Honouring Te Tiriti’ and ‘Engaging with Māori’
• ‘Journey into Te Reo’ language evening course has been oversubscribed from a wide range of staff
• Once again, the JRBM Scholarship has been generously offered to Northland DHB employees to undertake health-specific undergraduate studies with an accredited education provider
  
  • This year we received 11 applications, and the panel members were impressed with the high standard of all of them
  • We were very happy to announce that three Northland DHB employees, all Māori, received the Scholarship this year.
• A previous recipient of the JRBM Scholarship was recommended for a BM Hons intensive 18-month academic pathway by Auckland University after completing the new entry to specialist practice (NESP): mental health and addiction nursing programme
• The Faculty of Medical and Health Sciences at the University of Auckland acknowledged and awarded two Northland DHB clinical teachers for their outstanding and valuable teaching contributions in their respective fields at the Distinguished Clinical Teacher Awards in March 2021
• Northland DHB anaesthetic technician's (ATs) proved their talents are endless after successfully pulling off what their colleagues around the country have called one of the best New Zealand Anaesthetic Technician Society (NZATS) conferences ever, in Waitangi, November 2020
  
  • The NZATS Conference is usually held in larger centres, so this year's new location saw ATs flock to the Bay of Islands for the event. They had roughly 75 delegates on any given day, from 37 institutions, encompassing both public and private institutions. Unfortunately, the Australian and the Pacific Island ATs were unable to attend due to COVID-19
• The conference's theme, 'Balance is Life', was well supported and helped them form the programme plan to include plenty of time for activities to make the most of the beautiful location, which they are all proud of and were happy to share.
• The average length of service at Northland DHB is 7.3 years.

Flexibility and Work Design

The tsunami threat, national COVID-19 Alert levels and various industrial actions has seen the DHB move into an Incident Management phase on more than one occasion in the last 12 months. During these phases many initiatives were either established or enhanced in order to support the wellbeing of our workforce and community.

Northland DHB also sought to assist its colleagues at the Auckland DHBs while they were in Level 4, re-deploying 20+ staff members to the region for several weeks during this challenging time.

Northland DHB operates 24 hours a day, seven days a week, providing full-time and part-time opportunities. Flexible work hours based on employee needs and the requirements of the position are available. Any specific impairment is recognised and is suitably provided for where possible.

Northland DHB has fostered an environment where our key partners can evolve the development of the primary care health system across Northland that eliminate health inequities for Māori, promote wellbeing and self-determination, provide value to the system and measure success through achieving population outcomes across a health and social care spectrum.

Northland DHB continues to be committed to a holistic primary-secondary partnership. This includes working closely with the PHE Mahitahi Hauora which was formed from representatives of the previous PHO boards as well as community and iwi representatives and the DHB Chief Executive as a non-voting member.

Achievements in 2020-21 include:

• During the Alert Level 4 in 2020, a project was initiated to create an interactive deployment tool that could enable rapid scalability
  
