An equitable, person directed approach to delivering wellbeing focused allied health enablement services in the community. The journey to transform clinical practice and gain the trust of a community

Ms Emma Green1

1Bay Of Plenty DHB, Tauranga, New Zealand

The Bay of Plenty DHB identified that there was a significant gap in the provision of enablement focused, early intervention that provided equitable options, particularly for Māori clients. It was apparent that restrictive, criteria led service delivery was not meeting the engagement needs of clients, with few Māori trusting community services to assist with improving wellbeing. A new model of care was endorsed to promote equitable, person-directed wellbeing services. The challenge ahead was to operationalise this at practice level in an environment where systems, processes and cultures were orientated around criteria led delivery with a strong medical model influence. Secondary care allied health clinicians were seconded within a kaupapa Māori community health team to co-design the service independently of the constraints of the system. It was predicted, that by allowing the service to develop outside of the DHB and within a kaupapa Māori working environment we would begin to see practice transformation. Access for Māori clients was improved via the development of wayfinding pathways to access the service through already established trust and connection points held with the community teams. The service is proactive and reaching those in our population that have not engaged with community services. The trust created has allowed the weaving in of specialist services utilising the trusted networks now built with the community. The clinicians have experienced significant practice transformation with inter-professionalism and cultural intelligence features emerging in their practice. Further research is underway to look at the conditions required for this practice transformation to emerge.


Working currently with Bay of Plenty DHB in NZ, Emma is an allied health clinician and health sciences doctoral student with experience in a range of health system contexts within clinical specialist, operational and programme roles. Her current role involves leadership within the integrated health strategic area, overseeing the implementation of initiatives that drive integration at a clinical and service level. These include community care coordination, enablement services and health care homes. Emma’s current research examines why and how DHB (secondary care) allied health practice boundaries should be challenged and the conditions required for new ways of working to emerge.

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