Implementing new forms of collaboration and participation in primary health care: leveraging past learnings to inform future initiatives

Lesley Middleton; Claire O’Loughlin; Tim Tenbensel; Pushkar Silwal; Marianna Churchward; Lynne Russell; Jacqueline Cumming

doi:10.1071/HC24026

RESEARCH ARTICLE (Open Access)

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Implementing new forms of collaboration and participation in primary health care: leveraging past learnings to inform future initiatives

Lesley Middleton

¹ ^* , Claire O’Loughlin ² , Tim Tenbensel

³ , Pushkar Silwal ³ , Marianna Churchward ² , Lynne Russell ² , Jacqueline Cumming ²

+ Author Affiliations

- Author Affiliations

¹ School of Health, Faculty of Health, Te Herenga Waka – Victoria University of Wellington, PO Box 600, Wellington 6140, New Zealand.

² Te Hikuwai Rangahau Hauora – Health Services Research Centre, Faculty of Health, Te Herenga Waka – Victoria University of Wellington, Wellington, New Zealand.

³ School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.

^* Correspondence to: lesley.middleton@vuw.ac.nz

Handling Editor: Felicity Goodyear-Smith

Journal of Primary Health Care 16(2) 198-205 https://doi.org/10.1071/HC24026

Submitted: 4 March 2024 Accepted: 18 April 2024 Published: 9 May 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Introduction

Within primary health care policy, there is an increasing focus on enhancing involvement with secondary health care, social care services and communities. Yet, translating these expectations into tangible changes frequently encounters significant obstacles. As part of an investigation into the progress made in achieving primary health care reform in Aotearoa New Zealand, realist research was undertaken with those charged with responsibility for national and local policies. The specific analysis in this paper probes primary health care leaders’ assessments of progress towards more collaboration with other health and non-health agencies, and communities.

Aim

This study aimed to investigate how ideas for more integration and joinedup care have found their way into the practice of primary health care in Aotearoa New Zealand.

Methods

Applying a realist logic of inquiry, data from semi-structured interviews with primary health care leaders were analysed to identify key contextual characteristics and mechanisms. Explanations were developed of what influenced leaders to invest energy in joined-up and integrated care activities.

Results

Our findings highlight three explanatory mechanisms and their associated contexts: a willingness to share power, build trusting relationships and manage task complexity. These underpin leaders’ accounts of the success (or otherwise) of collaborative arrangements.

Discussion

Such insights have import in the context of the current health reforms for stakeholders charged with developing local approaches to the planning and delivery of health services.

Keywords: Aotearoa New Zealand, care coordination, collaboration, consumer engagement, general practice, integrated care, localities, primary health care.

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