Appendix One.pdf

Appendix One
GDOs and Clinical Leaders
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13 August 2024
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Agenda
1. Karakia and welcome – Mark Shepherd
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2. FY 2024/25 - budgets and sustainability programme - Jo Lusk
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3. Recruitment update - Mark Shepherd
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4. Lifting Performance by Empowering Regions – update (P&C)
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5. AOB and Q&As
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Karakia
Whakataka te hau ki te uru
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Whakataka te hau ki te
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Kia mākinakina
the  ki uta,
Kia mātaratara ki tai.
E hī ake ana te
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.
He tio, he huka, he hauhū.
Tihei Mauri Ora!
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• H&SS Budget allocations for FY 24/25
Background:
• In 23/24 H&SS budget expenditure allocation was $14.396b, and
73,778.7 FTE
• For 24/25 H&SS have been allocated budgeted expenditure of
$14.927b and 74,710 FTE
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• H&SS Run-rate of expenditure towards the end of 23/24 was above
the equivalent of 16.35b, and over 78,000 FTEs, so returning to the
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allocated expenditure rate will require significant effort.
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Regions have already put significant work toward identifying
opportunities and initiatives targeting a net 4% reduction in expenditure,
the
however there is a further budget 'gap' of $770m to be closed.
Some central placeholders and identified duplications in pipeline
initiatives have reduced this by circa $68m, the remaining $701m now
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needs to be embedded in Regional and District budgets. The majority of
this will be achieved by restricting FTE budgets to the permitted level.
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The $701.8m of additional savings has been allocated across the regions as per the below. The same methodology has been applied
consistently across all Regions.
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• Next Steps
• The savings plans for the initial 4% and the proposed allocations of the additional savings were submitted for review and feedback last week.
• Regional Directors and the Regional Finance Leads have been sent the detailed working files for the additional savings at RC/AC level
• These budget reductions will be embedded into budgets, where we can
• Phasing will take place based on provided assumptions; these reflect working or calendar days with adjustments for stat days and known
staffing changes/price uplifts.
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• The below shows the final budgets for each region:
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Business Rules
Regional recruitment can occur within the rules of earned autonomy as follows;
1. Within the defined fortnightly total district recruit to FTE, taking into account the new hires and exits in the previous period
2. Within the defined total district recruit to FTE for the professional group, taking into account the new hires and exits in the
previous period; and any agreed FTE changes for model of care changes
3. With reference to the base budget allocated to the professional group and district1982
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This assumes that:
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Each district commits to an affordable FTE reduction target to within 4 months
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• Actual paid FTE = contracted FTE+overtime+ additionnal hours (converted to FTE)
• For districts to have autonomy to recruit overtime and additional hours must be within reduction target for that period
the
• Outsourced personnel remains within budget
• Business cases for changes to models of care that are “spend to save” initiatives or require transfers of FTE between professional
groups are approved regionally and outcomes tracked to ensure delivery of savings (see Slide 5)
• Reductions from current actual to target reduced FTE will be tracked across this time as a “ sinking lid” of FTE to achieve the
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targeted FTE
• Recruitment week to week will be determined by exits and hires for the prior period and take into account the target reduced FTE
• The FTE reduction target for each district will be re-calculated at the end of 6 months if personnel costs still exceed available
budget
• Districts remain “On track” month/ytd delivering savings obligations
• Green list roles and NETP appointments are monitored and included in the new hires of the prior period to determine the
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recruitment total for approval
• Appointments of Fellows, RMOs and HOs are monitored to ensure actuals do not exceed current allocation, i.e. districts take a “1
in 1 out” approach

Affordable FTE Target Calculation and Tracking
To achieve earned autonomy, each district will:
1.
Determine the first tranche of FTE reduction from their current contracted FTE to the new recruit to FTE target to be achieved over the next 4 months
2.
Use the weekly turnover report (leavers and new starters) to determine the actual Recruit to FTE for the period (i.e. sinking lid target FTE, less new hires, plus
exits) eg 19 Aug, Sinking lid recruit to target 972 , - 14 exists+ 9 starters ( net decrease -3) = 3 FTE recruitment this period
3.
For each period, any Outsourced Personnel FTE numbers exceeding budget are deducted from the Recruit to FTE number; and any agreed changes of FTE for
model of care changes are also deducted or added to this total
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4.