  • A group was tasked by the Incident Management Team and the Chief Medical Officer to develop an application that would create visibility across the workforce for redeployment requirements
  • The Staffing Deployment application is a 24/7 centralised system that enables rapid search and deployment across the whole system (or deploy to other regions) to equip our organisation for scalability, be it across changing alert levels or during a mass casualty. This offers granular visibility, is easy to use, based on Northland DHB allocation processes, flexible and secure.
• The Our People and Capability service were deployed to provide IMT Welfare support during the June 2021 NZNO strike. The team were responsible, with IMT Planning, Logistics and Operations, to ensure Contingency Support cover during the 8-hour strike across three shifts
• Deployment centres were established, and 'volunteers' were briefed and provided with information to ensure a smooth transition to the various wards
• The Calderdale Framework (CF) is a clinically-led workforce development tool to facilitate a 'best for the patient, best for system' approach. It provides a delegation model for assistants and other support workers, and a workforce model for skill sharing across professions in the team, leading to improved workforce efficiencies
• Across Northland DHB, 20 CF Facilitators across two cohorts have been trained over the past two years. The Facilitators work across several professions, including Physiotherapy, Occupational Therapy, Nursing and Psychology
• Eight Cohort 1 Facilitators were congratulated in March for completing their training and became fully credentialed as Calderdale Framework Facilitators
• Across Northland, five Calderdale Framework projects have been implemented, with several outcomes achieved across various services. In Public Health, Kaiāwhina were upskilled to throat swab children who reported having a sore throat, freeing from public health nurses (PHNs) for other duties. This project's outcomes included increased job satisfaction for both Kaiāwhina and PHNs and reduced FTE cost, which enabled two more Kaiāwhina to be employed to support throat swabbing
• Another example is Northland DHB's Paediatric Speech-Language Therapy (SLT) service, where the preparation time before starting the Videofluoroscopic Studies of Swallowing was delegated to a healthcare assistant, saving 13.5 hours of SLT clinical time during 2020 despite resource constraints and COVID-19 impact. There was an increase in studies by 42 percent from 2019 to 2020. Waiting time for studies requested before June 2020 averaged 182 days, and after this date, it reduced to an average of 34 days
• At the moment, 15 CF projects are underway and at various stages of implementation. There are several projects in the pipeline awaiting facilitator availability
• A telehealth emergency triage and clinical support service was trialled in the rural hospitals, which provides after-hours support to the rural hospital clinical teams. The Emergency Consult system enables access to specialist advice and has been shown to support clinical teams to better manage workloads as well as support more efficient patient flow
• Paediatric telehealth outpatient clinics were and continue to be trialled with new service design to create more opportunities to connect with patients and whānau. Results show this new approach makes a significant difference in clinic attendance and the provision of options for access to healthcare for Northlanders. Learnings are informing ongoing utilisation in Child Health and strategic planning for the adoption of telehealth across the organisation.
• The telehealth services continue to use the mobile RITA (Rapid Information Telehealth Assessment) acute care telehealth network
• Zoom video conferencing continues to be well embedded for staff use for non-clinical and clinical (telehealth) communications. Upgrades to the meeting room and some hospital clinical areas have kept pace with the growth in demand for supporting team communications.

Remuneration, Recognition and Conditions

Northland DHB adheres to the good employer requirements in section 118 of the Crown Entities Act 2004 which covers:

• Good and safe working conditions
• An equal employment opportunities programme
• The impartial selection of suitably qualified persons for appointment
• Recognition within the workplace of the aspirations and needs of Māori, other ethnic or minority groups, women and people with disabilities and/or impairments.

The concept of the ‘good employer’ is bound up with the principles of natural justice and requires employment procedures to be ‘fair in all circumstances’. Northland DHB recognises that all individuals and groups should have opportunities without barriers or biases.

Northland DHB’s workforce is covered by 23 collective employment agreements. This increased from 22 in the previous year. A smaller proportion of staff are on individual employment agreements. Transparent job evaluation criteria, developed in consultation with relevant unions, are in place for a range of employee groups. This includes specific merit programme criteria which are available for most employee groups.

Northland DHB has participated in the national Pay Equity process. The Equal Pay Amendment Act 2020 has provided principles and allowed for a framework which addresses systemic gender based pay discrimination in female dominated roles. This is a collaborative process between the unions and DHB employers. Pay equity claims have been lodged by unions for the Clerical/Administration, Allied/Technical, Nursing and Midwifery work groups.

In 2021 there was an interim settlement for the Clerical and Administration work group that saw the majority of employees in this workforce receiving an interim adjustment to salary.

Achievements in 2020-21 include:   

• International Nurses Day and International Day of the Midwife was recognised and celebrated in May 2020 with care packages being distributed throughout the DHB. The theme for this year’s International Nurses Day is ‘Nurses: A Voice to Lead – A Vision for Future Healthcare’
• Catering for our growing population needs requires improved working conditions for staff and patients alike. Over the last twelve months the following new units have been established
  • Wahi Arotake, Assessment Unit
  • Cath Lab
  • Wāhi Tirohia Oranga Whēkau, the new Endoscopy suite
  • Theatre extensions
  • Two 2-bed transitional rooms and new ultrasound room for Te Kotuku, Maternity Unit
  • Rongoā clinic space at Bay of Islands Hospital.
• A suitable enhancement to Tumanako, the inpatient mental health unit and Whangārei Hospital introduced a 46-metre long mural by local Māori artists. The mural is about the light. It is about the light that existed before time and the light that provided when Ranginui and Papatūānuku separated.
• The National Holidays Act compliance project has three key aspects:
  
