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[null," Te Manawa Taki Immunisation Work Plan 2023-2024\n\nPurpose\n1. To outline the action-orientated activities at local and regional levels across Te Manawa Taki to ensure Māori, Pacific, and Tāngata whaikaha can protect their hapu māmā, pepi and tamariki from Vaccine Preventable Diseases (VPDs). The  activities will also contribute to Te Manawa Taki: \n               a. achieving the National Immunisation Programme (NIP) priorities (outlined below);\n               b. reaching the target set by the Minister of Health of 90% uptake of childhood immunisations for each tier one ethnicities at 24-months by 30 June 2024;\n               c. support delivery through the 2023 winter period and scaling up for winter 2024.\n2. To identify opportunities, efficiencies, and new ways of working within Te Manawa Taki that:\n               a. are sustainable into the future, in particular for Māori and Pacific providers;\n               b. demonstrate a commitment to Te Tiriti, achieving equity and the aims of Te Pae Tata;\n               c. listen and respond to whānau voice;\n               d. allow for collaboration across the region and utilise a regional approach where appropriate; \n               e. ensure all communities are adequately supported to protect their whānau from VPDs.\n3. To support monitoring of activities as well as progress towards regional and national indicators.\n\nCurrent context\nChildhood immunisation rates have continued to decline nationally since 2018, with the decline accelerating since the start of the COVID-19 pandemic in early 2020 (1). In addition, inequities have worsened with tamariki Māori and Pacific tamariki less likely to be fully vaccinated at any time point compared to European or Asian tamariki (2). With immunisation coverage below target, our tamariki are at risk of lethal and costly, vaccine-preventable and epidemic disease, and the health system in Aotearoa at risk of significant burden (1). As a result, equitably improving immunisation rates is a joint priority for both Te Whatu Ora and Te Aka Whai Ora Boards. \n\nOf the four Te Whatu Ora regions, Te Manawa Taki has the lowest percentage of fully immunised tamariki at all milestone ages up to, and including, 5 years; exposing our pēpi and children to significant risk (2,3).  Current childhood immunisation rates in Te Manawa Taki at 24 months are 76.2% (Māori 62.1%, Pacific 73.8%, European 82.0%, Asian 93.4%, and Other 85.1%) (3). Of the four regions, Te Manawa Taki also has the largest equity gap at this milestone, with a 21.8% difference in immunisation coverage at 24 months between tamariki Māori and non-Maōri tamariki (all figures as of 31 March 2023) (3). To fulfil obligations under Article 3 of Te Tiriti o Waitangi, which explicitly states equity of outcomes for Māori, and the Crown’s obligation for active protection, the priority for Te Manawa Taki’s Immunisation Action Plan is to eliminate such inequities. \n\nAt present, the majority of childhood immunisations are delivered through primary care. In addition, districts have a National Immunisation Register (NIR) team, Immunisation Coordinator/s, a School Based Immunisation Programme (SBIP), and an Outreach Immunisation Service (OIS). The role of these teams is to support primary care and other providers to engage with and deliver immunisations to tamariki who are either unable to be reached by their General Practice or are not enrolled with a primary care provider. \n\nThe primary care-based model for delivering immunisations is not working for all communities. Research consistently shows common barriers to accessing immunisations through primary care include; practices not accepting new patients, inability to get a non-urgent appointment in a timely manner, typically only open during business hours, transport to and debt at the practice, additionally, not everyone is comfortable taking their children to a waiting room with people who are unwell (2). Stage One of the WAI 2575 Health Services and Outcomes Kaupapa Inquiry concluded that the primary care system is not funded or structured to provide equitable outcomes, and this is also true of the current immunisation system (1, 4). For some members of our community the current system is working well and they do not need additional resource to access supports, however this is not the case for Māori, Pacific and Tāngata whaikaha communities. \n\nThe COVID-19 pandemic created many issues, but there were also positive developments including newly created capacity and capability, an increase in iwi-led solutions, strategies that empowered immediate action when the opportunity presented itself, and a more explicit national focus on creating more accessible services for under-served populations. In 2022, the Pae Ora (Healthy Futures) Act legislated the transformation of the Aotearoa health system to better honour Te Tiriti o Waitangi, specifically the responsibilities under Article 2 to uphold Tino Rangatiratanga and support Māori-leadership and Article 3 regarding the responsibility of the Crown to deliver equitable health outcomes. Now with the pandemic in a less acute phase, and the health reforms underway, there is an opportunity to not only take stock but also look at how we deliver services in order to achieve Pae Ora.\n\nThe National Immunisation Taskforce Report (December 2022) outlined initial priorities for the National Immunisation Programme in Aotearoa, including achieving rapid catch up of under-vaccinated tamariki Māori and Pacific; embedding an immunisation programme that achieves on-time vaccination of the whole population to target levels of 95% fully vaccinated; and prioritising the following groups: tamariki Māori, Pacific tamariki, tamariki with disabilities, and hapū māmā (pregnant mothers) (1). The Report also advises on actions to be taken locally, regionally, and nationally to achieve key targets for the Aotearoa childhood vaccination schedule, seasonal influenza, and COVID-19 vaccination programmes.  The National Immunisation Taskforce is working on an implementation plan for the 54 Report recommendations, under the following ten key priority areas:\n1.\tExpansion of the vaccinator workforce\n2.\tAuthorisation of childhood vaccinators\n3.\tAntenatal immunisations \n4.\tEnrolment into health services from birth\n5.\tProactive outreach immunisation services \n6.\tCatch-up immunisations \n7.\tFunding for providers that is long-term and sustainable\n8.\tGovernance, technical advice, and service coverage oversight\n9.\tDevelopment of new provider and consumer-facing resources for immunisations\n10.\tQuality and standards for providers delivering immunisations to tamariki in New Zealand\n\nAt a regional level, this joint Plan between Te Whatu Ora and Te Aka Whai Ora, outlines activities districts already have underway and plan to continue, or those they intend to start within the 23/24 financial year. These activities aim to provide some immediate resource and support across the region to lift immunisation rates among Māori, Pacific, and Tāngata whaikaha pepi, tamariki, and hapu māmā (using the Prioritisation Matrix (1)), and take steps towards changes that will be needed over time. In the longer term, there is a need for sustainable systemic transformation to support Māori, Pacific, and Tāngata whaikaha peoples to protect members of their whānau from VPDs. This will include strengthening the understanding of the protective benefits of immunisation, improving access pathways, and ensuring sustainable Māori and Pacific services providing responsive immunisation supports across Te Manawa Taki.\n\nThe Plan is split into regional and local activities and includes a dashboard for monitoring progress, space for risks and issues to be identified and a timeline Gantt chart to ensure activity is spread across the year. This Plan will be reviewed on a quarterly basis to make sure it continues to align with locality, Iwi Māori Partnership Board, and national & regional priorities, and will be updated as District Operational Groups and priorities are identified and evolve.\n\nReferences\n1.\tTe Whatu Ora - Health New Zealand. Initial Priorities for the National Immunisation Programme in Aotearoa 2022 [cited 5 May 2023. Available from: https://www.tewhatuora.govt.nz/publications/initial-priorities-for-the-national-immunisation-programme-in-aotearoa/.\n2.\tChildhood Immunisation dashboard [Internet]. NPHS Intelligence - Reporting & Analytics, Manatu Hauora - Ministry of Health. 2023 [cited 20 May 2023]. Available from: https://mohgovtnz.sharepoint.com/sites/CVIPDataAnalytics/SitePages/Children-immunisation.aspx?xsdata=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%3D&sdata=QzA2Z1B1citaRjY0ZW1Nc3lib3libTRzU1JKaVpidnBJTUJGblkzWEpZcz0%3D&ovuser=23cec724-6d20-4bd1-9fe9-dc4447edd1fa%2CKaitlin.Greenway%40health.govt.nz&OR=Teams-HL&CT=1683859275773&clickparams=eyJBcHBOYW1lIjoiVGVhbXMtRGVza3RvcCIsIkFwcFZlcnNpb24iOiIyNy8yMzA0MDIwMjcwNSIsIkhhc0ZlZGVyYXRlZFVzZXIiOnRydWV9.\n3.\tTe Whatu Ora - Health New Zealand. Quarterly childhood immunisation coverage by milestone age and deprivation, Q3 22-23 (1 Jan-31 Mar 2023) 2023 [updated 4 April 2023. Available from: https://www.health.govt.nz/our-work/preventative-health-wellness/immunisation/immunisation-coverage/national-and-regional-immunisation-data\n4.\tWai 2575 Waitangi Tribunal. HAUORA - Report on Stage One of the Health Services and Outcomes Kaupapa Inquiry. Waitangi Tribunal; 2023."]

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[null,"Monitoring Dashboard"]
[null,"When the indicators have been agreed to, this tab will be used as a monitoring dashboard to track the status of individual activities against progress towards indicators using a RAG rating."]
[null,"Each of the indicators will have one or more activities that are are related to them (either directly or indirectly)."]
[null,"If progress towards an indicator is in RED but the related activities are GREEN then this would prompt a relook at the activities to see why they aren't resulting in progress towards indicators."]
[null,"Ideally, this dashboard would update automatically from the Activities spreadsheet so that teams would only need to update one page."]

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["How priority groups will be prioritised","Activity","Summary/description","Activity status and commentary","Timeframe","Responsible","Alignment to Immunisation Taskforce Report Key Priority Areas","Indicators ","Within existing resources or extra funding required?"]
[]
["NPHS Led Activities",null,null,null,null,null,null,null,null,null,"KEY","On track"]
["Enabling Lead Maternity Carers",null,null,null,null,null,null,null,null,null,null,"Minor issue / Delayed"]
["Priority given to Māori and Pacific Midwives or those working closely with wahine māori/pacific. ","Funding to support LMC's (and others) to attend local operational groups.","LMC's participating in local immunisation operational groups receive a 'koha' for their time. \nConsider extending this model to others who currently serve priority groups that are not funded by health (e.g. disability providers, iwi/hapū representatives, Māori Womens Welfare league, etc).","Not started","Q3",null,null,null,"Underspend to support progressing this recommendation. Estimate $50 per hour of meeting time. ",null,null,"Significant issues / offtrack"]
["Same as above","Support LMC access to cold chain, either there own or partnered with other provider. ","Undertake engagement with midwifery services across Te Manawa Taki. Offer either funding to cover set up costs for midwives that work in a collective, or partner midwives with specific pharmacies/providers. ","Not started","Q3",null,null,null,"Estimate up to $20K per midwifery service set up costs (including support for training). ",null,null,"Not started"]
["Utilising Health Promotion Workforce"]
[null,"Education packages are provided to LMCs to ensure they feel comfortable and confident delivering and discussing immunisations with whānau","Working with IMAC, explore whether education packages could be supported by NPHS Staff. \nHauora a Toi have potentially already created something similar. Regional Comm's resource to ensure its fit for purpose and support implementation.  ","Not started","Q3",null,null,null,"Communications contractor to support. "]
[null,"NPHS community and whānau wellbeing teams support LMCs, WCTO providers, Hauora Māori partners, Pacific providers, SBIP, and hapū wānanga and antenatal classes with immunisation health promotion and education.","This to include the incorporation of 'immunisation information' into existing Health Promotion programmes. Utilising NPHS teams to develop relationships with Early Childhood. ","Not started","Q3 and Q4"]
[null,"Midwives are supported by NPHS staff to deliver immunisation education during hapū wānanga and antenatal classes","Working with IMAC, explore whether education packages could be supported by NPHS Staff. Working with IMAC, explore whether education packages could be supported by NPHS Staff. \nHauora a Toi have potentially already created something similar. Regional Comm's resource to ensure its fit for purpose and support implementation.","Not started",null,null,null,null,"Communications contractor to support. "]
["Utilising Communications Support"]
[null,"Establish a regional communications resource that can work closely with wider to Te Whatu Ora communications teams as well as support local partners and providers to adapt national messaging. Feedback would also be provided to the national team about what communications would be useful for local communities.","Communications contractor at Hauora a Toi currently offering 15hrs per week to support regionally.  ","Underway - limited hours currently but all local leads have provided input into priorities moving forward. ","Ongoing",null,null,null,"Additional contracted resource. \nPromotion Directorate has funding to support providers (awaiting details). This resource would support that. "]
[null,"Develop a regional communications strategy that ensures all communities across Te Manawa Taki are empowered with information about how to protect their whānau from VPDs.","Communications contractor at Hauora a Toi currently offering 15hrs per week to support regionally.  ","Underway - limited hours currently but all local leads have provided input into priorities moving forward. ","Q2-Q3",null,null,null,"Additional contracted resource. "]
[null,"20-week scan is an opportunity to encourage antenatal immunisations and direct hapū māmā to an immunisation provider, e.g. local pharmacy","To be included in a regional communications strategy. All ultrasound providers to have information regarding antenatal immunisations and can direct hapū māmā to a convenient providers. ","Not started","Q3",null,null,null,"\n"]
["Other recommendations"]
[null,"Improve newborn enrolment processes","Suggest NPHS and HSS work together (with support from Commissioning for the PHO relationship) to streamline the enrolment process. \nWhaihua newborn enrolment system potentially improving these processes. Would need to review again once it goes live. ","Not started","Q3",null,null,null,"Resource to review and improve? Local leads?"]