Overtime and additional hours need to be within the target % reduction for the period
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In the graphical example below:
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• The base FTE budget for that district and professional group is assumed to be 1000 (blue line) and the target reduction is 100 for the period 1 July – 31
December (i.e. down to a total of 900). The orange line is the target FTE required each week to meet the 31 December target of 900.
• The yellow bar is the number of exits in the week and the grey bar is the number of new hires
the
• The purple line is the number of FTE that an be recruited to in that week, i.e. the Recruit to FTE. Any Outsourced Personnel FTE exceeding budget will be
deducted from this number.
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Regional Approval Process for Model of Care Changes
Business Rules for Model of Care Savings
1. For all model of care changes that result in changes to the FTE baseline, a business case that
outlines the proposed model of care change, the clinical and patient impacts and the costs, benefits
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and savings must be presented to the Regional FSP Governance Group for approval
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2. Model of care changes must result in an overall $$ savings for the district/s
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3. Business cases for model of care changes must have an implementation timeline and a date by
which savings will be achieved and outline the mechanism
the  for tracking savings achievement
4. When the district/s implement the agreed change, baseline FTE numbers are adjusted accordingly.
This could be a change or a workforce composition which may require a transfer of FTE between
professional groups or an increase in FTE in one or mor
under  e pr
under the  ofessional group, associated with a
budget saving elsewhere
5. Where FTE reductions in one or more professional group are agreed, these roles are removed from
the organisational structure, subject to relevant HR processes
6. Outcomes are reported to the regional governance group monthly to ensure savings are being
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7. A final report is presented to the regional governance group following the agreed savings
achievement date to confirm delivery of savings

Definitions
Definition
Earned Autonomy
Delegation within a set of business rules to approve recruitment that is;
• Affordable
• Within a determined reducing FTE to achieve a defined target FTE
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Budget FTE
FTE numbers in budget (less savings target – to be c
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Paid FTE
Hours paid converted to an FTE figure the
Accrued FTE
Accrued FTE is Paid FTE plus leave accrual adjustments
Outsourced FTE
Non- employed staff e.g. locums, agency, contracted roles, often paid at a premium rate
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Contracted FTE
The total FTE currently in post
Sinking Lid
The total FTE a manager is allowed to recruit up to with earned autonomy. This is the target
Recruit to FTE
FTE with the sinking lid reduction applied, plus any exits, less any new hires for that period
target
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From:
Margie Apa
To:
Lester Levy; lester.levys 9(2)(a)
Subject:
Fwd: Follow up from GDO / Clinical Lead hui
Date:
Tuesday, 13 August 2024 3:10:17 pm
Attachments:
image001.png
see below and group its gone to
From: Charlotte Long <[email address]> on behalf of Fionnagh
Dougan <[email address]>
Sent: Tuesday, August 13, 2024 1:39 PM
To: Andrew Boyd <[email address]>; Christine Lowry [WaikatoDHB]
<[email address]>; Mark Shepherd (WDHB)
<[email address]>; Richard Sullivan
<[email address]>; Russell Simpson
<[email address]>; Tui Vito <Tui.Vito@middlemore co.nz>; Joanna
Lusk <[email address]>; Alex Pimm (NDHB)
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<[email address]>; Brad Healey (WDHB)
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<[email address]>; Michael Shepherd (ADHB)
<[email address]>; Vanessa Thornton (CMDHB)
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<[email address]>; Michelle Sutherland [WaikatoDHB]
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<[email address]>; Pauline McGrath – [Hauora a Toi Bay of
