Focus area

Objective for area

  Actions and agencies responsible

  Progress made in 2022

  Planned activity for 2023


Area 1: Recognition

Recognising carers and their contributions


The work carers do will be identified and more recognised

1.1

MSD - Promote recognition of carers by government, employers, and the community as a distinct group with specific needs and whose contributions are valued

·      MSD - Contributed funding to various research projects and reports, such as The State of Caring in Aotearoa (see below), which helped promote recognition of carers and their needs.

·         There are no further actions.

1.2

MSD and Carers Alliance - Raise awareness of carers and how they can be supported

·         The Carers Alliance – Published The State of Caring in Aotearoa report, with funding support from Carers NZ, IHC, Alzheimers NZ, and MSD. The report and its recommendations were shared publicly and with government.

 

·         The Carers Alliance - Other research was produced in 2022, including a report from Infometrics updating the economic value and sacrifices of family caregiving in Aotearoa.

 

·         Carers New Zealand - An end of year survey was also undertaken by Carers NZ.  The survey provided an opportunity to check-in with carers and enable them to give input about their wellbeing as part of a pandemic evaluation, given that carers had to do more through COVID-19 due to disrupted services and lack of respite.

·         MSD - will publish a tool for policy practitioners about carers, their issues and policy.

 

·         Whaikaha - Now that Whaikaha has been established they will recognise carers in communications and information relevant to their role in supporting disabled people to live the life they choose.


Carers will be better supported with improved knowledge and information about caring

1.3

MSD - Create a fund to research the needs of carers and undertake research, including:

·         research on young, older, Māori, and Pacific carers

·         research into the barriers and impact for carers who work

·         research into the incidence and impact of family violence for carers.

·         MSD - Commissioned Auckland University of Technology to conduct a research project on this topic. A research proposal has been developed, ‘Creating safe spaces: understanding family carers’ experiences of violence’.

 

·         No further actions at this stage.

1.4

MSD and Carers Alliance - Improve data about carers through

·         opportunities to use existing data collection tools

·         supporting work to develop a tool to help identify young carers

·         MSD - Published the 2022 Youth Health and Wellbeing survey in October, which includes data on young people (12-18) who care for others.

 

·         The Carers Alliance - The Multidimensional Assessment of Caring Activities survey results were analysed. MACA is a United Kingdom survey adapted for the New Zealand context.

 

·         The State of Caring in Aotearoa report included data gathered from over 1600 carers which was used to provide insights into carers issues.

·         The Carers Alliance - A data report from the Multidimensional Assessment of Caring Activities survey will be finalised and shared.

1.5

MSD and Carers New Zealand - Support the inclusion of young carers in policy development

·         The Carers Alliance - Established a Young Carers NZ Leadership Group.

·         The Carers Alliance - While COVID-19 has disrupted opportunities to meet in 2023 there will be quarterly meetings. The Group’s aims are to provide a public face and voice for young carers and guide key policy and practical outcomes for this population.


Area 2: Navigating

Ensuring carers receive support and services


Carers will be better supported to access culturally safe and appropriate services

2.1

MoH - Identify and assess best-practice options for supporting people and their carers with the management of continence

·         Manatū Hauora[1] - Conducted a survey of district health boards’ continence services in 2021 and worked with Carers NZ in 2022 to prioritise the key findings.

 

·         Te Whatu Ora[2] - In 2022 progress on the continence services work was reported to senior leadership at the Manatū Hauora and Te Whatu Ora, with emphasis on the DHB Survey results and the alignment of these results with previous reports regarding continence services in Aotearoa New Zealand. Recommendations arising from these reports have been shared.

·         Te Whatu Ora -The focus is to establish a cross-agency working group to further respond to issues raised in the DHB survey of continence services and to contribute to development of strategic policy.

 

2.2

MoH, ACC, MSD and Carers Alliance - Strengthen navigation across all parts of the care and support system (including health, welfare, and ACC) to ensure carers are aware of, and supported to access, available assistance for themselves and those they care for.

·         Manatū Hauora - Following Budget 2021 funding digital health infrastructure and capability over four years including Hira (the national health information platform) work in this space is in progress. Hira (the national health information platform) community engagement plan commenced since 2021 is in progress. The Hira community engagement plan has a focus on establishing relations at a community level, a key priority group is Disability.