[null,"All partners and providers have access to immunisation data and can status check in real time","Nationally - AIR/Whaihua, GIS Mapping and National Childhood Immunisation Dashboard. \nRegionally, utilising underspend to support providers that need to upgrade computer equipment, cell phones and/or software. Software would be initial license only (would not include ongoing subscription fees). ","Scoping spend to support in Q2, implementation in Q3 and Q4"]
[null,"Immunisation coordinators and NIR teams begin working collectively across the region to share best practice and innovation.","Q2 - Discuss with IMAC regional manager and develop distibution list of teams. \nQ3 - Bring teams together to discuss how regional ways of working could work. \nQ4 - Implement ideas","Underway and ontrack"]
[null,"Co-design actions with tāngata whaikaha to deliver equitable immunisation outcomes and experiences for disabled people and their dependents","Q2 - Working group established. \nQ3 - Engagement activities and incoporation ","Underway and ontrack"]
["School Based Immunisation Programmes"]
[null,"Update processes to enable catch up immunisations as part of the SBIP.","Activities pending national review being finalised. ","Not started"]
[null,"Consent process is digitalised, straightforward and easy for whānau","Activities pending national review being finalised. ","Not started"]
[null,"Immunisation data is up to date and staff can status check in real time. This would require technology so that PHNs have access to the AIR while at schools. E.g. laptops and internet.","Activities pending national review being finalised. ","Not started"]
[null,"Increased number of kaimahi Māori and Pacific kaimahi are involved in both education and delivery","Activities pending national review being finalised. ","Not started"]
[null,"Work with the Ministry of Education to support relationships between the SBIP and local schools and ensure a clear understanding of VPD risk (e.g. to support during a measles outbreak)","Activities pending national review being finalised. ","Not started"]
["Leadership and Coordination"]
[null,"Where possible, leadership, accountability, and coordination structures/roles are made permanent (e.g. regional and local immunisation leads), and sit within the same business unit of Te Whatu Ora. ","Local Lead role outline in development. Regional Directors to progress. ",null,"Q3"]
[null,"Local operational groups are established, co-chaired by the local immunisation lead and a representative elected by local Hauora Māori partners.","Immediate urgent need to establish in Hauora a Toi and Lakes. May need review and changes to ways of working in other areas. ","In areas where these don’t exist it difficult to progress with the urgency needed. ","Q2 - Q3","NPHS with Te Aka Whai Ora"]
[null,"Regional immunisation group (currently the Immunisation Collaborative) membership is reviewed.","Given evolving change processes, membership and function of the Regional Immunisation Group will be reviewed each quarter. ",null,"Ongoing"]
[null,"There are clear communication channels within and between Te Aka Whai Ora and Te Whatu Ora that ensures local relationships are appropriately maintained. ","Local leads will continue to work closesly with Hauora Māori Relationship Leads to ensure Hauora Māori Partners are well supported. ",null,"Ongoing"]
[null,"The process for clinical sign-off of authorised vaccinators is reviewed, including whether this needs to be an immunisation coordinator","Have established that 'assessors' are signed of by Medical Officers of Health. Pending determination of what's being progressed nationally - consider supporting training of experienced authroised vaccinators who would like to become assessors (especially those within Hauora Māori Partners and Pacific providers). ",null,null,null,null,null,"Assessor Course via Te Pūkenga:\nhttps://earnlearn-tepukenga.ac.nz/assessment/4098-assessor-training/ "]
[null,"Review the title ‘Immunisation Coordinator’ and propose a new name that better reflects the current function of technical expertise and support","Not an urgent action. Could look to progress once team is working regionally. Query IMAC involvement?",null,"Q4"]
[null,"Regional reporting systems established for immunisation priorities and governance.","Monthly reporting from local leads established to align with updates to the RIT. Clear processes for escalation of risks and issues. ",null,"Q3"]
["Indicators will be specific to priority groups.","Establish data and reporting against indicators for Te Manawa Taki","Indicators are agreed, dashboard for monitoring is still in development. ","In progress - on track but risks/issues","Quarter 1","Te Manawa Taki Immunisation Collaborative","Governance technical advice and service coverage oversight"]
[null,"Pathways developed to collect qualitative information on whānau voice and experience of the immunisation system to support continuous improvement, including experiences of tāngata whaikaha and access barriers/enablers.","Working with Commissioning and Te Aka Whai Ora to incorporate into provider reporting. ",null,null,null,null,null,"Providers that utilise events funding asked to capture and provide?"]
["HSS Led Activities"]
[null,"When Te Whatu Ora is acting as the lead maternity carer there are robust processes in place to ensure antenatal vaccinations are offered","Q2 - HSS Maternity Team Leads are identified\nQ3 - Established best practice processes and implementation has begun\nQ4 - Action completed","Underway - HSS Leads being identified","Q2-Q4"]
[null,"All outpatient antenatal clinics include education and delivery of antenatal immunisations. \nAlso recommend having processes in place to offer opportunistic immunisations to all attending HSS services, including outpatients, ED, and inpatients.","HSS Leads being identified","Underway - HSS Leads being identified","Q2-Q4"]
[null,"Increase vaccination rate amongst Te Whatu Ora employed clinical staff","Potential for national support being followed up. ","Not Started"]
[null,"Enforce robust anti-racism systems including compulsory Te Tiriti training for all staff and racism reporting mechanism – wider system and deliberate action. Starting with staff regularly delivering immunisations.","Potential for national support being followed up. ","Not Started"]
["Commissioning Led Activities"]
[null,"Primary Care - Develop a regional approach to resolving practice debt as an access barrier for priority populations.","Regional PHO collective Hui to agree action plan for implementation.","Not Started","Q 3/4","Living Well Team"]
[null,"Primary Care - Develop an environment that is culturally safe and encouraging of immunisations. ","Examples include developing robust anti-racism systems, cultural safety training, education about the importance of immunisations, and training around what is and isn’t required for childhood immunisations to be delivered (e.g. not required to be enrolled with the practice, outstanding debt shouldn’t stop immunisation delivery).\n\nRegional PHO collective Hui to agree action plan for implementation","Not Started","Q 3/4","Living Well Team"]
[null,"Realign contracts to planned and opportunistic services and ensure contracts include coordination, promotion and relationship building, and an expectation of service provision outside of business hours.","Regional Commissioning Integration team will ensure current and new agreements maximise the opportunity for vaccination in community settings and review key indicators to monitor resource utilisation for future investment planning.  \n\nTo be started in partnership with the regional collaborative team monthly","Not Started","Q 3/Q 4","Starting Well ",null,"Resource indicators","Within exisiting resource for monitoring"]
[null,"Shift OIS service delivery to Hauora Māori partners and Pacific providers, supported by contracts that are long-term, sustainable and holistic (ideally 3-5 years with right of renewal). Contracts should also allow for outbreak response.","See notes and thoughts in project report - this to be done in partnership with Te Aka Whai Ora. \nEstablish regional approach and  framework of agreements for monitoring.","Not Started","Q 4","Staring Well and Te Aka Whai Ora"]
[null,"Create a process to bring online more opportunistic vaccination services and maintain a relationship with opportunistic service providers.","See notes and thoughts in project report - this to be done in partnership with Te Aka Whai Ora. Also potential for NPHS to support. Complete stocktake of current agreements for review at the regional and local levels. ","Not Started","Q 3",null,null,null,"Funding to support start up costs for new providers. Up to $20k per provider. \nFunding to support additional hauora events for existing providers. Up to $1,500 per event. \nPotential for Pharmacy, Midwifery and WCTO/Plunket Engagement Leads to support onboarding. "]
[null,"Work alongside health partners to redesign models of care and service delivery for `Kahu Taurima` implementation across the region:","Align opportunistic childhood immunisation with Kahu Taurima service delivery at 6 weeks. \nEnsure service descriptions prioritise antenatal (Hapu Mama) and post natal (6 weeks) immunisation.","Not Started","Q 4","Starting Well "]
[null,"Contracts specify the need for collaboration and coordination between community providers and partners.","Review current agreements, for local co-ordination and regional monitoring.\nCo-ordinate with regional collaboration team members alignment of contracts to contributory measures that improve rates of coverage by 8 months.","Not Started","Q 3","Starting Well "]
["Te Aka Whai Ora and Pacific Health Led Activities"]
[null,"Professional development pathways are in place for kaimahi Māori and Pacific kaimahi (for clinical and non-clinical staff, regulated and unregulated), including micro-credentialling for kaiāwhina to become VHWs."]
[null,"Hauora Māori partners and Pacific providers delivering immunisation services have access to Oranga governance and oversight.","Oranga or ‘wellness’ governance refers to governance that includes the wider determinants of health, not just clinical governance.",null,null,null,null,null,"Potential for contractor?"]
[null,"Hauora Māori partners and Pacific providers are supported with workforce pipeline planning for vaccinators and kaiāwhina.",null,null,null,null,null,null,"Training funds for Authorising Vaccinators, VHW's, Cold Chain Technicians and Immunisation support workers. This could be used to cover cost of courses, staff time and/or backfill cover if needed. "]
["Nationally Led Recommendations"]
[null,"Mixed model contracting approach with retainer and pay per dose, and funding to cover time LMCs spend attending training, education courses and operational groups","The NPHS Prevention Directorate are working with Kahu Taurima to develop a Pay Per Dose (PPD) funding arrangement and an onboarding package as the first step for both LMC’s and Plunket. Approximate timeframe – by June 2024."]
[null,"Improve timely notification of pregnancy and birth to primary care, Hauora Māori partners and Pacific providers","The NPHS Prevention Directorate are working with Manatū Hauora to establish a database of pregnant people with the aim of linking this to antenatal immunisation data. Timeframe – TBD."]
[null,"Funded third trimester GP visit for Māori, Pacific, and tāngata whaikaha (self-identified). The visit could be with a practice nurse and include a discussion about immunisations (antenatal and childhood), delivery of antenatal immunisation, whānau enrolment (if not already enrolled), and start the newborn enrolment process, with pre-call scheduled for 6-week immunisations.","Kahu Taurima are already exploring this option. Timeframe – TBD."]
[null,"Funded postnatal in person handover between LMC, WCTO, and general practice (for Māori, Pacific, and tāngata whaikaha), ideally in a wellness setting.","Kahu Taurima are already exploring this option and aligning it to system level measures. Timeframe – March 2024 for confirmation."]
[null,"Newborn enrolment processes","The NPHS Prevention Directorate are working on an enhanced newborn enrolment system that will link with HSS data to identify newborns and ideally also pick up pēpi who have fallen off b-code enrolments (i.e, did not become fully enrolled by 3-months). This will support with data but won’t change the enrolment process. Timeframe – TBD."]
[null,"Develop a coordinated system that contacts all whānau regarding immunisations via a range of communication methods, including information about where and how they can access an immunisation service. ","NPHS (National and Regional) and Data and Digital. Investigate the potential for a coordinated system for contacting whānau and scheduling all immunisations (not just those overdue)."]
[null,"Vaccinator training is delivered as part of a Kaupapa Māori immunisation education package, with Kaupapa Māori educators.","NPHS Prevention Directorate already progressing this with Te Aka Whai Ora. \nAn EOI process is underway to broaden access to training, to ensure a more equitable training service is being provided, including Kaupapa Māori education packages. The intention is that it is in place from 1 March 2024. Ideally training offered in a range of ways - virtually and in person."]
[null,"Kaupapa Māori Nurse Educator positions are established and recruited to, to support the vaccinator workforce across Te Manawa Taki","This is built into the EOI process outlined above"]
[null,"Data Sharing Agreements completed for all Hauora Māori partners and Pacific providers","Being progressed through National Prevention Directorate, however Regional Lead to ensure understanding for the region in terms of increasing the number of providers, and ability to utilise data. ",null,null,null,null,null,"Potential for contractor to support, in terms of data usability?"]
[null,"Access to the National Childhood Immunisation Dashboard given to all Hauora Māori partners and Pacific providers to provide an overview of immunisation coverage within their local area by SA2 level","Being progressed through National Prevention Directorate, however Regional Lead to ensure understanding for the region.",null,null,null,null,null,"Potential for funding for providers re software required to access? E.g. PowerBI license?"]