Plenty] <[email address]>; Alan Wilson [Lakes]
the
<[email address]>; John Swiatczak [Tairawhiti]
<[email address]>; Katy Sheffield [Te Whatu Ora Taranaki]
<[email address]>; Paula Jones – [Hawke's Bay] <[email address]>;
Sarah Fenwick-EXT <[email address]>; Katherine Fraser-Chapple –
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Te Whatu Ora - Whanganui <[email address]>; Jamie Duncan
under the
[CCDHB] <Jamie.Duncan@ccdhb org.nz>; Kieran McCann [WrDHB]
<[email address]>; Lexie O'Shea [Nelson Marlborough]
<[email address]>; Rachel Mills - SC <[email address]>; Hamish
Brown [Southern] <[email address]>; Philip Wheble-EXT
<[email address]>; Elizabeth Jeffs Middlemore
<[email address]>; Margie Apa <[email address]>;
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[email address] <[email address]>; Andrew
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McKinnon <[email address]>; Frank van Ham
<[email address]>; Andy Hilton - SC <[email address]>;
Andre Cromhout [CCDHB] <[email address]>; Andrew Connolly (CMDHB)
<[email address]>; Anil Nair [Tairawhiti] <[email address]>;
Benjamin Pearson – [Hawke's Bay] <[email address]>; Brendan Marshall
[Te Tai o Poutini] <[email address]>; Carl Eagleton (ADHB)
<[email address]>; Cecilia Smith Hamel - SC <[email address]>; David Gow
[Southern] <[email address]>; Gerrie Snyman [Lakes]
<[email address]>; Greg Simmons-EXT <[email address]>;
Jennifer Walker (NDHB) <[email address]>; Johan Peters
[Tairawhiti] <[email address]>; Jonathan Christiansen (WDHB)

<[email address]>; Julia Carr [WaikatoDHB]
<[email address]>; Kate Grimwade – [Hauora a Toi Bay of Plenty]
<[email address]>; Kelvin Billinghurst [MidCentral]
<[email address]>; Lara Hopley
<[email address]>; Lisa Williams [Te Whatu Ora Taranaki]
<[email address]>; Margaret Fisher [WaikatoDHB]
<[email address]>; Maria Poynter
<[email address]>; Martin Thomas <[email address]>;
Matthew Wheeler – [Hauora a Toi Bay of Plenty] <[email address]>;
Nathalie de Vries – Te Whatu Ora - Whanganui <[email address]>; Richard
French [Waitaha] <[email address]>; Steve Low [Nelson Marlborough]
<[email address]>; Steven Earnshaw [3DHB]
<[email address]>; William Weiderman [Tairawhiti]
<[email address]>; Nick Baker [Nelson Marlborough]
<[email address]>; Nicole Pihema <[email address]>;
Murray Patton <[email address]>; Nadine Gray 1982
1982
<[email address]>; Sue Waters (ADHB) <[email address]>; Nina
Scott <[email address]>; Carlton Irving <[email address]>;
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Jenny Parr (CMDHB) <[email address]>; Rosalind Jackson – [Hauora a Toi
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Bay of Plenty] <[email address]>; Yvonne Stillwell [MidCentral]
<[email address]>; Sue Hayward [WaikatoDHB]
the
<[email address]>; Jane Wilson [Southern]
<[email address]>; Karyn Bousfield – [Hawke's Bay]
<[email address]>; Sandy McLean-Cooper [Nelson Marlborough]
<[email address] nz>; Maurice Chamberlain – Te Whatu Ora -
Whanganui <[email address]>; Diana Fergusson [Te Whatu Ora
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Taranaki] <[email address]>; Maree Sheard (NDHB)
<[email address]>; Kate Gilmour (WDHB)
<[email address]>; Becky Hickmott [Waitaha]
<[email address]>; Gary Lees [Lakes] <[email address]>;
Serita Karauria [Tairawhiti] <[email address]>; Claire Jennings [HVDHB]
<[email address]>; Phill Halligan [WrDHB]
<[email address]>; Brenda Close – [Hauora a Toi Bay of Plenty]
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<[email address]>; Anna Wheeler - SC <[email address]>;
Margaret Dotchin (ADHB) <[email address]>
Cc: Andy Windsor <[email address]>; Charles Tutagalevao
<[email address]>; Duncan Bliss
<[email address]>; Joanne Gibbs
<[email address]>; Karla Bergquist
<[email address]>; Kate Coley <[email address]>;
Laura Aileone <[email address]>; Mary Cleary-Lyons <Mary.Cleary-
[email address]>; Rachel Haggerty <[email address]>;
Sally Dossor <[email address]>; Andrew Nwosu – [Hawke's Bay]
<[email address]>; Nicky Rivers-EXT

<[email address]>; Gabrielle Scott [MidCentral]
<[email address]>; Jennifer de_Ridder [CCDHB]
<[email address]>; Louise Allsopp-Ext <[email address]>;
Tamzin Brott (WDHB) <[email address]>; Sanjoy Nand (CMDHB)
<[email address]>; Geoff Goodwin (WDHB)
<[email address]>; Hannah McCarrison
<[email address]>; Claire Tahu [WaikatoDHB]
