Skills for integration

To date the following specific Integration skills have been developed to support integration in primary and community health in the Aotearoa New Zealand context:

• Team work and collaboration
• Integrated wellbeing planning, and coordination
• Working effectively in the primary health setting

These skills represent the current priorities identified by stakeholders. They will be refined and additional skills will be added over time, as the sector’s experience of integration deepens and we grow our shared understanding of workforce development needs.

The skills for integration are focussed on the knowledge and skills relevant to working in an integrated way, as a sub-set of the broader range of knowledge and skills required by those working in and with primary and community health services. The broader range of knowledge and skills are supported in other ways eg, professional competencies and codes, legal and regulatory frameworks and organisational policies and procedures.

Each skill comprises the following:

1. Intended outcome: this describes what we aim to achieve by applying the performance indicators associated with the skill.
2. Sub-headings: these differentiate components of the skill.
3. Indicators: offer examples of the knowledge and/or skills that apply to each sub-heading at different performance levels - essential and leadership.

The performance levels are categorised as follows:

• Essential level: applies to everyone regardless of role, profession or organisation.
• Leadership level: applies to those in leadership roles who can influence and support an effective integrated approach in primary and community health settings.

While workforce development activity can improve the knowledge, skills and capabilities of staff, organisational development supported by skilled leadership is vital. Without skilled leadership effective integration of services is unlikely. For this reason, this guidance includes indicators to support leadership, recognising the critical role of those who are in a position to influence and shape the structure, culture and climate of the primary or community health setting. It is acknowledged that this can extend beyond those in formal leadership roles.

The challenges for leadership include resolving many of the systemic issues that are known to create barriers for integrated service delivery. These include siloed funding arrangements, inadequate technology, lack of clarity about roles, confusion about the model of integration, poor understanding between different services and a lack of cultural leadership.