[null,"Successful rollout of AIR and Whaihua with priority to Hauora Māori partners and Pacific providers (this includes the ability to status check in real time)","Being progressed through National Prevention Directorate, however Regional Lead to ensure understanding for the region.",null,null,null,null,null,"As above - funding to support IT upgrades that would allow all functionality of AIR/Whaihua to be accessed in real time. "]
[]
["See Summary/description.","Develop a strategy  to ensure equitable immunisation supports and protection for our Tāngata whaikaha whānau ","Related to Reimagining the Future State Immunisation Project.\n\nAn SRO and operational lead from each local area, and members of Te Manawa Taki Immunisation Collaborative to attend the 2-hour Disability Capability workshop (facilitated by Rachel Noble and Leo Goldie-Anderson) by 31 August 2023. This will provide a baseline understanding of the importance of reframing disability in our work.\nFollowing the workshop, Rachel and Leo will support immunisation teams to develop a strategy (including specific activities to be included in this Plan, and appropriate indicators), to ensure equitable immunisation supports and protection for our Tāngata whaikaha whānau.","In progress - on track","Quarter 1","Te Manawa Taki Immunisation Collaborative","Quality and standards for providers delivering immunisations to tamariki in New Zealand",null,"Workshop is free. Once a strategy is developed, need to determine any extra resourcing required to implement."]
["Not specific to any priority group (aside from Pacific RSE workers) but at risk of outbreak given typically an under-vaccinated population living in close arrangements.","Develop an immunisation approach for RSE workers and refugees","Related to Reimagining the Future State Immunisation Project.\n\nThis will include linking in with the Pacific Island Community Trust (BOP) who are already providing immunisations within the RSE space, and equivalents in other local areas.","Not started","Quarter 3 ","Te Manawa Taki Immunisation Collaborative",null,null,"TBD."]
["Enabler to reach priority groups.","Development of future years action plan","Use the information from the above activities to review and develop future years action plan with a focus on improving whānau immunisation outcomes for Māori, Pacific and Tangata whaikaha. \nPlan should be co-designed with partners from priority populations and include opportunities for system design changes.","Not started","Quarter 3 ","Te Manawa Taki Immunisation Collaborative","Quality and standards for providers delivering immunisations to tamariki in New Zealand",null,"Within existing resources."]
[]
["Enabler to reach priority groups.","Provide regional support for local education and awareness-raising campaigns (regional comms resource). ","Linked with Reimagining the Future State Immunisation Project. \n\nIdentify a regional team (including potential communications lead/resource) that can provide support for local campaigns designed with (and for) Māori, Pacific, and Tāngata whaikaha to protect whānau from vaccine preventable diseases. \nThis could be providing national/regional material for local teams to use and adapt, and technical expertise to assist with webinars/collateral, etc. ","Not started","July - December 2023","Te Manawa Taki Immunisation Collaborative","Development of new provider and consumer-facing resources for immunisations",null,"TBD."]
["See Summary/description.","Develop a regional awareness campaign for Boostrix and Flu available in pharmacies ","Co-designed with Māori, Pacific and Tāngata whaikaha whānau with a focus on antenatal immunisations.\n\nNote: NIP have developed and run a range of socials tiles and digital media in this space at a national level and shared examples of the material. Plan to connect with the NIP around how we could pair the national and local pieces.","Not started","Quarter 3","Regional communications support team identified in the activity above.","Development of new provider and consumer-facing resources for immunisations",null,"Need to check with the NIP what resourcing is available/planned to support nationally."]
["Prioritise laboratories and USS providers in areas of high deprivation and/or high proportion of Māori or Pacific.","Provide information on antenatal immunisations to all hapū māmā attending laboratories and USS providers.","Antenatal immunisation communications and collateral will be a key part of the communications initiatives through the Taskforce work. Plan to connect with the national team around what resources would be advantageous locally. And then with support from local teams, distribute resources to laboratories and USS clinics. \n\nAim for 100% of laboratories and USS clinics contacted and supported to provide antenatal immunisation information to hapū māmā.\n\nAlso, the NIP will be looking to connect with a range of teams to progress Recommendation 17 ‘Provide information to hapū māmā about antenatal immunisation at every point of contact with the health system’. Plan to support with this work.","Not started","Quarter 2","Regional communications support team identified above.","Antenatal immunisations",null,"Need to check with the NIP what resourcing is available/planned to support nationally."]
["See Activity.","Support implementation of decisions from the NZ College of Midwives (NZCOM) to their members, to proactively support efforts to increase immunisation uptake by hapū māmā ","Support national work to deliver on Taskforce recommendations 15 and 16:\n15.\tConvene an expert working group to develop and implement a comprehensive antenatal immunisation system.\n16.  Ensure antenatal immunisations are included in the work of a future National Immunisation Technical Advisory Group (NITAG).","Not started","Quarter 4","Local immunisation leads","Quality and standards for providers delivering immunisations to tamariki in New Zealand",null,"Within existing resources."]
["See Activity.","Regionally work with PHO's to ensure General Practices will proactively increase immunisation uptake using the Prioritisation Matrix","This is linked with Reimagining the Future State Immunisation Project  and Determine a framework or approach to provider accountability for Te Manawa Taki. ",null,"July - December 2023","Te Manawa Taki Immunisation Collaborative","Quality and standards for providers delivering immunisations to tamariki in New Zealand",null,"Within existing resources."]
[]
["Enabler to reach priority groups.","Immunisation workforce strengthening    ","To identify expert RN’s to lead and strengthen the workforce in Immunisation disease state management and professional cultural supervision in a local Kaupapa Māori Educators role. Quarter 1 - planning, Quarter 2 - implementing.",null,"Quarter 1","Te Manawa Taki Immunisation Collaborative","Expansion of the vaccinator workforce",null,"TBD."]
["A focus on increasing the number and proportion of Māori and Pacific fully authorised vaccinators. See local activities - Increase the number of vaccinators authorised to deliver childhood immunisations (including within external providers)","Regionally coordinate vaccinator training to increase the number of authorised vaccinators","With a focus on increasing the number of Māori and Pacific fully authorised vaccinators - set up a working group with the immunisation coordinators, IMAC, representation from Māori and Pacific providers and PHO's to work on: \n- A regionally coordinated vaccination training program that standardises the approach to training and clinical sign off of fully authorised vaccinators across the region, and provides education packages that are more responsive/appropriate from a Te Ao Māori perspective.  \n- Regional support for Vaccinating Health Workers to complete Stage 2 and maintain skills.\n- Having more accessible training days held in our region.\n\nNote: Plan to connect nationally with Christine Nolan (NIP) who is leading the Workforce Taskforce work with IMAC around this.","Not started","July - December 2023","Te Manawa Taki Immunisation Collaborative","Expansion of the vaccinator workforce",null,"TBD."]
["Prioritising Māori, Pacific, hapū māmā, and disability providers and events.","Coordinate regional authorised vaccinator support for local immunisation events","Using the additional vaccinator resource created above, coordinate available authorised vaccinators across the region to support local immunisation events:\n- Deploy to areas of need for both organised and short-notice events led by Māori, Pacific or Tāngata whaikaha.\n- Support local teams to stand up vaccination events in response to outbreaks.\nNote: This may require having the same reporting line for all authorised vaccinators (including Public Health Nurses (PHN’s)) in order to flex and deploy to areas of need, which is related to Reimagining the Future State Immunisation Project.","Not started","Quarter 3","Te Manawa Taki Immunisation Collaborative","Proactive outreach immunisation services, Catch-up immunisations",null,"TBD."]
["See Summary/description.","Create a heat map to show the pharmacies providing antenatal immunisations by area","Although focusing on antenatal immunisations, the heat map will show all pharmacies, those that are providing immunisations, and a breakdown of what immunisations are being offered.\n\nThis data would then be used by local teams to identify areas with reduced access to antenatal immunisations and prioritise increasing access in areas of high deprivation and/or high proportion of Māori or Pacific. This could be done by either supporting pharmacies to vaccinate, offering outreach services or alternative approaches to increase access in those areas.\n\nNote: Creating a heat map is relatively straightforward and Hauora a Toi Bay of Plenty team can do this for the region.","In progress - on track","Quarter 1","Hauora a Toi Bay of Plenty Immunisation directorate","Antenatal immunisations",null,"Within existing resources"]

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["Priority group/s",null,"How priority groups will be prioritised","Regional or local activity?","Activity","Summary/description","Activity status","Activity status commentary","Timeframe","Responsible","Setting / Provider / Community partner","What could be supported or coordinated regionally and/or nationally?","Links with other Local Plans","Alignment to Immunisation Taskforce Report Key Priority Areas","Indicators ","Within existing resources or extra funding required?"]
["Priority group/s","Other - explain"]
[null,"Understanding the landscape"]
[null,null,"Enabler to reach priority groups.","Waikato","Review/develop relevant local level operational groups","Currently convening all Kaupapa providers weekly, Waikato Immunisation Network fortnightly (WIN - all providers across the region), and clusters meeting weekly. Approach will be reviewed to ensure fit for purpose.  ","In progress - on track","Regular review of groups occurs at the Waikato Immunisation Network hui.  This group has moved from monthly to fortnightly.  This is also an open forum for all providers involved in immunuisations.  A presence from the pharmacy sector is currently being addressed.   The 7 local provider clusters endeavor to also now meet fortnightly in the inbetween week. As much as possible the local leadership and convening of the clusters is supported and encouraged.  An additional forum focussed on NewBorn Enrolments now convenes forthnightly has also been established - this includes Newborn enrolment service and PHOs.","Quarter 2","SRO Immunisation","Waikato Immunisation Network (WIN) geographic cluster groups: Kaupapa Māori and Pasifika Providers, PHO OIS teams, HHS OIS and PHN teams, WHIRI Hapori team.",null,null,"Governance technical advice and service coverage oversight",null,"Within funding allocated for 23/24."]
[null,null,"Enabler to reach priority groups.","BOP","Review/develop relevant local level operational groups","Review the whole operational model of engagement for Bay of Plenty, as well as the structure of meetings. Previously had various levels of governance and operational meetings along with changes to the management structure of key stakeholders. We have approached key stakeholders regarding the structure of these meetings and will have this in place within the next couple of months.","In progress - on track","Feedback now recieved from key stakeholders. Plan is under development - to be reviewed.(6th Nov 2023-We continue to meet with providers individually but as yet have not progressed a whole of system Operational Group due to providers various progress in their respective Imm's plan.)","Quarter 1","Immunisation directorate","Community providers/key stakeholders",null,null,"Governance technical advice and service coverage oversight",null,"Within funding allocated for 23/24."]
[null,null,"Enabler to reach priority groups.","Lakes","Review/develop relevant local level operational groups","Lakes Increased Immunisation Uptake Action Group (LIIUAG)  group, which will be facilitated by Localities and Community Services Manager, Kathy Rex. \nThe intention is to identify current barriers to success, as well as new and innovative approaches that we can test in a fail fast, quality improvement type environment. An implementation plan will be developed on the back of the first workshop (30 March 2023) for broader consultation and approval. ",null,null,"Quarter 2","Karin Norman","Community providers",null,null,"Governance technical advice and service coverage oversight",null,"Within funding allocated for 23/24."]
[null,null,"Enabler to reach priority groups.","Taranaki","Review/develop relevant local level operational groups","Operational group already underway - a network or current providers, who meet fortnightly to discuss local activity, any changes to immunisation schedule, and prioritisation of activity.","In progress - on track but risks/issues","This group continues to meet fortnightly. New members have been invited to the group, pharmacy, midwifery.","Quarter 1","Immunisation Lead - Taranaki TBC","Community providers",null,null,"Governance technical advice and service coverage oversight",null,"Cross -organisation partnership, within existing resources of organisations for 23 /24."]
[null,null,"Enabler to reach priority groups.","Tairāwhiti","Review/develop relevant local level operational groups","Reset the Tairāwhiti Immunisation Steering Group (ISG). Bringing together all the partners/stakeholders to agree  immunisation approaches for Tairāwhiti. ","Not started",null,"Quarter 2","Commissioning","Community providers",null,null,"Governance technical advice and service coverage oversight",null,"Not necessarily extra funding but needs an agreed lead to do this work."]
["Māori tamariki, Pacific tamariki, Hapū māmā, Deprivation quintile 5",null,"Moving the service closer to priority communities by prioritising providers who have continued and established relationships with high needs populations.","Tairāwhiti","Reset, co-design and agree immunisation approaches across Tairāwhiti ","\nIn  partnership with Hauora Māori providers (this includes WCTO providers), primary care and community stakeholders.\n\n","In progress - not on track",null,"Quarter 2","Commissioning","Hauora Māori providers, primary care and community stakeholders",null,null,"Proactive outreach immunisation services, Catch-up immunisations",null,"Not necessarily extra funding but needs an agreed lead to do this work. Actions that come out of this will be covered by the Te Aka Whai Ora funding that has been ring-fenced for providers."]