<[email address]>; Alicia Scott – [Hawke's Bay]
<[email address]>; Kendra Sanders <[email address]>;
Ngaire Buchanan <[email address]>; Joe Monkhouse [Lakes]
<[email address]>; Hilary Exton-EXT <[email address]>;
Kaye Hudson-Ext <[email address]>; Jo Wright (Nursing Director) (ADHB)
<[email address]>; Robert Gerrie [Nelson Marlborough]
<[email address]>; Nina Scott [WaikatoDHB]
<[email address]>; Susan Wood <[email address]>;
Sarah Clarke <[email address]>; Alison Sarginson [Waitaha]
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<[email address]>; Andrew Slater
<[email address]>; Luke Gillespie [Waitaha]IA
<[email address]>; Laurie Edwards
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<[email address]>; Andrew Ellis-EXT
<[email address]>; Kelly Orrell-EXT <[email address]>;
the
craig green-EXT <[email address]>; simon barrett-EXT
<[email address]>; Roger Huntington [Tairawhiti]
<[email address]>; Georgina Watt – [Hauora a Toi Bay of Plenty]
<[email address]>; Tania Kelly-EXT <[email address]>; David
Green <[email address]>; David Warrington – [Hawke's Bay]
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<[email address]>; Nicolas Harrison – [Hauora a Toi Bay of Plenty]
<[email address]>; Sarah Jackson <[email address]>;
Jacqui Lunday Johnstone [Waitaha] <[email address]>; Rene
Templeton - SC <[email address]>; Prue Beams [Waitaha]
<[email address]>; Geoff Goodwin <[email address]>;
Sarah Fenwick [MidCentral] <[email address]>; Sandy Clemett-EXT
<[email address]>; Margie Apa <[email address]>;
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Frank van Ham <[email address]>
Subject: Follow up from GDO / Clinical Lead hui
Kia ora koutou
Thanks for attending the hui this morning. You were provided with some information aimed
at sharing some thinking about how we will work to stay within budget within HSS. It was
an indicative model only. It does not reflect a decision or detailed plans. There is more
work to do – as we discussed – at regional and local levels to review how we provide
services and organise care with the resources we have.

As Margie has confirmed this morning, HSS and the funded sector are the only groups that
will be receiving additional funding uplift.
We are holding funds to address clinical and safety risks, as they are escalated.  These are
bottom lines for us and will remain so.
We will continue to prioritise clinical patient-facing roles, new and replacement, that are
within the budgets we have.
Please keep working with your Regional Directors and Clinical Leaders.
Thanks to all of you for your leadership and support.
Ngā mihi
Fionnagh
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Fionnagh Dougan
Nationa  Director – Hospita  and Specia ist Services
waea pūkoro: s 9(2)(a)
| īmēra: fionnaghdougan@tewhatuoragovtnz IA
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the
Hea th New Zea and   Te Whatu Ora
At Health New Zealand | Te Whatu Ora we value flexible working. Regardless of when you receive this
email, I do not expect a response outside of your normal working hours.
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From:
Margie Apa
To:
Lester Levy; [email address]
Subject:
Budget Incident
Date:
Wednesday, 14 August 2024 12:34:55 pm
This email expresses my disappointment at the leaking of budget information that was wrong.  I
also apologise for not taking your advice and writing a response to the organisation that clarify our
position and relying on accountable leaders to own the problem.  To understand what happened I
have spoken to Mark Shepard who chaired, Jo Lusk who presented, Richard Sullivan who
normally attends those meetings.  At the time of writing this email I hadn’t connected with
Fionnagh by phone as we have missed each other. I also tracked back from my emails to check
my own instructions to the team on budget process.
The meeting is a regular weekly HSS stand up that is chaired by the National Director and invites
Regional Directors, local hospital Directors, CMOs, DoNs, DAHs and finance people.  It has
evolved from a focus on financials and recruitment and now seems to drift.   have had feedback
from local leaders that its purpose is not clear and the information does not always add value to
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their work.  I don’t normally attend but chose to last week 6th August and this week as observer
given leadership transitions.