 

The focus in the quarter to December 2022 has been connection with key disability groups and peak bodies. Contact and relationships have been established with Chief Executives from Carers NZ, Disabled Person Assembly, NZ CCS, Workbridge Inc, NZ Disability Support, NASCs, Low Vision, NZ Citizen Blind, People First, Te Whatu Ora districts and Disability Action groups.

 

Further engagements have been held with Te Hiringa Mahara - Mental Health and Wellbeing Commission.

 

Patient Portal NHI Project Governance Group identified Disabled people and their access needs are currently invisible in health datasets. The cross-government representation of the project group include Te Whatu Ora, Whaikaha (MSD), Manatu Hauora, Te Aka Whai Ora and Hira (Disability – Business Partner). The Patient Portal NHI Project Governance Group are investigating funding resources to strengthen and support the outcomes of the project. 

 

·         MSD - Published a ‘A Quick Guide for Carers’ to complement the ‘Guide for Carers’ which is only available online. The guide includes information on a range of help available for carers.

 

·         ACC - Had responsibility for updating a number of information materials available to carers. Work commenced to update the resource ACC7116 Supporting People to Move at Home, which was funded by ACC but developed by Carers NZ and the Home and Community Health Association.

·         Te Whatu Ora - 2023 will see further work with the Carers Alliance and Carers NZ to ensure their requirements are understood and taken into consideration as whānau and community requirements are developed for Hira.

 

·         Whaikaha[3] - Has a significant interest and potential to influence navigation and information for carers in their support for disabled family members. An integral component of existing Enabling Good Lives (EGL) models is access to a ‘kaitūhono/connector’ to assist in goal setting, planning and service access.

 

·         Whaikaha - Will continue to strengthen the role of kaitūhono/connectors and improve the responsiveness of service pathways. Whaikaha aims to ensure that carers are aware of, and supported to access, available assistance for themselves and those they care for in relation to disability support services.

 

·         MSD - The Quick Guide is being sent to all service centres and groups in the community in 2023.

 

·         ACC’s is planning to connect with WorkSafe regarding updates to guidance for carers, including the ACC7116 Supporting People to Move at Home. Over time, the expertise required to update this and other resources has shifted between agencies, and ACC may need to outsource some of the updates required.

 

Given challenges in progressing ACC’s responsibilities under action 2.2 to date, it is timely to review the range of navigation and information supports ACC provides or funds, and revisit how ACC proposes to ensure these are fit-for-purpose in 2023 and beyond. This will need to include consideration not only of funding, but of how ACC engages and retains relevant expertise, and maintains focus on actions.

2.3

TPK - Identify whānau, aiga, and family-centred tools and initiatives to provide culturally safe and responsive approaches for Māori and Pacific carers and their whānau, aiga, and families

·         TPK - Has been working on whānau-centred policy tools to provide culturally safe and responsive approaches for Māori and Pacific carers and their whānau, aiga, and families. In Whiringa-ā-Rangi/November 2022 the Social Wellbeing Board endorsed the key concepts of whānau centred approaches and agreed to adopt them for implementation with social sector agencies under the Child and Youth Wellbeing Strategy.

·         Te Puni Kōkiri is currently working on the development of a revised tool to support agencies to implement whānau-centred approaches, building on the whānau-centred policy tool developed in 2019. This work is expected in early 2023.

 

Carers can take breaks from their care role

2.4

MoH and ACC - Improve the quality, accessibility and equity of services across New Zealand so carers can take breaks (including the flexible disability respite budgets – I Choose)

·        Te Whatu Ora - In Budget 2022 Government allocated $12 million over 4 years to begin testing improvements to supports for people with dementia - mate wareware, their whānau and carers, informed by priority action areas identified in the sector developed, Dementia Mate Wareware Action Plan.

Budget 2022 identified Māori, Pacific, rural and people with younger onset dementia as priority populations.  

The $12 million is allocated to the following initiatives:

1.      $2 million for four post diagnostic supports trials

2.      $3.2 million for the introduction of Dementia Navigators to coordinate post diagnostic supports and work with people with dementia - mate wareware, their whānau and carers in trial locations

3.      $4.4 million to trial innovative respite options for flexible and person-centred respite for carers

4.      $2.4 million to support providers to establish and in delivery of services. 