["Māori tamariki, Pacific tamariki",null,"Prioritising tamariki Māori, tamariki Pasifika and non-engaged/non-enrolled whānau.","Tairāwhiti","Co-design agreed approaches to how we address whānau not engaged with immunisations or overdue","Establish with our community partners:\n- Who is engaged and holds relationships with these whānau?\n- What are the appropriate methods to engage?\n- What resourcing is needed? Including workforce capability.","Not started",null,"Quarter 2","Commissioning","Primary care, Hauora Māori partners, NGO's",null,null,"Catch-up immunisations, Proactive outreach immunisation services",null,"Not necessarily extra funding but needs an agreed lead to do this work. Actions that come out of this will be covered by the Te Aka Whai Ora funding that has been ring-fenced for providers."]
["Hapū māmā",null,"See Summary/description.","Tairāwhiti","Develop an agreed approach to hapū māmā vaccination ","Organise all stakeholders (including community midwives, hospital-based maternity services, pharmacies, general practices, Hauora Māori providers) to come together to discuss an agreed approach to hapū māmā vaccination.","Not started",null,"Quarter 4","Collective (HSS and community providers)","See Summary/description",null,null,"Antenatal immunisations",null,"Can continue within existing resources but extra resources may be required depending on agreed outcomes."]
[]
[null,"Improving awareness of the benefits of immunisation"]
["Māori tamariki, Pacific tamariki",null,"A prioritisation tool is used to identify higher risk tamariki for the service to contact first, using the Prioritisation Matrix combined with other variables such as hospital admissions, deprivation, whether they have received the flu vaccine, etc.","Waikato","Comprehensive Campaigns for Priority Populations","Data extraction at NHI level of priority populations for campaigns including Flyer drops, community engagement, SMS Text, Chipper Email and Calling",null,"Completed campaigns include:\n* 0-2 ys Maaori & Pacific Unenrolled and Unvaccinated.  As second round of this campaign is currently underway. \n* MMR 1 Unenrolled Maaori & Pacific unenrolled born born 2004 \nThe campaign is delivered locally via the hubs and link to local imms services. ","Quarter 2","SRO Immunisations","Waikato Immunisation Network i.e. Kaupapa Providers, PHO OIS teams, HHS OIS and PHN teams, WHIRI Hapori team.","Regional - Potential to be used more broadly across the region. See activities for review under As an urgent action, bring together key leads from each local area",null,"Catch-up immunisations",null,"Within funding allocated for 23/24."]
[null,"Enhanced Outreach and Opportunistic Immunisation"]
["Māori tamariki, Pacific tamariki",null,"Prioritising Māori and Pasifika providers to deliver childhood immunisations. Expanding to include more regular opportunities for whānau in transitional/emergency housing, supported by family start services and MSD – specific childhood vaccination events. Prioritisation matrix implemented as part of the geographical approach to identifying priority children.","Waikato","Partner / collaborate with Iwi Hauora and Pasifika providers to deliver Outreach Immunisations (including contracted OIS and opportunistic immunisation services)","Continue supporting Māori Pasifika and OIS providers to deliver childhood immunisations\n\nThrough OISs schedule regular outreach to whānau in transitional/emergency housing. \n\nMaking connections with MSD Family Start services, who support whanau who are struggling with challenges or problems that may make it harder for them to care for their baby/child, to identify under immunised children within their programme and in partnership with a local immunisation provider engage whanau in immunisation discussion and immunisation in the home.\n\nGeographical approach to identify under immunised priority children and contact the family to arrange support to immunisation services or immunisation in the home.","In progress - on track","Providers continue to be supported to deliver immunsations.  In particular training is provided to nurses who didnt yet feel confident in the outreach process, safety advice given for best way to approach clinical settings in culturally appropriate ways in whaanau homes, standing orders facilitated in order to operationalised immunisation resources.  Family Start services and Wellchild/Tamariki ora services are now connected with local clusters.","Ongoing activity","SRO Immunisations","Waikato Immunisation Network (WIN) geographic cluster groups: Kaupapa Māori and Pasifika Providers, PHO OIS teams, HHS OIS and PHN teams, WHIRI Hapori team.","Regional - Consider whether other local areas could implement some (or all) of Waikato's approach. See regional activity As an urgent action, bring together key leads from each local area,",null,"Proactive outreach immunisation services, Catch-up immunisations",null,"Within funding allocated for 23/24."]
["Māori tamariki, Pacific tamariki, Deprivation quintile 5",null,"Prioritising Māori and Pasifika providers to deliver childhood immunisations. Potential to expand to include regular outreach to whānau in transitional/emergency housing.","BOP","Partner / collaborate with Iwi Hauora and Pasifika providers to deliver Outreach Immunisations (including contracted OIS and opportunistic immunisation services)","Continue current partnerships and collaboration with Iwi Hauora and Pasifika providers for OIS in areas of high need and opportunistic immunisation services – e.g. specific childhood vaccination events.\nMeet with Iwi Hauora providers to discuss the possibility of a split model to avoid a mismatch between referrals and their capacity (which has been an issue in the past).","In progress - on track","Hui ongoing with all key Hauora Maori Partners and Pasifik providers. Acknowledging some providers now have Kahu Taurima contracts.(6th of Nov 2023- This is ongoing)","Quarter 2","OIS vaccinators and admin","Hauora Māori and Pacific providers",null,null,"Proactive outreach immunisation services, Catch-up immunisations",null,"Within funding allocated for 23/24."]
["Māori tamariki, Pacific tamariki, Deprivation quintile 5",null,"Prioritising Māori and Pasifika providers to deliver childhood immunisations. ","Lakes","Partner / collaborate with Iwi Hauora and Pasifika providers to deliver Outreach Immunisations (including contracted OIS and opportunistic immunisation services)","Meet with IMPBs to work with Marae leaders and hapū delegates to provide a whanau-centred immunisation response (all immunisations).    \nContinue to have an RN who sits in the housing hub to identify unenrolled children in transitional/emergency housing. Continue to support Rotorua Pacific Island Development Charitable Trust to deliver immunisations as per their Annual Plan. ",null,null,"Ongoing activity","Lakes Increased Immunisation Uptake Action Group (LIIUAG). ","IMPB's, Marae leaders\nHousing Hub",null,null,"Proactive outreach immunisation services, Catch-up immunisations",null," Future funding required for additional vaccinators and coordinators to expand OIS services to reach 90%"]
["Māori tamariki",null,"Prioritising Māori providers to deliver childhood immunisations.","Taranaki","Partner / collaborate with Iwi Hauora and Pasifika providers to deliver Outreach Immunisations (including contracted OIS and opportunistic immunisation services)","Support Hauora Māori providers to lead and run pop-up immunisation clinics (either weekday or weekend).","In progress - on track","These are continuing with support from Te Whatu Ora Taranaki and PHO","Ongoing activity","Immunisation Lead - Taranaki ","\nHauora Māori providers Tui Ora, Ngāti Ruanui, and Ngaruahine.",null,null,"Proactive outreach immunisation services, Catch-up immunisations",null,"Collaborative approach between organisations, within funding and capacity for 23/24."]
["Māori tamariki, Pacific tamariki, Hapū māmā, Deprivation quintile 5",null,"Moving the service closer to priority communities by prioritising providers who have continued and established relationships with high needs populations.","Tairāwhiti","Partner / collaborate with Iwi Hauora and Pasifika providers to deliver Outreach Immunisations (including contracted OIS and opportunistic immunisation services)","Move OIS to sit within Hauora Māori providers, including moving appropriate resource to support this.\nThese Hauora Māori providers have validated approaches in meaningful and successful outcomes with whānau.","Not started",null,"Quarter 2","Commissioning","Hauora Māori providers",null,null,"Proactive outreach immunisation services, Catch-up immunisations, Funding for providers that is long-term and sustainable",null,"Moving System Level Agreement funding out of HSS into Māori providers. However, may require further sustainable funding for 1 full RN FTE per Māori provider (Ngati Porou Oranga and Turanga Health) when this move happens."]
["Māori tamariki, Pacific tamariki","Under immunised children ethnicity under immunised children and pregnant women. ","Significant majority of children attending WaiKids clinic and ED are Māori / Pacific or live in deprivation quintile 5 areas. ","Waikato","Strengthen planned and opportunistic hospital-based immunisations","Locations: Waikids Outpatient Ward. Meade clinical centre outpatient services, iHub: Whanau Hauora Assessment referrals.\n4 clinics per week to be expanded. Pre review of immunisation status of children attending clinic. Pre call to parents to let them know what immunisations their child has missed and the immunisation nurse will be in clinic. Follow up of children in the community who require additional immunisations to catch up to the schedule.\nRegular engagement with allied services to ensure ongoing delivery/referral pathway is socialised.","In progress - on track","Pilots in Waikato hospital ED and NICU completed.  Referrral to the Hospital OIS team for vaccination rather than a rostered presence in ED and NICU is now being implemented.  \nPrecalling pilot now being extended from Waikids Outpatient clinics to all outpatient clinics with tamariki attendance.  ","Quarter 2","SRO Immunisations","Waikids Service, Hospital Opportunistic Immunisations service, WHIRI Hapori Hapori Clinical Team ","\n",null,"Proactive outreach immunisation services, Catch-up immunisations",null,"Within funding allocated for 23/24."]
["Tamariki Māori, Pacific tamariki, Deprivation quintile 5, Hapū māmā","All those whanau requiring lifespan immunisations. Opportunistic delivery not only focuses on the Childhood Immunisation, it covers a lifespan approach.","Opportunistic immunisations to be supported by Immunisation Champions on all appropriate wards. All referrals to OIS to be prioritised  with reference to Prioritisation Matrix.","BOP","Strengthen planned and opportunistic hospital-based immunisations","Reinstate Immunisation Champions in different hospital departments to support opportunistic immunisations being delivered by ward staff. Locations: ED, Paediatric (in-patient and outpatient), General Outpatients. \n\nStrengthen planned immunisation clinics within the hospital. E.g. Gateway (Oranga Tamariki referrals), hapū māmā, etc.\n\nWill also engage with Newborn Hearing Screening and Local Nursing Team plus Bladder and Bowel Childhood Service to ensure they are aware of the referral process to OIS. ","In progress - on track","6th Nov 2023-  This is ongoing with regard to Imm's Champions on the ward. We are also working with Community Health for Kids( PHN's) about Imm's opportunites in thier respective clinics. )","Quarter 2","Immunisation directorate","Hospital-based",null,null,"Proactive outreach immunisation services, Catch-up immunisations",null,"Within funding allocated for 23/24."]
["Tamariki Māori, Pacific tamariki, Deprivation quintile 5",null,"Utilising the Prioritisation Matrix as a guidance tool.","Lakes","Strengthen planned and opportunistic hospital-based immunisations","Develop processes  to identify tamariki with overdue immunisations and immunise as part of planned care or opportunistically, with a whole of whanau approach. ",null,"Work underway currently in response to prioritising immunisation within HSS","Ongoing activity","Alan Wilson/Jessica James","Hospital and Lakes community based services ",null,null,"Proactive outreach immunisation services, Catch-up immunisations",null,"Within current resource"]
["Māori tamariki, Hapū māmā, Tamariki with disabilities",null,"Prioritise Māori tamariki and hapū māmā, plan to prioritise disabled tamariki attending  physio and OT appointments. ","Taranaki","Strengthen planned and opportunistic hospital-based immunisations","Continue current pilot where there is a vaccinator available at paediatric outpatient clinics Mon-Fri, all immunisations offered including childhood and antenatal. \nChildren attending appointments are screened to see who is overdue and prioritise Māori tamariki. If unable to be immunised at clinic will refer to OIS for follow-up at home.\nExpand to include tamariki with disabilities attending outpatient OT and physio appointments.\n","In progress - on track but risks/issues","Pilot is continuing, seeing good results for childhood and antenatal immunisations. A business case has now been put forward.","Quarter 2","Immunisation coordinators.","Hospital-based",null,null,"Proactive outreach immunisation services, Catch-up immunisations",null,"Within funding allocated for 23/24.\n\nResource interdependent with hapū māmā  vaccination clinics. "]
["Māori tamariki, Pacific tamariki",null,"Prioritised to Māori and Pasifika tamariki who are hospitalised and  have overdue vaccinations.","Tairāwhiti","Strengthen planned and opportunistic hospital-based immunisations","Continue opportunistic immunisations on the paediatric ward and dental paediatric lists (status queries and immunisation in theatre where consented).\nIncrease capacity to regularly offer immunisations at paediatric outpatient clinics.\n","In progress - on track",null,"Quarter 4","Hospital Child and Maternity General Manager","Hospital-based - paediatric ward staff, OIS team, Oral Health team",null,null,"Proactive outreach immunisation services, Catch-up immunisations",null," Within funding allocated for 23/24."]