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The background to events are:
A slide was shared by Finance presentation at 13th August Tuesday 8am weekly HSS stand
up.  The slide was part of agenda item that was updating on budgets.  The slide applied a
the
formula to expenditure lines including FTEs that showed a scale of reduction that would be
required to meet budget.  This was meant to be illustrative, not presented as final
decisions;
The meeting was Chaired by Mark Shepard who tells me he was asked to step in as chair
the day before at Fionnagh’s request, hadn’t seen an agenda or the slides to be presented;
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The slide was presented by Jo Lusk was asked to step in at the last minute Andrew Boyd
was on leave.  She believed that the information was okay to present because HSS
leadership had been working on finalising details week beg 5th  August through a series of
workshops and the RDs had been engaged and had spoken with their local teams on the
implications;
The slide was not a decision, I hadn’t seen it before it was presented.
I was copied a slide pack on 2nd August that instructed team to hold until they had walked
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me through it.  I haven’t opened it (still unread) but I understand this slide was in that pack.
I rang Andrew Boyd on the 6th August and told him to organise a 2 hour session in my diary
to be briefed on HSS budget in detail 8th or 9th August.  This didn’t happen and I forgot to
follow up to get it scheduled when I didn’t see it in my diary.  This would have exposed to
me the models and I would have intervened ahead of Tuesday.
Other discussion points fyi at the meeting were:
What is process and decision making for impact on clinical services and process for
escalating and managing risk to which I replied we are holding a risk reserve and Richard
Sullivan’s office is escalation point and requires evidence of risk
Need for more regional visibility and local decision making on issues that matter most for

delivery and are likely to be more cost effective to which I and Mark confirmed the intent of
Reg Dep CEOs will have wider delegations and authority. I said it is important that regional
commissioners are more proactive on community-based demand management initiatives
that make a difference for hospital front door
Challenge on how budgets are devolved so that there is autonomy at the right levels i.e.
Regions or local GDOs may prefer to allocate savings and revenue differently across
divisions and services.  I agreed.
Actions I am/have taken:
Mark Shepard as Chair of the meeting Tuesday is issuing a message to meeting attendees
to clarify the status of the information that was presented as wrong and not decisions;
Fionnagh finishes on Monday and I am confirming today transition of accountabilities for
HSS.  Today I am concluding the consultation process and shifting reporting lines for
hospital GDOs and regional commissioners with instructions on priorities effective from
Monday including plans to support budget, National Health Targets.  This gives me
accountable people whom will take responsibility for budgets and actions to get back to
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budget;
I have instructed Richard Aldous and Regional Directors today to finalise how we delegate
budgets down to hospital, divisional and service level with judgement on how far down
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they should manage being a local and regional decision not finance and delete the content
on FTE reductions and leave to planning;
I am finalising the paper to your next Commissioner meeting to sign off budget with caveats
the
to access contingency/risk reserve if we encounter risks;
Delete the scenarios that finance have presented from our work.
In hindsight, I should have sent an email quickly to respond to the status of this information. I was
focused on ELT meeting yesterday to confirm budget and flush out risks in implementation.
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s 9(2)(g)(i)
I hope this clarifies what happened and am happy to discuss.
Nga mihi, Margie.
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From:
Mark Shepherd (WDHB)
To:
Margie Apa
Subject:
FW: Weekly GDO and Clinical Lead Forum- fyi
Date:
Wednesday, 14 August 2024 6:35:00 pm
fyi
Mark Shepherd
Regional Director, Hospital & Specialist Services
Northern Region
waea pūkoro: s 9(2)(a)