 

·       ACC - A draft joint Respite Position Statement was developed by Manatū Hauora, with support from ACC, in September 2021. Following significant personnel changes, as well as shifts in funding responsibilities to new agencies during the course of health and disability system reforms implemented over 2022, the position statement remains in draft and has not yet been finalised.

·         Manatū Hauora -The respite statement will be amended to reflect the changes from the health reforms and be put up on the relevant websites.

Specifically, Manatū Hauora will ensure it is in a user-friendly format to enable Te Whatu Ora, Te Aka Whai Ora and the ACC to add their service specific information on respite to provide appropriate guidance to carers and whānau on respite care.

Te Whatu Ora - The Commissioning process for the Budget 2022 initiatives will commence in March 2023. Contracts will be in place with successful applicants by the end of June 2023.

·         Whaikaha will continue to consider and improve on respite information, options, and supports for disabled people and carers and contribute to any collective statement on the importance of respite.

·         ACC - In reviewing/refreshing this action, it is likely to be appropriate to expand responsibility for this action to include Whaikaha and Te Whatu Ora as well as the Ministry of Health and ACC. Appropriate joint working structure/s with the relevant expertise to progress this action will need to be re-established across involved agencies.


Area 3: Supporting

Caring for carers and supporting their wellbeing


The health and wellbeing of carers will be improved

3.1

OT, MSD, MoH and TPK - Identify and support young carers, their families, whānau and aiga to access the support they need

·       TPK - Has a number of youth initiatives and seeks to support young Māori carers to engage in Mahi aroha and tell their story.

 

·       MSD – Following workshops in 2021, MSD scoped the ‘issues of young carers’.

·        Agencies are not expecting to progress this action in 2023 due to shifting priorities.

3.2

MSD and Carers Alliance - Help carers to participate in social networks, have opportunities to keep up relationships, and enjoy interests outside their caring role, with a specific focus on older carers

·       The Carers Alliance and MSD - Weconnect.nz was launched with one-off COVID-19 funding from MSD in 2022. It provides links to opportunities online and in communities across the country for connection, experiences, learning, befriending, respite, and activities. There is an opportunity to sustain and expand this discovery portal in the new Action Plan.

 

·       The Carers Alliance sought support for a project to help reduce social isolation in older people from MSD; this did not advance as no support was available.

 

·       MSD - The First Action Plan of Better Later Life – He Oranga Kaumātua 2019-2034, launched in September 2021, has a number of actions to improve digital inclusion for older people which will also encompass older carers. While delivery of programmes offered by digital literacy training providers during 2022 have been impacted by impacted by the Covid-19 pandemic, the Office for Seniors is working closely with them to support the successful delivery of the contracts.

·         MSD - The Office for Seniors has been allocated a total of $1.341 million over three years through Budget 2022 to continue supporting older people to be digitally included. a component of the funding is for research, with a portion of the research fund allocated to providers for the collection of data from participants of the programme they run. From this research it is hoped that insights will be gathered on the number of older carers participating in digital literacy training and how the skills learnt to use devices has impacted general wellbeing.

3.3

MoH - Enhance access to information, guidance and support of mental health and addictions, for carers and the services and organisations working with the families, whānau, and aiga of people who have a mental health and/or addiction issue

·         Manatū Hauora - Mental health and addiction leaders in Manatū Hauora have had ongoing discussions with the Carers’ Alliance to scope work to gather data and information to identify services currently available to families and carers of people with mental health and addiction needs, what is missing and what types of support carers want. Work has commenced and is progressing but was delayed somewhat in 2022 due to staffing resource constraints. 

 

The rollout of investment and efforts to expand mental health and addiction support in communities continues, which will hold benefits both for carers and those they care for with mental health and addiction needs. This includes Budget 2019 investment in the five-year national rollout of primary mental health and addiction services (known as the Access and Choice programme), as well as investment in telehealth and digital tools, addiction services and suicide prevention initiatives. Budget 2022 made further investment in supports for children and young people, as well as specialist mental health and addiction services to increase the availability of focused supports in select areas and enable new community-based models to be trialled.

·       Manatū Hauora - With the establishment of Te Whatu Ora and Te Aka Whai Ora, Manatū Hauora will facilitate engagement across the health entities and the Carers’ Alliance to continue work to consider current services, gaps and the support carers of people with mental health and addiction needs want. Collectively, health entities will then ensure there is enhanced access to information, guidance and support for carers of people with mental health and addictions.

 

·       Wider expansion of mental health and addiction supports will continue to enhance access to services for carers and those they care for.

