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Questions and Answers on the Revised Health and Disability Services Standards 2008

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1. What comprises the Health and Disability Services Standards 2008?

There are a total of 57 Standards:

43 Core Standards
8 Restraint Minimisation and Safe Practice Standards
6 Infection Prevention and Control Standards.

The revised Health and Disability Services Standards 2008 are made up of four sets of Standards:

NZS 8134.0:2008 Health and Disability Services (General) Standard
NZS 8134.1:2008 Health and Disability Services (Core) Standards
NZS 8134.2:2008 Health and Disability Services (Restraint Minimisation and Safe Practice) Standards
NZS 8134.3:2008 Health and Disability Services (Infection Prevention and Control) Standards.

View the Health and Disability Services Standards 2008.

2. When do the 2008 Standards come into force?

The Health and Disability Services Standards 2008 were gazetted on 2 October 2008. The Standards come into force on 1 June 2009.

3. What do the 2008 Standards replace?

They replace the four groups of Standards that made up the Health and Disability Standards 2001:

NZS 8134:2001 Health and Disability Sector Standards
NZS 8141:2001 Restraint Minimisation and Safe Practice
NZS 8142:2001 Infection Control
NZS 8143:2001 National Mental Health Sector Standard

4. Have the Standards completely changed?

Of the 57 Standards contained in the Health and Disability Services Standards 2008, there are 2 new Standards (and their associated criteria) and 7 separate new criteria.

In the main, changes involve updates or amendments designed to reduce duplication in the Standards and provide greater clarity and consistency.

Feedback received from stakeholders during the consultation process indicated there was widespread support for:

less duplication in the Standards
more clarity around some requirements, and
greater consistency.

The resulting Health and Disability Services Standards 2008 are largely revised standards rather than new standards and are focused on outcomes for consumers. The Mental Health requirements have been absorbed into other service standards so that the Health and Disability Services Standards 2008 now incorporate the National Mental Health Sector Standard 2001.

Providers who are compliant with the current Standards can anticipate that they will have few issues becoming compliant with the revised Standards.

5. What current Standards have been updated or amended?

There have been some updates and amendments to the Standards covering Consumer Rights, Organisational Management, Service Delivery, Infection Control and Mental Health.

6. What is new in the 2008 Standards?

The 2 new Standards are:

NZS 8134.1.3 Continuum of Service Delivery
1.3.11 Use of Electroconvulsive Therapy (ECT): Consumers who are administered electroconvulsive therapy are well informed and receive it in a safe manner.
(This only applies to mental health services which provide ECT).

Restraint Minimisation and Safe Practice Standard
NZS 8134.2.1.1 Restraint Minimisation: Services demonstrate that the use of restraint is actively minimised.
(The Restraint Standard has changed in line with requests from the aged care and mental health sectors for services to practice ‘restraint free’ whenever possible).

The 7 new criteria are:

NZS 8134.1.1 Consumer Rights
1.1.7.1 Discrimination: services have policies and procedures to ensure consumers are not subjected to discrimination, coercion, harassment and sexual or other exploitation.
(The Consumer Rights Standard is a legal requirement under the Human Rights Act 1993)

1.1.7.3 Professional boundaries: service providers maintain professional boundaries and refrain from acts or behaviours which could benefit the provider at the expense or well-being of the consumer.

(This a legal requirement in the Crimes Act 1961 for non-health practitioners and codes of practice for health practitioners)

1.1.9.1 Full and open disclosure: consumers have a right to full and frank information and open disclosure from service providers.

1.1.11.3 Staff advocacy education: service providers are educated to recognise the right (of consumers) to have an advocate/support person present and identify and appropriately address situations where an advocate/support person is not possible or appropriate.

NZS 8134.1.2 Organisational Management
1.2.4.4 Adverse event reporting/open disclosure policy: adverse, unplanned and untoward events are addressed in an open manner through an open disclosure policy.

NZS 8134.1.4 Safe and Appropriate Environment
1.4.2.7 Policies and procedures for vehicle transport: where a consumer is required to be transported by vehicle, there are policies and procedures that minimise risk.

NZS 8134.3:1 Infection Prevention and Control

NZS 8134.3.1.5 Infection Control Management
There is a defined process for gaining infection control / infectious disease / microbiological advice and support, where this is not available within the organisation.