| īmēra: [email address]
124 Shakespeare Road, Takapuna
From: Mark Shepherd (WDHB)
Sent: Wednesday, 14 August 2024 6:35 pm
To: Fionnagh Dougan <[email address]>; Andrew Boyd
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<[email address]>; Christine Lowry [WaikatoDHB]
<[email address]>; Mathew Parr <[email address]>;
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Richard Sullivan <[email address]>; Russell Simpson
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<[email address]>; Tui Vito (CMDHB) <[email address]>;
Stephen Clarke1 <[email address]>; Joanna Lusk
<[email address]>; Alex Pimm (NDHB) <[email address]>;
the
Brad Healey (WDHB) <[email address]>; Michael Shepherd (ADHB)
<[email address]>; Vanessa Thornton (CMDHB)
<[email address]>; Michelle Sutherland [WaikatoDHB]
<[email address]>; Pauline McGrath – [Hauora a Toi Bay of Plenty]
<[email address]>; Alan Wilson <[email address]>; John
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Swiatczak [Tairawhiti] <[email address]>; Katy Sheffield [Te Whatu Ora Taranaki]
<[email address]>; Paula Jones – [Hawke's Bay] <[email address]>; Sarah
Fenwick-EXT <[email address]>; Katherine Fraser-Chapple – Te Whatu
Ora - Whanganui <[email address]>; Jamie Duncan [CCDHB]
<[email address]>; Kieran McCann [WrDHB]
<[email address]>; Lexie O'Shea [Nelson Marlborough]
<[email address]>; Rachel Mills - SC <[email address]>; Hamish Brown
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[Southern] <[email address]>; Philip Wheble
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<[email address]>; Elizabeth Jeffs (CMDHB)
<[email address]>; Margie Apa <[email address]>; Geoff
Goodwin (WDHB) <[email address]>; Andrew McKinnon
<[email address]>; Frank van Ham
<[email address]>; Andy Hilton <[email address]>; Andre
Cromhout [CCDHB] <[email address]>; Andrew Connolly (CMDHB)
<[email address]>; Anil Nair [Tairawhiti] <[email address]>; Benjamin
Pearson – [Hawke's Bay] <[email address]>; Brendan Marshall [Te Tai o
Poutini] <[email address]>; Carl Eagleton (ADHB) <[email address]>;
Cecilia Smith Hamel - SC <[email address]>; David Gow [Southern]
<[email address]>; Gerrie Snyman [Lakes]
<[email address]>; Greg Simmons (Taranaki DHB)

<[email address]>; Jennifer Walker (NDHB)
<[email address]>; Johan Peters [Tairawhiti] <[email address]>;
Jonathan Christiansen (WDHB) <[email address]>; Julia Carr
[WaikatoDHB] <[email address]>; Kate Grimwade
<[email address]>; Kelvin Billinghurst [MidCentral]
<[email address]>; Lara Hopley <[email address]>;
Lisa Williams [Te Whatu Ora Taranaki] <[email address]>; Margaret Fisher
[WaikatoDHB] <[email address]>; Maria Poynter
<[email address]>; Martin Thomas <[email address]>;
Matthew Wheeler – [Hauora a Toi Bay of Plenty] <[email address]>; Nathalie de
Vries – Te Whatu Ora - Whanganui <[email address]>; Richard French [Waitaha]
<[email address]>; Steve Low <[email address]>; Steven Earnshaw
[3DHB] <[email address]>; William Weiderman [Tairawhiti]
<[email address]>; Nick Baker [Nelson Marlborough]
<[email address]>; Nicole Pihema <[email address]>; Murray
Patton <[email address]>; Nadine Gray
<[email address]>; Sue Waters (ADHB) <SWaters@adhb govt.nz>; Nina Scott
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<[email address]>; Carlton Irving <[email address]>; Jenny Parr
(CMDHB) <[email address]>; Rosalind Jackson – [Hauora a Toi Bay of Plenty]
<[email address]>; Yvonne Stillwell [MidCentral] IA
<[email address]>; Sue Hayward
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<[email address]>; Jane Wilson [Southern]
<[email address]>; Karyn Bousfield – [Hawke's Bay]
the
<[email address]>; Sandy McLean-Cooper [Nelson Marlborough]
<[email address]>; Maurice Chamberlain – Te Whatu Ora - Whanganui
<[email address]>; Diana Fergusson [Te Whatu Ora Taranaki]
<[email address]>; Maree Sheard (NDHB) <[email address]>;
Kate Gilmour (WDHB) <[email address]>; Becky Hickmott [Waitaha]
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under
<Rebecca.Hickmott@cdhb.health nz>; Gary Lees [Lakes] <[email address]>; Serita
Karauria [Tairawhiti] <[email address]>; Claire Jennings [HVDHB]
<[email address]>; Phill Halligan [WrDHB]
<Phill.Halligan@wairarapa dhb.org.nz>; Brenda Close – [Hauora a Toi Bay of Plenty]
<[email address]>; Anna Wheeler - SC <[email address]>; Margaret
Dotchin (ADHB) <[email address]>
Cc: Andy Windsor <[email address]>; Charles Tutagalevao
<[email address]>; Duncan Bliss
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<[email address]>; Joanne Gibbs <[email address]>;