  • Review – identifying non-compliance
  • Rectification – fixing areas of non-compliance to enable compliance with the Holidays Act moving forward
  • Remediation – the calculation of what was paid to employees compared to what should have been paid under the now agreed MOU (what compliance looks like for DHBs) between the DHBs UNIONS and MBIE
  • Northland DHB have completed the Review phase and have had sign off from the labour inspector for both the Review and Rectification stages of the project Northland DHB are working closely with the unions and other DHBs to resolve a number of national questions which will enable the completion of the project at Northland.

Harassment and Bullying Prevention

Northland DHB’s zero tolerance to bullying and harassment is reinforced by its Managing Unacceptable Behaviour in the Workplace Policy. This supportive document provides all staff with clear guidelines.

The ‘DATIX’ electronic reporting tool continues to be the vehicle for reporting incidents of alleged violence, bullying and harassment. We have continued engagement with our union partners to refine and increase confidence in the tools and process to ensure that all employees are safely able to raise concerns.

Achievements in 2020-21 include: 

• New Eliminating Racism policy has been developed and established
• An external review of the bullying and harassment policies and procedures has taken place to ensure the organisation is following good practice and has the tools and capability to deal effectively with complaints received, promoting a safe working environment
• The Workplace Violence Prevention Advisory Group continues their commitment to eliminate workplace violence and support staff safety. The Workplace Violence Prevention Framework has six focus areas:
  
  • Interpersonal Relationships
    - Building trust and awareness with staff
  • Training and Education
    - A four tier training programme now available
    - Over 1,000 staff have had some form of training and education
  • Work Environments
    - Three service areas have developed workplace violence prevention plans
  • Reporting
    - The reporting of workplace violence is crucial in understanding how to prevent workplace violence
    - Significant increase of reporting has been seen over the last twelve months
  • Support
    - Policies and procedures have been revised
    - Staff seeking advice earlier
  • Strategic Leadership
    - Purpose built intranet page with appropriate resources
    - Greater connections with key stakeholders and sponsors developed

Health, Safety and Wellbeing

Northland DHBs Values are centred round Safety, Health and Wellbeing. The organisation is committed to providing a culturally and physically safe workplace for employees, patients, whānau, visitors and contractors.

Legislation and contractual obligations ensures the organisation has effective emergency and corporate risk management systems and processes in place.

Staff wellbeing continues to be a focus for Northland DHB with full support from its Executive Leadership team. Wellbeing is promoted in various ways across the organisation with extra dedication from the Workforce Development & Wellbeing department.

Achievements in 2020-21 include:

• The adoption of the Safe365 tool to assess and monitor the workplace health and safety management system, with an overall score of sixty-three percent in 2021
• ACC Partnership Programme retained tertiary level accreditation
• The adoption of the Protective Security Requirements (PSR) model for monitoring personnel and physical security, and establishment of a Security for Safety Improvement Programme governance group
• Occupational Health response and support for COVID-19 including enhanced testing, vaccination clinics and mask fit testing on site for staff
• The Mayo Clinic Wellbeing Index continues to be preferred tool for staff to use for measuring their wellbeing. The Index provides strategies to promote staff wellbeing. It supports shared responsibilities between employee and employer. It cultivates a productive solution of awareness, engagement and resources
  
  • Over 50 percent of Senior Medical Officers are regularly accessing the Index, having displayed high engagement with the Index since it was rolled out last year
• A number of interventions have been developed by the Workforce Development & Wellbeing department, including 
  • A series of short online Manaaki modules
  • A dedicated He Wāhi Haumaru - Wellbeing Hub based on Te Whare Tapa Whā
  • Wellbeing check in templates for managers and peers
  • A coordinated and increased focus on professional supervision
  • Continued and regular promotion of Employment Assistance Programme / RAISE
  • A number of wellbeing workshops available via zoom and face to face.

In July 2021 Northland DHB chose to mark Matariki with a week of various events that staff could attend to learn more about this special Aotearoa season.