["Māori tamariki, Pacific tamariki",null,"A prioritisation tool is used to identify higher risk tamariki for the service to contact first, using the Prioritisation Matrix combined with other variables such as hospital admissions, deprivation, whether they have received the flu vaccine, etc.","Waikato","Integrate OIS within a Mātauranaga Māori model","Covid immunisation team and funding (WHIRI Hapori)  pivoted to do OIS but within a Mātauranga Māori model including a whānau hauora assessment that covers life course immunisations for the whole whānau as well as screening, smoking, mental health wellness, wahine hapū, healthy homes, oral health, Well Child and B4 school checks. It is the wholeness and integration of the team that works. Plan to continue this model.","In progress - on track","Whaanau hauora assessments (WHA) are manaaki-led, whaanau centred and now localled delivered via the hubs.  The screening components for GP enrolment and immunisations are now linked to outreach in-home service delivery teams across the district.  ","Ongoing activity","SRO Immunisations","Waikato Immunisation Network i.e. Kaupapa Providers, PHO OIS teams, HHS OIS and PHN teams, WHIRI Hapori team.","Explore using aspects of this model across the region. See regional activity As an urgent action, bring together key leads from each local area.",null,"Proactive outreach immunisation services, Catch-up immunisations",null,"Within funding allocated for 23/24."]
["Tamariki Māori, Pacific tamariki, Hapū māmā, Deprivation quintile 5",null,"Prioritisation would concentrate on those providers working in areas of high risk and low uptake.","BOP","Create additional OIS resource, including kaiāwhina support","Support key staff who delivered Covid vaccinations to become Childhood Immunisation OIS providers and/or provide kaiāwhina support to OIS teams.\n\nNote: Iwi providers are in remote areas in the BOP and are currently unable to resource themselves due to lack of local availability with geographical limitations. Hauora a Toi OIS teams travel to support them. The OIS team is able to shift resourcing to providers with the greatest need and provide support where there is a sporadic need for vaccinators.","In progress - on track","We continue to support providers to upskill their workforce (6th Nov- This is ongoing and will continue on into Quarter2 and 3)","Quarter 1","Immunisation directorate","OIS",null,null,"Proactive outreach immunisation services, Catch-up immunisations",null,"Within funding allocated for 23/24."]
["Tamariki Māori, Pacific tamariki, Deprivation quintile 5, Hapū māmā",null,"Using the Prioritisation Matrix as a guidance tool for OIS services.","Lakes","Create additional OIS resource, including kaiāwhina support","Support Rotorua PHO outreach services and Hauora Maori Partners, as an additional service to the OIS team at the Hub. Including increasing OIS, Immunisation Coordinators, and kaiāwhina support.",null,null,"Quarter 2","RAPHS PHO and OIS","RAPHS PHO",null,null,"Proactive outreach immunisation services, Catch-up immunisations",null,"Further resources required to increase OIS , Imms Coordinator and Kaiāwhina support in order to achieve 90%.\n"]
["Māori tamariki",null,"Supporting Iwi Hauora providers to provide an OIS service.","Taranaki","Create additional OIS resource, including kaiāwhina support","Support Hauora Māori providers (especially in North) to provide enhanced OIS service by providing vaccinators. \nContinue to support primary care by contacting unenrolled tamariki and providing home visits for immunisations and encouraging enrolment with a general practice.","In progress - on track","Continuing to support all Hauora Maori providers with vaccinators to support OIS","Quarter 2","Immunisation Lead-Taranaki ","Hospital OIS",null,null,"Proactive outreach immunisation services, Proactive outreach immunisation services",null,"Within funding allocated for 23/24."]
["Māori tamariki, Pacific tamariki, Deprivation quintile 5",null,"Using a prioritisation tool to prioritise all eligible unimmunised tamariki by the Prioritisation Matrix and other indicators (e.g. hospital admissions, deprivation, flu vaccination status, etc)","Waikato","Advanced outreach pathway for tamariki Māori and Pacific tamariki","Continue with WHIRI Hapori's current model of creating a list of all eligible unvaccinated children, use a prioritisation tool to prioritise children (based on the prioritisation matrix as well as hospital admissions, flu immunisation, and other measures), split the list into clusters and meet weekly with providers to work out what providers will do engagements with what children. ","In progress - on track","Also refer to 2. above.\n\nModel is also manaaki-led, whaanau centred locally delivered via the hubs and associated local providers. Each allocated case is contacted via phone.  For those unable to be contacted SMS text follows up.  After third attempt home visits are intiated to connect with the whaanau and support them in education and providing information about vaccinations.  Case allocation is currently as follows:\n \nTirohanga o Korokii-Kahukura for \nWaipā District: Cambridge, Arapuni, Pukeatua, Te Awamutu \n\nTe Hauora o Ngaati Haua for Matamata, Waharoa, Morrinsville, Waitoa, Tauwhare, Matangi, Tamahere, Pukemoremore \n\nWaikato for Taupiri, Ngaruawahia, Horotiu               \n\nTe Ngaakau a Kiwa, Ethnic hub and Pacifika for Hamilton City \n\nPookekatia te Iwi for Raahui Pookeka \n\nWhaingaroa for Raglan Ward \n\nTe Whare Taumarutanga for\nNorth Ruapehu District \n\nPuutiki for Waitomo District & Ōtorohanga District TLA (excluding Kawhia Moana) \n\nSouth Waikato for South Waikato District TLA \n\nHauraki for Hauraki District TLA & Te Aroha, Thames-Coromandel District \n\nKirikiriroa Pacific for Pasifika Community in Kirikiriroa and parts of Waikato, Waitomo + Matamata-Piako DC areas - Supported Te Ngaakau a Kiwa \n\nWaikato Ethnic Community for Ethnic Communities throughout the Waikato DHB region - Supported Te Ngaakau a Kiwa \n","Ongoing activity","SRO Immunisations","Waikato Immunisation Network i.e. Kaupapa Providers, PHO OIS teams, HHS OIS and PHN teams, WHIRI Hapori team.","Consider rolling out the prioritisation tool and process of splitting the list into clusters for providers regionally. See Consistent regional approach to OIS services.",null,"Catch-up immunisations",null,"Within funding allocated for 23/24."]
["Māori tamariki, Pacific tamariki, Deprivation quintile 5",null,"Prioritising Māori and Pacific tamariki and those of high deprivations to be referred to OIS services sooner than Non-Māori Non-Pacific and low deprivation.","BOP","Advanced outreach pathway for tamariki Māori and Pacific tamariki","Work with providers to enable enrolled Māori and Pacific tamariki and those of high deprivation to be referred to OIS services at any point past their due date for vaccination – not waiting for historical overdue timelines which delay vaccinations being offered. NB Unenrolled are already referred prior to becoming due.","In progress - on track","All PHO's are being reminded to ensure GP providers are aware of early referral process. (6th of Nov 2023-  Advanced Pathway has been communicated to the PHO's as well  to the GP's. WPHO has resumed an OIS- 10 referrals a week) ","Quarter 2","Immunisation directorate","Primary care, PHO OIS teams, Iwi Hauora and Pasifika OIS providers, Hauora a Toi BOP OIS team.",null,null,"Catch-up immunisations",null,"Within funding allocated for 23/24."]
["Māori tamariki, Pacific tamariki, Deprivation quintile 5",null,"Prioritising Māori and Pacific tamariki and those of high deprivations to be referred to OIS services sooner than Non-Māori Non-Pacific and low deprivation.","Lakes","Advanced outreach pathway for tamariki Māori and Pacific tamariki","Work with providers to enable enrolled Māori and Pacific tamariki and those of high deprivation to be referred to OIS services at any point past their due date for vaccination – not waiting for historical overdue timelines which delay vaccinations being offered. NB Unenrolled are already referred prior to becoming due.",null,null,"Quarter 4 2023","Karin Norman",null,null,null,"Catch-up immunisations",null,"Within current resource"]
["Māori tamariki, Pacific tamariki, Deprivation quintile 5",null,"Prioritising Māori and Pacific tamariki and those of high deprivations to be referred to OIS services sooner than Non-Māori Non-Pacific and low deprivation.","Taranaki","Advanced outreach pathway for tamariki Māori and Pacific tamariki","Pilot underway by PHO to highlight Māori and Pasifika (high deprivation) non-enrolled and find spaces at GP services for them. Focus will then be on GP process to ensure on-time immunisations.","In progress - on track","This is starting to show good gains with the unenrolled being enrolled.","Quarter 4 2023","Taranaki Immunisations Operational Group and Pinnacle MHN/Commissioning Team",null,null,null,"Catch-up immunisations",null,"PHO funding stream - within existing funding and capacity  for 23/24."]
["Māori tamariki, Pacific tamariki, Deprivation quintile 5",null,"Introduced an advanced pathway to ensure primary care are aware they can refer tamariki Māori, Pacific and high dep children to OIS at any time past due date (not waiting for historical overdue timelines). The track and trace reports prompt Primary Care to identify all children past due and supports them to prioritise using the Prioritisation Matrix.","BOP","Capturing overdue tamariki vaccinations ","OIS is being used to target missed immunisation events, as well as ‘track and trace’ reporting to primary care providers identifying Māori and Pasifika who are past due immunisations.  Primary care requires support to ensure referral  back to OIS if they are unable to immunise the child within a suitable timeframe.","In progress - on track","6th of Nov 2023-ongoing and will continue into each quarter. ","Ongoing activity","Immunisation Directorate plus local key stakeholders ","Primary care","Consistent regional approach to OIS services.",null,"Catch-up immunisations",null,"Within funding allocated for 23/24."]
["Tamariki Māori, Pacific tamariki, Deprivation quintile 5",null,"Using the Prioritisation Matrix as a guidance tool for OIS services.","Lakes","Capturing overdue tamariki vaccinations ","OIS and WCTO providers being used to deliver immunisations to tamariki who have missed immunisation events.",null,null,"Ongoing activity","OIS","WCTO providers","Consistent regional approach to OIS services.",null,"Catch-up immunisations",null,"Will require further resource to reach 90%"]
["Tamariki Māori, Pacific tamariki, Deprivation quintile 5",null,"Utilising the prioritisation matrix as a guidance tool.","Taranaki","Capturing overdue tamariki vaccinations ","GP unknown list is identified, whānau are contacted by T.W.O Taranaki vaccinator who arranges home visits to vaccinate. Vaccinations are offered to all whanau.","In progress - on track","Continues. Looking to expand with more vaccinators","Ongoing activity","OIS Te Whatu Ora","Home visits","Consistent regional approach to OIS services.",null,"Catch-up immunisations",null,"Shared between Te Pa Harakeke, and Screening Team ( Te Whatu Ora), within existing funding and capacity for 23/24."]
["Hapū māmā",null,"Having maternal immunisation services available in maternity facilities and the local community","Waikato","Hapū māmā vaccination clinics","Maternal Immunisations available at Hospital Antenatal Clinics - review of immunisation status of women with high risk pregnancy clinic and whaanau mai community midwifery clinic (Māori / Pacific / dep 5 women not enrolled with an LMC) pre calling prior to clinic appointment that an immunisation nurse will be available at clinic to korero about maternal immunisation and give vaccination while they are at their appointment. \n\nCurrently 3 primary birth facilities have an immunisation clinic one day per week for any Hapū Mama to attend. The target is to have an immunisation clinic at all maternity hubs / birthing facilities.\n\nOne afternoon per week Immunisation nurse available to NICU parents for boostrix and any other immunisations they are eligible for and would like (e.g. flu, COVID, MMR)\nNurse Immuniser available at every Hapū Wananga session for maternal immunisation.","In progress - on track","Regular imms clinics operating in all birthing facilities to vaccinate wahine hapuu. Facilities includes Birthcare Huntly, Waterford Birth Centre, River Ridge Birth Care, Pohlen Hospital Birth Centre, Te Awamutu Birthing Centre, Waihi Lifecare Birthing, Thames Hospital Birthcare Centre, Taumaranui Hospital Birthing Unit, South Waikato Primary Birthing Unit. \n\nImmunusation team continues to attend Hapuu Waananga (antenatal birthing education sessions with wahine hapuu and support whaanau) across the district.  \n\nVaccinator support also being provided in Women's outpatient clinics at Waikato hospital and Womens Assessment Unit.","Ongoing activity","SRO Immunisations","Hospital Antenatal Clinics, Primary Birthing Facilities, NICU and \tHapū Wananga ","National - See Nationally work with the NZ College of Midwives to ensure members will proactively increase immunisation uptake by  hapū Māori, Pacific and Tangata whaikaha.  \n\nNational - Obtain information to support populating the AIR with the pregnant population by 16 weeks gestation.",null,"Antenatal immunisations",null,"Within funding allocated for 23/24."]