Karla Bergquist <[email address]>; Kate Coley
<[email address]>; Laura Aileone <[email address]>; Mary
Cleary-Lyons <[email address]>; Rachel Haggerty
<[email address]>; Sally Dossor <[email address]>;
Nils Moeys <[email address]>; Andrew Nwosu – [Hawke's Bay]
<[email address]>; Nicky Rivers-EXT <[email address]>;
Gabrielle Scott [MidCentral] <[email address]>; Jennifer de_Ridder
[CCDHB] <[email address]>; Louise Allsopp-Ext
<[email address]>; Tamzin Brott (WDHB) <[email address]>;
Sanjoy Nand (CMDHB) <[email address]>; Hannah McCarrison
<[email address]>; Claire Tahu [WaikatoDHB]

<[email address]>; Alicia Scott – [Hawke's Bay]
<[email address]>; Kendra Sanders <[email address]>; Ngaire
Buchanan <[email address]>; Joe Monkhouse [Lakes]
<[email address]>; Hilary Exton <[email address]>; Kaye
Hudson-Ext <[email address]>; Jo Wright (Nursing Director) (ADHB)
<[email address]>; Robert Gerrie [Nelson Marlborough]
<[email address]>; Nina Scott [WaikatoDHB]
<[email address]>; Susan Wood <[email address]>; Sarah
Clarke <[email address]>; Alison Sarginson [Waitaha]
<[email address]>; andrew.slater <[email address]>; Luke
Gillespie [Waitaha] <[email address]>; Laurie Edwards
<[email address]>; Andrew Ellis-EXT
<[email address]>; Kelly Orrell-EXT <[email address]>;
Craig.Green <[email address]>; Simon Barrett (TDHB) <simon.barrett@tdhb org.nz>;
Roger Huntington [Tairawhiti] <[email address]>; Georgina Watt – [Hauora a Toi
Bay of Plenty] <[email address]>; Tania Kelly (Southern Canterbury DHB)
<[email address]>; David Green <[email address]>; David Warrington –
1982
1982
[Hawke's Bay] <[email address]>; Nicolas Harrison – [Hauora a Toi Bay of
Plenty] <[email address]>; Sarah Jackson <[email address]>;
Jacqui Lunday Johnstone [Waitaha] <[email address]>; Rene
IA
Templeton - SC <[email address]>; Prue Beams [Waitaha]
OIA
<[email address]>
Subject: RE: Weekly GDO and Clinical Lead Forum- fyi the
Kia Ora Team
As most of you would be aware , the GDO and Clinical Lead Forums were set up as a short
term way to connect across the system on our financial and recruitment challenges. Can I
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thank you for the continued participation, energetic discussion and focus on solutions.
Further yesterday was the last meeting in the series, as our system looks to reset with the
new Deputy Chief Executive roles of our regions ,commencing in at least two regions next
week ( Northern and Te Manawa Taki) we will need to decide as a priority the ongoing
purpose of this style of meeting , the scope , attendance and standing items to continue to
connect across the motu.
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As the rotating chair of yesterday’s meeting I do need to apologise for the concern raised
by the budget presentation which was shared that represented a finance model that was
not approved or decided as final. We ask that you do not share this information as it is not
representative of the decisions we will need to take as regions, districts and as local
teams.  I need to reinforce that while our Finance colleagues have modelled costs based
on formulaic assumptions,  it is our job in operations to make the necessary decisions to
work within budgets.
We are all aware of the challenge we face of living within budgets and in particular, doing
this while preserving clinical frontline services and managing clinical and safety risks.   We
are working with Finance directly this week to confirm budgets.   While these numbers will

be challenging there were also opportunities that colleagues raised we should take that
include getting the balance better between local and national decision making.
One of the opportunities I will take with my peer Regional Deputy CEs is to ensure we look
to devolve the decision-making rights to allocate and prioritise within our districts and
regions, ensuring we are working alongside you and your teams.
Finally, while it may be a number of weeks away we will look to reset this weekly meeting
once Deputy CEs are on board to ensure it adds value to your work, your feedback on what
are useful agenda topics would be welcome.
Appreciated.
Mark
Mark Shepherd
1982
1982
Regional Director, Hospital & Specialist Services
Northern Region
IA
OIA
waea pūkoro: s 9(2)(a)
| īmēra: [email address]
124 Shakespeare Road, Takapuna
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Released
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