Who's involved - Service Planning and New health Intervention Assessment (SPNIA)

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Service Planning and New Health Intervention Assessment (SPNIA)
Who's involved?

Information on the groups involved in the SPNIA process is provided below. More detailed information can be found in the SPNIA Framework document.

DDG-CEO Group

The DDG-CEO Group governs NSTR. The group has met bi-monthly since 2003 and comprises five DHB CEOs and five Ministry of Health DDGs. The recommendations of NSTR must be endorsed by the DDG-CEO Group.

The DDG-CEO Group is responsible for:

resolving key national strategic operational matters
making decisions on national service matters, new health interventions, cost effectiveness and related principles
ensuring advice is available to the National Capital Committee on regional and national clinical service planning where appropriate.

NSTR was intended to be governed by the DDG-CEO group. This group is in abeyance because it has been functionally superseded by meetings of all District Health Board (DHB) Chief Executive Officers (CEOs) and the Ministry of Health’s Executive Leadership Team (ELT). NSTR is referring its recommendations on all national SPNIA business cases to the DHB CEOs Group and the Ministry's ELT in the interim.

National Service and Technology Review Subcommittee (NSTR)

NSTR is governed by the DDG-CEO Group. It is responsible for horizon scanning, co-ordinating business case development, and analysing and evaluating proposals for change and business cases. It makes recommendations to the DDG-CEO Group on national service matters and new health interventions that have a national impact.

View more information on the NSTR in the What is SPNIA? section.

Ministry of Health

The Ministry of Health provides secretariat and analytical support for NSTR and DDG-CEO group, and assists DHBs to establish the overall SPNIA framework.

They:

provide strategic policy advice to stakeholders such as regional DHB groups and clinical experts regarding service planning and new intervention assessment
act as a key point of contact, champion the SPNIA framework and facilitate its introduction and proper use
horizon scan and maintain a register of new health interventions and potential disinvestments
maintain a register of previous NSTR recommendations and DDG-CEO decisions
co-ordinate sharing of regional service forum work plans
collate proposals for change for NSTR
collate business cases for consideration by NSTR
facilitate and contribute to the analysis of and recommendations regarding proposals for change and business cases for NSTR
advise on budget decisions regarding evidence analysis and evaluation of business cases.

District Health Boards

DHBs use local DHB structures to scanning the horizon and act as the DHB’s gatekeeper of proposals for change.

These local structures:

horizon scan for new health interventions that should be subject to a formal assessment
horizon scan for services and health interventions that are obsolete, ineffective or inadequate and therefore exit or cessation should be considered
refer results of horizon scans to the regional forum and NSTR if they relate to regional or national matters
refer matters with flow-on or precedent-setting effects to the regional forum
be the DHB-level gatekeeper on service change and new health interventions.

Each DHB makes its own decisions on new health interventions or new health services where the critical mass of patients required for the process or service to be viable will be resident within the DHB’s boundaries.

DHBs also provide analytical support for NSTR evaluation of proposals for change and business cases and their expertise is required to develop and take responsibility for writing business cases.

It is important that the potential impacts of an individual DHB’s decision on other DHBs are addressed. If a DHB makes a decision that has a flow-on or precedent-setting effect that cannot be agreed directly with the DHBs affected, then the regional forum or NSTR will have jurisdiction. Local structures must therefore take precedent-setting impacts into account when considering a matter, and may choose to refer a matter on to the regional forum, which will consider referral to NSTR if it has national impacts.

Regional forums

Regional forums are responsible for ensuring optimal regional service configuration and considering new health interventions that have a regional or national impact. They are also responsible for assisting with the analytical support required to complete proposals for change and full business cases.

Regional forums agree on which proposals from their region should be forwarded to NSTR and agree their annual work plan.

The role of regional forums is to:

enable DHBs to deliver a sustainable, clinically viable and cost-effective regional configuration of health services and the introduction of new interventions
horizon scan for new health interventions that should be subject to a formal assessment
horizon scan for services and health interventions that are obsolete, ineffective or inadequate and therefore exit or cessation should be considered
collaborate with Regional Capital Committees to ensure that the development of business cases is closely linked with regional and national service planning
provide analytical support to assist in the preparation of proposals for change and business cases for the introduction of service changes and new interventions with regional or national impacts (this resource will be considered as a national resource and will therefore be made available to contribute to the development of proposals or business cases that are not being led by the regional forum’s home region)
be the regional-level gatekeeper for service change and new health interventions proposals.

Regional forums are accountable to the DHBs in their region, and make recommendations to those DHBs on regional matters. Individual DHB boards are responsible for making final decisions, drawing on the advice of the regional forums.

Other groups

Analytical support
Organisations such as Pharmac, the New Zealand Guidelines Group, New Zealand Health Technology Assessment and the National Health Committee provide analytical support for NSTR evaluation of proposals for change and business cases.

Expert subgroups
NSTR may invite people with expert knowledge on an issue to advise NSTR and take part in, but not vote on, NSTR discussions on that issue, subject to resolving conflicts of interest.

Sector consultation
The following groups are consulted during the SPNIA process:

Service Framework Group and Service Improvement Group
National CEO group
Regional and national Inter-District Flow (IDF) groups.

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Page last updated: 7 October 2008