["Hapū māmā",null,"See Summary/description.","BOP","Hapū māmā vaccination clinics","Vaccination clinics alongside LMC led antenatal clinics in Whakatane and Tauranga Hospitals and in key localities with historic low vaccination uptake. Clinics running three times per week in conjunction with planned ante natal clinics within key areas.\nSupport community-based WCTO RN’s to upskill in conversation/delivery of hapū māmā vaccinations. ","In progress - on track","Ongoing discussions with midwifery team lead to identify opportunities to improve uptake. (6th Nov- we continue to support these clinics but have insitgated a review as to how we can better support the LMC's.  We are also going to implement a pathway with the PHO's for unenrolled Hapu Mama to enroll them with a GP. ","Ongoing activity","Hauora a Toi Bay of Plenty OIS team (admin and vaccinators) and Immunisation Coordinators","Hospital antenatal clinics",null,null,"Antenatal immunisations",null,"Within funding allocated for 23/24."]
["Hapū māmā",null,"See Summary/description.","Taranaki","Hapū māmā vaccination clinics","Vaccination clinics Mon-Fri at the childhood and adolescent community care centre (outpatients) close to antenatal clinics. Hapū māmā are told that they (and the wider whānau) can be vaccinated at the clinic, all immunisations including childhood and antenatal (see Strengthen planned and opportunistic hospital-based immunisations). Clinic running until the end of June 2024 with plans to continue if successful. ","In progress - on track","Continues. Have expanded to Friday as well. Starting to see more uptake.","Ongoing activity","Immunisation coordinators","Taranaki hospital outpatient clinics",null,null,"Antenatal immunisations",null,"Within funding allocated for 23/24."]
["Hapū māmā",null,"See Summary/description.","Waikato","Supporting pharmacies to vaccinate hapū māmā ","Maintain and reuglarly review the registry for the pharmacies (as at 9/6/23 there are 53) already delivering antenatal immunisations and (1) send the updated lists to LMC’s and community midwives so that they can tell their hapū māmā where vaccinations are available (2) ensure updated list are communicated via TWOW facebook tiles ","In progress - on track","District attendance at Improving Vaccination in Pharmacy Workshop 2023 - noted feedback re: barriers in the community that can be remedied by pharmacy.  \n\nPharmacy engaement with clusters currently being advanced with both Midland Pharmacy Group and Chemist Warehouse. \n\nPhamarcy registry regularly review and updated to LMCs and Whaanui Mai (community midwives)","Ongoing activity","SRO Immunisations","Waikato Immunisation Network (WIN) geographic cluster groups: Kaupapa Māori and Pasifika Providers, PHO OIS teams, HHS OIS and PHN teams, WHIRI Hapori team.",null,null,"Antenatal immunisations",null,"Within funding allocated for 23/24."]
["Hapū māmā","This will also support pharmacies to provide flu and Covid vaccinations","See Summary/description.","BOP","Supporting pharmacies to vaccinate hapū māmā ","Maintain registries for the 34 pharmacies already delivering antenatal immunisations and send the lists to LMC’s and community midwives so that they can tell their hapū māmā where vaccinations are available.\nIncrease the number of pharmacies offering antenatal immunisations in areas of high deprivation and/or high proportion of Māori or Pacific.","In progress - on track","Underway ( 6th of Nov 2023- still underway)","Start Quarter 1, then Ongoing activity","Immunisation coordinator and Immunisation directorate.","Pharmacies","See One off heat map to show the number of pharmacies providing antenatal immunisations by area. ",null,"Antenatal immunisations",null,"Within funding allocated for 23/24."]
["Hapū māmā","This will also support pharmacies to provide flu and Covid vaccinations","See Summary/description.","Lakes","Supporting pharmacies to vaccinate hapū māmā ","Pharmacies have pharmacist vaccination contracts for antenatal immunisations but as staff change not all pharmacies will have vaccination qualified staff. Action to increase the number of vaccinating sites by assisting with training vaccinators, and supporting pharmacies with supply and cold chain etc.",null,null,"Ongoing activity","Immunisation directorate  ","Pharmacies","See One off heat map to show the number of pharmacies providing antenatal immunisations by area. ",null,"Antenatal immunisations",null,"Within funding allocated for 23/24."]
["Hapū māmā","This will also support pharmacies to provide flu and Covid vaccinations","See Summary/description.","Taranaki","Supporting pharmacies to vaccinate hapū māmā ","Meet with all pharmacies face to face to discuss providing immunisations across the life course. Prioritise pharmacies in areas with Māori, Pacific, high deprivation. ","In progress - on track but risks/issues","Working with Immunisation Co-ordinators to meet with pharmacies","Quarter 2","Immunisation coordinators and immunisation lead (sitting under planning and funding).","Pharmacies","See One off heat map to show the number of pharmacies providing antenatal immunisations by area. ",null,"Antenatal immunisations",null,"Within existing resources for 23/24."]
["Māori tamariki, Pacific tamariki",null,"Increase the number of Māori and Pacific providers delivering OIS.","Waikato","Increase the number of vaccinators authorised to deliver childhood immunisations (including within external providers)","Identify and support to training unregulated Māori and Pacific provider staff wanting to deliver Childhood immunisations.  \nIdentify and suport TWOW regulated local staff completing training to become fully authorised vaccinators for redeployment into Māori and Pacific providers.","In progress - on track","Ongoing a planned.","Ongoing activity","SRO Immunisations","Waikato Immunisation Network (WIN) geographic cluster groups: Kaupapa Māori and Pasifika Providers, PHO OIS teams, HHS OIS and PHN teams, WHIRI Hapori team.","Regionally coordinated vaccinator training.",null,"Expansion of the vaccinator workforce",null,"Within funding allocated for 23/24."]
["Māori tamariki, Pacific tamariki",null,"Increase the number of Māori and Pacific providers delivering OIS.","BOP","Increase the number of vaccinators authorised to deliver childhood immunisations (including within external providers)","Identify local staff who require training to become fully atuthorised vaccinators and support to undertake training. \nIncrease the number of Māori and Pacific providers able to deliver Childhood OIS.","In progress - on track","6th of Nov- still ongoing and will continue in all quarters. ","Ongoing activity","Commissioning","Hauora Māori Partners, Hauora a Toi OIS teams","As above.",null,"Expansion of the vaccinator workforce",null,"Within funding allocated for 23/24."]
["Not specific to any priority group",null,"Enabler to reach priority groups.","Lakes","Increase the number of vaccinators authorised to deliver childhood immunisations (including within external providers)","Identify local staff who require training to become fully atuthorised vaccinators and support to undertake training. ",null,"Work currently underway to map current vaccinator workforce in Lakes (Immunisation Coordinators/J. James)","Ongoing activity","Commissioning","Māori and Pacific providers","As above.",null,"Expansion of the vaccinator workforce",null,"Within current resource"]
["Māori tamariki, Pacific tamariki",null,"Increase the number of Māori and Pacific providers delivering OIS.","Taranaki","Increase the number of vaccinators authorised to deliver childhood immunisations (including within external providers)","Provide additional funding/  FTE to Iwi Providers for vaccinators to help improve immunisation numbers. Currently OIS is being supported by Te Whatu Ora vaccinators.","In progress - on track","Finalising currently","Ongoing activity","Commissioning ( Te Whatu Ora and Te Aka Whai Ora)","Iwi providers","As above.",null,"Expansion of the vaccinator workforce",null,"Within funding allocated for 23/24."]
["Tamariki Māori",null,"Prioritise supporting Hauora Māori partners. Increasing the number of vaccinators among providers who have continued and established relationships with high needs populations.","Tairāwhiti","Increase the number of vaccinators authorised to deliver childhood immunisations (including within external providers)","Support VHW workforce to complete all requirements to enable them to deliver at the top of their scope.\n\nSupport vaccinators to become fully authorised vaccinators.","In progress - on track",null,"Ongoing activity","Commissioning","Hauora Māori providers, Te Whatu Ora.","See Increase the number of authorised vaccinators by regionally coordinating vaccinator training .",null,"Proactive outreach immunisation services, Catch-up immunisations",null,"Ring-fenced Te Aka Whai Ora funding for Immunisations coordination within Ngati Porou Oranga and Turanga Health. So that they can certify and grow their workforce within providers."]
["Māori tamariki, Pacific tamariki",null,null,"Waikato","Develop/Strengthen Wellchild/Tamariki Ora (WCTO) partnerships ","Pilot is currently operating with Plunket. Next step is to scale up to include all WCTO/Tamarik Ora providers that are not already vaccinating during home visits.  This would also include the newly contracted Kahu Taurima providers.  The pilot also provides an opportunity to upskill WCTO nurses to provide immunisation education and ultimately become vaccinators. ",null,"Tamariki ora providers engaged locally with clusters.  Pilot with Plunket still to be extended.\n\nAwaiting confirmation of Kahu Taurima contracted providers - though many have already been in contact with WIN or already are a part of WIN.  Separate forum for these providers will be convened.","Ongoing activity","SRO Immunisations","Waikato Immunisation Network (WIN) geographic cluster groups: Kaupapa Māori and Pasifika Providers, PHO OIS teams, HHS OIS and PHN teams, WHIRI Hapori team.",null,null,"Expansion of the vaccinator workforce",null,"Within funding allocated for 23/24."]
["Tamariki Māori, Pacific tamariki, Deprivation quintile 5",null,"In conjunction with WCTO providers to support prioritisation in relation to Immunisation Prioritisation Matrix.","BOP","Develop/Strengthen Wellchild/Tamariki Ora (WCTO) partnerships ","All WCTO services currently refer through to OIS. \nRevisit training for WCTO providers on referral pathways and ensure they can access to immunisation history for clients. \nReview opportunity to support WCTO with vaccinators for visits requiring the WCTO provider to be present during immunisations (case by case basis in collaboration with WCTO providers). ","In progress - on track","Meetings planned to work through operational aspects of process. Potential for Hauora a Toi vaccinators to support WCTO in the home - investigating options. (6th of Nov- still to arrange meeting with the 3 WCTO providers)","Ongoing activity","Commissioning and WCTO providers","WCTO providers","Regionally coordinate how this is done, e.g. if Plunket and other WCTO providers have a regional lead link in with them and coordinate processes including for when children move throughout the region. See As an urgent action, bring together key leads from each local area ",null,"Proactive outreach immunisation services",null,"Within funding allocated for 23/24."]
["Not specific to any priority group",null,"Offered to all tamariki attending WCTO services.","Lakes","Develop/Strengthen Wellchild/Tamariki Ora (WCTO) partnerships ","All WCTO providers already offer immunisations - Lakes was an early adopter.",null,null,"Ongoing activity","Commissioning and WCTO providers","WCTO providers",null,null,"Expansion of the vaccinator workforce",null,"Within current resource"]
["Tamariki Māori, Pacific tamariki",null,"Prioritised supporting Hauora Māori partners","Taranaki","Develop/Strengthen Wellchild/Tamariki Ora (WCTO) partnerships ","Ngati Ruanui already vaccinating alongside WCTO program. Plan to confirm if Tui Ora are also able to do this.","In progress - on track but risks/issues","Tui Ora still building their workforce for this.","Ongoing activity","Commissioning and WCTO providers","Ngāti Ruanui and Tui Ora",null,null,"Expansion of the vaccinator workforce",null,"Within funding allocated for 23/24."]
["Māori tamariki, Pacific tamariki",null,"Use the prioritisation matrix to prioritise deploying to providers delivering immunisations to priority groups.","Waikato","Strengthening Immunisation workforce","If a provider in the network needs a resource then deploy RN and Kai Manaaki workforce to them. Enabling community and Kaupapa providers to deliver immunisations.\n\nResource driven by need in community with the ability to flex, dependant upon population due/overdue.",null,"Reployment model ongoing - currently support is being provided to PHO OIS  teams, 2 medical centres, 5 kaupapa providers.  \n\nAcross WIN nurses and VHWs from Tuuhono, Te Hauora O Ngati Haua VHWs, Ko wai Au have been supported with their imms training. Standing orders have also been actioned were required.","Ongoing activity","SRO Immunisations","Waikato Immunisation Network (WIN) geographic cluster groups: Kaupapa Māori and Pasifika Providers, PHO OIS teams, HHS OIS and PHN teams, WHIRI Hapori team.","Regional - see Coordinate regional authorised vaccinator support for local immunisation events.",null,"Proactive outreach immunisation services, Catch-up immunisations",null,"Within funding allocated for 23/24."]
[null,null,"Enabler to reach priority groups.","BOP","Strengthening Immunisation workforce","Vaccinator resource currently offered to providers to support their local immunisation programmes. Administrative support for systems/process. \nClinical and Pharmacy oversight plus dedicated Immunisation Coordinator support.  ","In progress - on track","6th of Nov 2023- ongoing and will continue in all quarters.","Ongoing activity","Hospital OIS",null,"As above.",null,"Proactive outreach immunisation services, Catch-up immunisations",null,"Within funding allocated for 23/24."]
[null,null,"Enabler to reach priority groups.","Lakes","Strengthening Immunisation workforce","Vaccinator resource currently offered to providers to support their local immunisation programmes. Administrative support for systems/process. \nClinical and Pharmacy oversight plus dedicated Immunisation Coordinator support.  ",null,null,"Ongoing activity","Karin Norman","All community providers","As above.",null,"Proactive outreach immunisation services, Catch-up immunisations",null,"Within current resource, leveraged off Covid funding."]