Carers will have adequate financial assistance to cover the costs of caring

3.4

MoH - Change to health sector Funded Family Care (FFC) policies and repeal of Part 4A of the New Zealand Public Health and Disability Act 2000

·         In June 2022, Cabinet agreed to allow payment of family members of people assessed as having low, moderate, high and very high health and disability support needs, for a wider range of services. On 1 July 2022, the health and disability reforms were implemented, and payment of family members became the responsibility of new entities.

·         Te Whatu Ora - Budget 2022 allocated funding of $72 million over 4 years for Te Whatu Ora and Te Aka Whai Ora funded home support services to be provided by paid family carers.

 

·         Te Whatu Ora and Te Aka Whai Ora - Finalised the operational policy in December 2022 to extend eligibility for having a whānau/family carer to those people assessed with low and moderate need.

 

·         Whaikaha - The ability to pay family/whānau/aiga who live in the same household as the disabled person through ‘Carer Support’ and respite funding, introduced during the COVID-19 pandemic was made permanent in December 2022. Budget 2022 funding (over four years) of $39 million for Whaikaha for paid whānau support in disability services is supporting this initiative.

 

 

·         Te Whatu Ora - Work during 2023 will focus on the monitoring and evaluation of the Paid Family Carer policy extension and safeguarding considerations for recipients of Paid Family Care.

·         Whaikaha – work during 2023 includes further work to transform the disability support system, with the expansion of the Enabling Good Lives (EGL) approach nationally; and monitoring the flexible approach for disabled people to engage family, whānau and aiga to provide supports.

 

3.5

ACC, MoH and MSD - Review carers financial support policy settings including consideration of:

·         Attendant Care policy (ACC)

·         Individualised Funding (MoH)

·         long-term Funded Family Care policy settings to ensure a coherent set of financial supports for carers (MoH)

·         Supported Living Payment (SLP) – Carers (MSD)

·         MSD - As part of the long-term work programme for the welfare overhaul, MSD is considering improvements to supports and services for disabled people, people with health conditions, and their carers. Work on SLP Carers is included in this work programme.

·         There is no active work underway for this item as part of the short- or medium-term welfare overhaul work. It may be considered as part of the long-term work.

3.6

MSD - Consider a carer payment and/or other types of improved financial support for carer wellbeing


Area 4: Balancing

Supporting paid work, study and other interests

Carers have options for remaining in employment and/or seeking employment, if they want to

4.1

Carers New Zealand - Launch the Carers New Zealand CareWise initiative to ensure workplaces are carer friendly and that carers are supported to stay in or return to employment when caring ends

·         Carers New Zealand - Launched CareWise. The programme is operational with several hundred participating employers at 600+ locations nationally. One-off Industry Partnerships funding, including funding from MSD, enabled CareWise to be launched.

·         There is currently no funding to sustain and build the programme and Carers NZ is exploring avenues for this.

 

·         A new Carers NZ contract with Industry Partnerships in 2023 will assist 20 carers on benefits to return to work with CareWise carer friendly employers as a pilot. It was initiated in response to the Infometrics report which found economic vulnerability among carers who often leave paid work to care, leading to long-term poverty for working age carers and inability to save for retirement.

Carers’ pathways to employment will be supported.

4.2

MSD and Carers Alliance - Support flexible study, training and education opportunities. Explore ways to credit skills and experience towards any training, qualifications and/or employment

·         MSD - Granted the Training Incentive Allowance (TIA) to carers on SLP Carers. The TIA was reinstated on 1 July 2021 to support eligible clients (including carers on SLP) to participate in study at levels 7 and below on the New Zealand Qualifications Framework (including Diplomas, Certificates, and Bachelors Degrees).

In 2022 of those who have been granted TIA 162 (3%) are carers. Historic uptake of the TIA by carers has been low, primarily due to the full-time caring obligations informing the eligibility for SLP carer.

·         [Redacted content]

 


[1]   Manatū Hauora refers to the Ministry of Health.

[2]   On the 1st of July 2022, New Zealand moved to a new national health system. Te Whatu Ora – Health New Zealand was created as part of the reform.

[3] Whaikaha - Ministry of Disabled People was established on 1 July 2022 including the Office for Disability Issues and the Disability Directorate of the Ministry of Health. Whaikaha works in partnership with the disability community and Māori.