7. Is there information available which compares the current Standards with the revised Standards?

The Ministry of Health has mapped the current Standards to the revised Standards and has sent this information to all certified health care services providers and the Designated Auditing Agencies. View the Comparison of the 2000/2001 Standards and the 2008 Standards.

8. Why were the Health and Disability Standards 2001 revised?

The Minister of Health is required to review the Health & Disability Services Standards (“The Standards”) at least every four years. The aim of the latest review was to reduce duplication in the Standards and provide greater consistency and clarity.

9. How was the review conducted?

The review process began with an informal review in 2005, followed by a formal review in 2008. As part of the 2008 review process, Standards New Zealand, working on behalf of the Ministry of Health, convened an expert committee, made up of representatives from the sector, to review and update the Standards.

10. What was the result?

The revised sector-agreed Health and Disability Services Standards 2008 are the result of three years extensive collaboration with many groups including consumers, providers, government and non-government agencies and the Ministry of Health.

The Standards are clearer, more up to date, better reflect the concerns of the sector and are structured in a way that will make them easier to review in the future

11. What is the purpose of the Health and Disability Services Standards?

The health and disability standards support the safe provision of services to consumers and set the minimum standard for rest homes hospitals and providers of residential care. The standards are mandatory for providers of health care services that are subject to the Health and Disability Services (Safety) Act 2001. This includes rest homes, hospitals and those providers of residential disability care that have five or more residents. The standards are designed to establish safe and reasonable levels of service for consumers and reduce the risk of harm. They are minimum standards and as such, some providers will exceed these. For example, most new residences for elderly people have rooms with ensuites although this is not required, Areas covered by the standards include:

Consumer rights
Organisational management
Service delivery
Safe and appropriate environments
Infection control
Restraint Minimisation.

12. Do health care services providers need to comply with all the Standards?

Health and disability services that are required to be certified under the Health and Disability Services (Safety) Act 2001 must comply with all relevant Standards.

There are three exceptions for compliance with a Standard:

where the Minister has granted an exemption to a provider; OR
where the Standard specifies it applies only to some health or disability services, e.g.
- Intellectual disability services;
- Mental health and addiction services;
- Acute, secondary, or tertiary services; OR
where the service can demonstrate that the Standard is not relevant to the service and therefore does not apply.

13. How should the statements in the Standards be interpreted?

The broad diversity and uniqueness of the health and disability sector has necessitated the use of generic phrases and terminology throughout the Standards. It is not the intention however, to standardise terminology throughout the different parts of the health and disability sector.

Rather, it is expected that each service provider will interpret the intent of the statements used in the Standards in the context of the services they provide.
For example, there may be different requirements for communal areas depending on the setting, the consumer groups and services provided (Core Standard 4.5).

14. Is there guidance on how to meet the criteria for each Standard?

Health and disability services that are required to be certified under the Health and Disability Services (Safety) Act 2001 must comply with all relevant Standards. The exceptions are noted above (question 10).

General guidance on how to meet the criteria for each Standard is included throughout the revised Standards document. The guidance is prefixed by the letter “G”. The general guidance provides examples to help with the interpretation of the criteria for each Standard. However, the examples are a guide only, and do not necessarily include all methods that could be used to meet the criteria for each Standard.

15. What are the implications for certification of health care services providers?

To gain certification (Health and Disability Services (Safety) Act 2001 section 27 (1) (c)) the Director-General of Health must be satisfied that the health care services provider meets the relevant Service Standards that (i) are already in force; or (ii) will be in force on the day on which the notice takes effect.

This means:

providers whose certifications expire before 1 June 2009 must be audited on the current Standards
providers whose certifications expire on or after 1 June 2009 must be audited on the revised Standards.

Therefore, providers whose certifications are due to expire on or after 1 June 2009 need to be prepared to be audited on the revised Standards.

16. What are the implications for other audits and reports on providers?

All surveillance audits due on or after 1 June 2009, must be conducted on the revised Standards.
Progress reports required as a condition of certification relate to the Standards in force at the time of certification.

17. Where can I purchase copies of the revised Standards?

Copies of the revised 2008 Standards are available from Standards New Zealand (www.standards.co.nz). You can also view and download the standards in the Introduction of the Health and Disability Services Standards 2008 section - View the Health and Disability Services Standards 2008.

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Page last updated: 6 March 2009