[null,null,"Enabler to reach priority groups.","Tairāwhiti","Strengthening Immunisation workforce","Support the ability of provider partners to share their workforce across each other, outside of hours (e.g. weekends and public holidays) in response to whānau need. Offering life course immunisations in places and spaces that work for whānau.","In progress - on track but risks/issues",null,"Ongoing activity","Commissioning","Hauora Māori partners and primary care","As above.",null,"Proactive outreach immunisation services, Catch-up immunisations",null,"Have ring-fenced Te Aka Whai Ora funding for shared approaches. Discussion with Te Whatu Ora and providers around employment agreements to be reflective of 7-day working week rather than Mon-Fri. This won't require resource but does need a documented conversation."]
["Māori tamariki, Pacific tamariki",null,"Contact Māori and Pacific infants at 5-weeks with the aim to deliver on-time vaccination at 6-weeks.","Waikato","Strengthen newborn enrolment ","The contracted Newborn enrolment team is based in Waikato Hospital.  The service currently contacts whaanau of all newborns. The list of newborns is collated from notifications from midwives.  Whaanau are contacted by letter and followed up by phone.  Pilot currently contacts Māori at five weeks. Plan to expand to also contact Pacific infants at five weeks with the aim of delivering on-time vaccination to both groups at six weeks. Further expansion to include linking whaanau still unenrolled to local providers for support to enrolment. Review of step by step process to maximise engagement and enrolment opportunity.","In progress - on track","As noted above - group formed which includes PHOs, Newborn Enrolement Waikato & OIS teams. Focus is on addressed the equity issue for 6 week Maaori and Pacific GP enrolments.\n\nReview of GP practises with high enrolements to gather information of what works well and to take learnings that could be used in other GPs . In the process of linking local hubs to follow up with whaanau who are unenrolled to support them through that process. Working with AIR/Whaihua programmers to ensure deveolopment of new system fits the needs for our region.  Eg, creating letter templates. Default GP replacing Waikato Hospital, grouping priority population, School Base programmes consenting process ","Ongoing activity","SRO Immunisations","Waikato Immunisation Network (WIN) geographic cluster groups: Kaupapa Māori and Pasifika Providers, PHO OIS teams, HHS OIS and PHN teams, WHIRI Hapori team.","Regional - A newborn enrolment programme could be supported regionally across all local areas. See As an urgent action, bring together key leads from each local area ",null,"Proactive outreach immunisation services",null,"Within funding allocated for 23/24."]
["Not specific to any priority group",null,null,"BOP","Strengthen newborn enrolment ","Tracking enrolment uptake on weekly basis, contacting GP providers and working with OIS providers to support enrolment.\nWorking with PHO’s to support GP systems and processes in accepting b-code enrolments, and identification of practices with open books. \nWorking with Systems related to identification of newborns (internal – Maternity HealthWare moving to BadgerNet). Use of data-matching NHI creation with NIR record creation to ensure capture of all newborns. \nEngagement with LMC’s who service homebirths – ensuring early notification of birth to NIR. ","In progress - on track","Working with BadgerNet team to ensure seamless crossover of newborn provider notifications to GP practice. Enrolment tracking continues. Digitisation of LMC notification on homebirth is underway outside of the RIT remit. ( 6th of Nov 2023- ongoing and will continue in all quarters)","Ongoing activity","Hauora a Toi NIR/Immunisation Support Admin, PHO and Hauora a Toi OIS teams","Primary care","As above.",null,"Proactive outreach immunisation services",null,"Within funding allocated for 23/24."]
["Tamariki Māori, Pacific tamariki, Deprivation quintile 5",null,"Using the Prioritisation Matrix as a guidance tool for prioritising newborn enrolment.","Lakes","Strengthen newborn enrolment ","Working with whanau, OIS services and providers to support newborn enrolment. Already underway, however, need an alternative model of primary care as we currently have most GPs with closed books and a significant population who cannot enrol.",null,null,"Ongoing activity","HSS immunisation lead","Primary care","As above.",null,"Proactive outreach immunisation services",null,"Te Whatu Ora portion of this is currently covered through existing resource."]
["Tamariki Māori, Pacific tamariki, Deprivation quintile 5",null,"Prioritisation matrix will  be used, with a focus on ensuring processes are working for Māori ","Taranaki","Strengthen newborn enrolment ","Review current outcomes  and look to improve this process. Will occur as part of the enrolment hub being delivered by Pinnacle MHN","In progress - on track but risks/issues","Ongoing","Quarter 1 and 2 ","Commissioning ","Primary care","As above.",null,"Proactive outreach immunisation services",null,"Within existing resources."]
["Not specific to any priority group",null,null,"Waikato","School Based Immunisation Programme (SBIP) collaboration","The SBI programme is operationalised by the TWOW Rural & Community PHN team.  From a WIN perspective the aim of the collaboration is to assist in the resolution of SIB programme issues in order to enable collaboration and catch-up immunisations for overdue tamariki.   Key planned activities include: maintaining active engagement and communication with the SIB programme via the WIN in order to identify, understand and resolve key issues. To date we have identified there are 3-4 school not particpating in this programme and there are approx 2000 outstanding NIR 3 forms awaiting uploading into NIR.  Remedial actions are underway to resolve these.  Identified opportuities include collaboration across the WIN provider clusters and their MDTs as well as planning to go \"paperless\".  NB: the School-based Immunisation Programme national review is also underway and active engagement by Waikato District is a sub activity.",null,"Scoping of collaboration with the School Based Immunisation Programme has commenced with PHN leadership.  Currently planning with Hauraki PHO re: HPV Primary Screening Rollout Roadshows to deliver the Gardisal Immunisations to the Intermediate school aged population.  Other services involved are Bowel Screening, Oral Health, Hearing and Vision, Dietetics, Diabetes Screening.","Quarter 3","SRO Immunisations","SBIP",null,null,"Catch-up immunisations",null,"Within funding allocated for 23/24."]
["Not specific to any priority group",null,null,"BOP","Support the School Based Immunisation Programme (SBIP) to provide catch-up immunisations for overdue tamariki","Catch up programme identifying who is overdue and providing specific catch up. As well as status checks during the SBIP for MMR specifically.\nPlanning - Quarter 2. Delivery - Late Quarter 3 and Quarter 4 onwards.","In progress - on track","MMR status continues to be checked. Catch-up programme under discussion for HPV's delayed due to Covid related service disruption (6th of Nov 2023- ongoing)","Quarter 2","Karen Thomas","SBIP",null,null,"Catch-up immunisations",null,"Within funding allocated for 23/24."]
["Not specific to any priority group",null,null,"Lakes","Support the School Based Immunisation Programme (SBIP) to provide catch-up immunisations for overdue tamariki","PHN's are planning a New Entrant catch up Immunisation programme as part of the SBIP.",null,null,"Quarter 2","Lynne McVicar","SBIP",null,null,"Catch-up immunisations",null,"Within existing resources."]
["Tamariki Māori, Pacific tamariki, Deprivation quintile 5",null,"As per prioritisation matrix - currently underway.","BOP","Develop partnership between OIS services and PHN’s","PHN’s to check vaccination status of all referrals and refer to OIS team as needed.\nActivity in the immediate term is to make sure all PHN's are aware of the process.\n\nConsider opportunities for building on OIS and PHN partnerships to improve immunisation uptake.","In progress - on track","PHN triage of high risk and unvaccinated referrals underway. Referral to OIS ongoing. Consideration of additional CH4K service support for immunisation is underway. (6th Nov 2023- This is underway with ongoing disucssions with regard to PHN support)","July - December 2023","PHN’s supported by the OIS team","School-Based Immunisation Programme (SBIP)","Regional - Could be done by all local areas with additional resourcing. See Reimagining the Future State Immunisation Project",null,"Catch-up immunisations",null,"Within funding allocated for 23/24."]
["Tamariki Māori",null,null,"Waikato","Partner with Early Childhood Education Centre's to provide catch-up immunisations","Currently underway - In Hamilton all ECE facilities (199 in total) have been contacted and an offer of F2F engaement extended.  This has lead to sharing of childhood immunisations collateral and completion of ECE based vaccination events. This project is now extending to South Waikato and being lead by the provider cluster in this area.",null,"In Hamilton, all ECE facilities (199) have been contacted and have been extended an offer of F2F engagement. Of the 199 contacted, 53 ECE facilities allowed F2F engagements with 7 of those engagements converting to successful immunisation clinics at those specific facilities. \nThe project has since extended to the South Waikato, Maniapoto, Hauraki, Waipa and North Waikato/Whaingaroa rohe.\nIn the South Waikato rohe, 27 of 29 ECE facilities have been contacted and presented with the opportunity of F2F engagements. Among those contacted, 16 were eager to establish connections, leading to the successful establishment of immunisation clinics at 7 of these facilities. \nMore recently, efforts have begun in the Maniapoto rohe, where contact has been made with 14 of 28 ECE’s, with 6 of those facilities accepting invitations for F2F engagements. \nIn Hauraki, 8 facilities have been contacted and 6 of those agreed to in-person connection. Likewise in the Waipa area, 3 ECE’s have been contacted so far, with 2 accepting invitations for F2F interactions. This project is also fresh to the North Waikato and Whaingaroa area’s, with contact to 21 ECE facilities so far. \nOut of the 14 ECE immunisation clinics conducted , a total of 101 immunisations have been administered, benefiting 71 tamariki across the district. A structured follow-up/catch-up plan was also put in place by the vaccinating provider to ensure continuity. 15 parents had their flu/COVID vaccinations while their children were immunised. \nAmong the 71 tamariki immunised, 27% identified as Māori, 20% as Pasifika, 28% as European, 15% as other, and 10% were from undocumented ethnic backgrounds.\nMajority, if not all, F2F engagements and ECE immunisation clinics have been executed in close collaboration with our Māori and Pacific health providers within each specific area. \nIt is also important to note that efforts across ALL mentioned rohe across the district, remain ongoing with continued effort to establish relationships/connections, provide relevant and accurate information, and to upstand more immunisation clinics to ensure our tamariki are protected.","Ongoing activity","Community Engagement Team","ECE's",null,null,"Catch-up immunisations",null,"Within funding allocated for 23/24."]
["Pacific tamariki",null,"See Summary/description.","Taranaki","MMR specific strategy ","MMR coverage low in Pacific communities – work with Pacific leads to do immunisation pop-ups focussing on MMR and other childhood immunisations.","In progress - on track","Have had two pop ups for Pacific communities, great uptake","Quarter 4 2023","Local Operational Immunisation group/ Pacific Coordination Service","Pacific leads",null,null,"Catch-up immunisations, Catch-up immunisations",null,"Within existing funding, subject to prioritisation of workforce."]
["Tamariki Māori",null,"As per prioritisation matrix - currently underway.","Taranaki","Partner with Ko Hanga and Early Childhood Centres to provide education and catch up immunisations","Beginning to look at meeting with Ko Hanga and Early Childcare Centres to plan education sessions and clinics for whanau attending these settings.","In progress - on track","Conversations have started","Quarter 4 2023","Immunisation Lead/Equity Lead","ECE's",null,null,"Catch-up immunisations",null,"Within existing resources."]

{"sheet":"Timeline","index":4,"n_rows":50,"n_cols":14,"rows_kept":50,"cut":false,"hidden":false,"merged":[[5,1,5,13],[24,1,24,13],[3,1,4,1],[3,2,3,4],[3,5,3,7],[3,8,3,10],[3,11,3,13]]}
[null,"Timeline 2023/24 Financial Year"]
[]
[]
[null,"Activity","Quarter 1",null,null,"Quarter 2",null,null,"Quarter 3",null,null,"Quarter 4"]
[null,null,"July","Aug","Sept","Oct","Nov","Dec","Jan","Feb","Mar","Apr","May","June"]
[null,"Regional Activities"]
[null,"Establish regional  strategic oversight and operational group(s)."]
[null,"Te Manawa Taki Immunisation System Design Project"]
[null,"As an urgent action, bring together key leads from each local area to review local activities in this Plan where approaches differ, and share, innovate and agree consistency where appropriate.  "]
[null,"Establish data and reporting against indicators for Te Manawa Taki"]
[null,"Develop a strategy  to ensure equitable immunisation supports and protection for our Tāngata whaikaha whānau "]
[null,"Create a heat map to show the pharmacies providing antenatal immunisations by area"]
[null,"Provide regional support for local education and awareness-raising campaigns"]
[null,"Regionally work with PHO's to ensure General Practices will proactively increase immunisation uptake using the Prioritisation Matrix"]
[null,"Regionally coordinate vaccinator training to increase the number of authorised vaccinators"]
[null,"Immunisation workforce strengthening"]
[null,"Provide information on antenatal immunisations to all hapū māmā attending laboratories and USS providers."]
[null,"Determine a framework or approach to provider accountability for Te Manawa Taki"]
[null,"Develop an immunisation approach for RSE workers and refugees"]
[null,"Development of future years action plan"]
[null,"Develop a regional awareness campaign for Boostrix and Flu available in pharmacies "]
[null,"Coordinate regional authorised vaccinator support for local immunisation events"]
[null,"Action Research Evaluation of the WHIRI Hapori Model "]
[null,"Support implementation of decisions from the NZ College of Midwives (NZCOM) to their members, to proactively support efforts to increase immunisation uptake by hapū māmā "]
[null,"Local Activities"]
[null,"Review/develop relevant local level operational groups"]
[null,"Create additional OIS resource, including kaiāwhina support"]
[null,"Develop partnership between OIS services and PHN’s"]
[]
[null,"Partner / collaborate with Iwi Hauora and Pasifika providers to deliver Outreach Immunisations (including contracted OIS and opportunistic immunisation services)"]
[null,"Integrate OIS within a Mātauranaga Māori model"]
[null,"Advanced outreach pathway for tamariki Māori and Pacific tamariki"]
[null,"Capturing overdue tamariki vaccinations "]
[null,"Hapū māmā vaccination clinics"]
[null,"Supporting pharmacies to vaccinate hapū māmā "]
[null,"Increase the number of vaccinators authorised to deliver childhood immunisations (including within external providers)"]
[null,"Develop/Strengthen Wellchild/Tamariki Ora (WCTO) partnerships "]
[null,"Strengthening Immunisation workforce"]
[null,"Strengthen newborn enrolment "]
[null,"Partner with Early Childhood Education Centre's to provide catch-up immunisations"]
[]
[null,"Reset, co-design and agree immunisation approaches across Tairāwhiti "]
[null,"Co-design agreed approaches to how we address whānau not engaged with immunisations or overdue for Tairāwhiti"]
[null,"Comprehensive Campaigns for Priority Populations"]
[null,"Support the School Based Immunisation Programme (SBIP) to provide catch-up immunisations for overdue tamariki"]
[null,"Strengthen planned and opportunistic hospital-based immunisations"]
[null,"Support the School Based Immunisation Programme (SBIP) to provide catch-up immunisations for overdue tamariki"]
[null,"School Based Immunisation Programme (SBIP) collaboration"]
[null,"Develop an agreed approach to hapū māmā vaccination for Tairāwhiti"]
[null,"MMR specific strategy "]

{"sheet":"Risks and issues","index":5,"n_rows":21,"n_cols":17,"rows_kept":21,"cut":false,"hidden":false,"merged":[[3,15,4,15],[3,16,4,16],[3,9,4,9],[3,10,4,10],[3,11,4,11],[3,12,4,12],[3,13,4,13],[3,14,4,14],[3,8,4,8],[3,2,3,3],[3,4,4,4],[3,5,4,5],[3,6,4,6],[3,7,4,7]]}
[null,null,"Risks and Issues"]
[null,null,"This tab will be used to document any risks and issues identified that may impact on progressing activities and/or reaching the 90% target by June 2024."]
[]
["Date risk identified","Author","Risk Level",null,"Regional or local?","Related activity","Summary/\ndescription of risk or issue","Resolution status","Mitigation Strategy","Timeframe (to resolution)","Responsible","Setting / Provider / Community partner","Could resolution be supported or coordinated regionally and/or nationally? If so, how?","Links with other Local Plans","Impact on Immunisation Taskforce Report Key Priority Areas","Impacted Indicators ","Within existing resources or extra funding required?"]
[null,null,"Consequence","Probability"]
["2023-07-21","Kaitlin Greenway",null,null,"Regional","Not specific to an activity but related to reaching the 90% target","Local teams and Haora Māori and Pacific providers require access to the  national dashboard, and ideally down to street level data linked with NHI's in order to identify where unimmunised tamariki are and use OIS to focus in these ares.","In progress - on track but risks/issues","Part of this issue has now been resolved and local teams can get access to the dashboard.\n\nNow working with HMP and Pacific providers to ensure timely data access.",null,"Kaitlin Greenway","OIS local teams and providers","National - see Mitigation Strategy.",null,"Proactive outreach immunisation services",null,"Within existing resources. "]
["2023-07-21","Kaitlin Greenway",null,null,"Regional","Strengthen newborn enrolment ","Reduced capacity in General Practice and many not taking new enrolments ","Not started","As part of the 'Strengthen newborn enrolment' working group - review Taranaki's initiative to support practices to review their books and identify patients who have moved out of area, etc to see if there is additional capacity. Use the working group to brainstorm any other initiatives that could support newborn enrolment and idenitfy initiatives that could be supported nationally.",null,"Strengthen newborn enrolment' working group","Primary care",null,null,"Enrolment into health services from birth"]
["2023-07-21",null,null,null,"BOP","Immunisation delivery","Ongoing recruitment and retention of staff - both for Te Whatu Ora and contracted providers.","In progress - not on track","Continue funding discussion and permanancy of contracts with Commissioning, RIT and NIP ","Ongoing","SRO","Full OIS programme - Hauora a Toi and Community Partners","Yes",null,"Proactive outreach immunisation services"]
["2023-07-21",null,null,null,"Regional","Data sharing/Data Sovereignty","The sharing of data to providers: multiple providers having access to the same identifiable data yet running conflicting programmes - ie Opportunistic Immunisation Programme as opposed to Outreach Immunisation Service","In progress - on track but risks/issues","Continue discussion with Te Aka Whai Ora, Te Whatu Ora and other key stakeholders including Iwi Partnership Boards - regarding operational implications on delivery",null,"RIT, NIP, Te Aka Whai Ora, Te Whatu Ora, Key Stakeholders","Provider and Community Partner Delivery","Nationally with Regional Support",null,null,"This will affect any indicator in which whanau are approached by multiple providers offering the same service"]
["2023-07-21",null,null,null,"Regional","Contracts, programmes of delivery","Expectations of various contracts which may have crossover with other immunisations eg Kahu Taurima, OIS delivery ","Not started","Awareness of contracts given to providers - through both Te Aka Whai Ora and Te Whatu Ora. Understanding of contract scope eg Kahu Taurima (immunisation component)",null,"SRO, Te Aka Whai Ora, NIP","Provider and Community Partner Delivery","Nationally and Regionally",null,null,"This will affect any indicator which involves an OIS or Opportunistic Immunisaiton Programme within the community."]
["2023-07-21",null,null,null,"BOP","New data collection/vaccinator portal/Kotahi integration","Integration of AIR, Whaihua and allied systems alongside Kotahi (Customer Management Programme for Hauora Maori Partners) via Te Aka Whai Ora funding.","In progress - on track but risks/issues","Continual dialogue with teams supporting system implementation. Workarounds put in place until solutions identified and established.",null,"NIP, AIR Engagement Team, Te Aka Whai Ora, Te Whatu Ora. Regional and Local Teams","All settings and providers/community partners affected by new system implementation","Nationally and Regionally",null,null,"All which are affected by timely delivery, access to vaccinator history, and connected to appropriate databases"]
["2023-07-21",null,null,null,"Regional","Engagement","Confusion among Providers around lines of work, who is communicating with them, how all systems work together. This being due to multiple new strategies and programmes all being implemented at the same time. This results in multiple working groups approaching the same providers and having similar conversations. Risk of disengagement.","In progress - not on track","Key stakeholder communication and oversight of different lines of work/understanding of programmes. Constant communication and updates between working groups to ensure appropriate stakeholder engagement.",null,"NIP, AIR Engagement Team, Te Aka Whai Ora, Te Whatu Ora. Regional and Local Teams","Providers and Community Partners","Nationally and Regionally",null,null,"All those supported by Community and Hauora Maori Providers"]
["2023-07-21",null,null,null,"Regional","Planning and Delivery","Reduced capacity to deliver at current resource levels. Multiple team members have moved to other roles due to lack of certainty","In progress - not on track","To ensure rapid recruitment as soon as procurement plan is approved. ",null,"Regional and Local Teams","OIS. Hospital, Community Partner","Mainly at local level - some aspects could be supported regionally"]
[null,null,null,null,"Regional","Planning and Delivery","Lack of clarity around the structure and expectation of Kahu Taurima from an immunisation perspective ie. funding, resources, who has a Kahu Taurima contract, service specs.","In progress - on track but risks/issues","Ongoing discussions with Kahu Taurima team.",null,"Regional and Local Teams","OIS, Community Partner","Regionally - with information and context."]
[null,null,null,null,"Regional","Planning and Delivery","Ongoing upskilling of vaccinator workforce - lack of opportunities for practicum, and stability of workforce.","In progress - on track but risks/issues"]
[null,null,null,null,"Regional","Planning and Delivery","Inability to measure uptake effectively. AIR will not be recording pregnancy indicator on vaccination."]
[null,null,null,null,"Waikato","Workforce -engagement planning delivery across the sector ","WHIRI Hapori team significant changes with reduction of team and EOI process started for appointment into future roles.This includes kaimanaki & RN Vacc workforce who have been supporting providers, HSS,IOS","In progress - on track","Open communication with providers and staff so plans can be made for future delivery accounting for the changes in workforce.Collaborative managemnet with providers to create opportunities",null,"SRO","All settings and providers/community partners affected by new system implementation","Nationally and regionally",null,null,"Immunisation engagement and delivery across sector would be impacted"]
["2023-09-18","Karin Norman",null,null,"Lakes","Leadership model not effective for continuity and cohesion of service","SRO in process of redeployment, no conclusive plan yet known for future of Imms services within TWO.","In progress - on track but risks/issues","Final structure and services in place within TWO Commissioning and NPHS.\nACNM Imms (HSS Lakes) taling on SRO responsibilities in short term to maintain consistency.",null,null,"All settings and providers/community partners affected by new system implementation","Nationally and regionally\nTimely decsions on restructuring and roles and responsibilities"]
["2023-09-18","Karin Norman",null,null,"Lakes","Lack of Imms Co-ordinator resource for district","1 co-ordinator part time across district","Not started","A/A",null,null,"All settings and providers/community partners affected by new system implementation","Nationally and regionally\nTimely decsions on restructuring and roles and responsibilities"]
["2023-09-18","Karin Norman",null,null,"Lakes","Decline rate high and not decreasing","Current decline rate is high and no cohesive effort to detirmine reasons why.\nHigh risk to community as not achieving sufficient coverage to prevent outbreaks","Not started","Closer collaboration with Kaupapa Maori services.\nMore authorised vaccinators available\nReview imms opportunities - Hau Ora events, Marae clinics etc",null,"Imms ACNM","All settings and providers/community partners affected by new system implementation","Nationally and regionally\nTimely decsions on restructuring and roles and responsibilities\nDirect collaboration with Te Aka Whai Ora and Kaupapa providers"]
["2023-09-18","Karin Norman",null,null,null,"High unenrolled / un-serviced population","Lakes district has a high unenrolled population with minimal capacity for PHO's to enroll plus an additional unserviced population with up to two primary practices with no or insufficient GP's.\nNo pre-emptive service or intervention at birth to enrol / capture newborns, no regular Hapu Mama interactions - current service specs don't support this way of working","In progress - not on track","Cover for un-serviced clinics part time and sale is underway.\nCloser collaboration with PHO providing services to unenrolled population but need to consider taking services to them not expecting presentation to a clinic.\nInovative models for pre-emptive interventions",null,"Imms ACNM with assistance from TMT team","All settings and providers/community partners affected by new system implementation","Nationally and regionally\nTimely decsions on restructuring and roles and responsibilities\nDirect collaboration with Te Aka Whai Ora and Kaupapa providers"]

{"sheet":"List sources (ignore)","index":6,"n_rows":13,"n_cols":5,"rows_kept":13,"cut":false,"hidden":false,"merged":[]}
["List sources"]
[]
["Priority groups","Immunisation Taskforce Report Key Priority Areas","Activity status","Regional or local activity","Indicators"]
["Tamariki Māori","Expansion of the vaccinator workforce","In progress - on track","Regional"]
["Pacific tamariki","Authorisation of childhood vaccinators","In progress - on track but risks/issues","Waikato"]
["Hapū māmā","Antenatal immunisations","In progress - not on track","BOP"]
["Tamariki with disabilities","Enrolment into health services from birth","Completed","Lakes"]
["Deprivation quintile 5","Proactive outreach immunisation services","Not started","Taranaki"]
["Not specific to any priority group","Catch-up immunisations",null,"Tairāwhiti"]
[null,"Funding for providers that is long-term and sustainable"]
[null,"Governance technical advice and service coverage oversight"]
[null,"Development of new provider and consumer-facing resources for immunisations"]
[null,"Quality and standards for providers delivering immunisations to tamariki in New Zealand"]