How much do we get each year?
How is the money divided?
How does it work?
So what do we decide locally?
So how do P&F actually decide how to cut the pie?
How can we tell if any difference is being made?
The nitty gritty
How do we measure and report performance?
The Planning and Funding Team



Every year, Whanganui DHB gets a sum of money from the Ministry of Health along with some direction on what is should be spent on, but under the DHB structure, the 'who gets how much' is now in local hands.

The team charged with providing all the information on which funding decisions are made is the Planning and Funding (P&F) team. The DHB has a vision of "Better Health and Independence" and Planning and Funding are part of turning that vision into a reality.

How much do we receive each year?

Each your our DHB receieves about 200 million dollars. Whanganui District Health Board receives two main types of funding from the Ministry of Health:

• Population Based Funding Formula (PBFF)
• One-off Direct Contracts

How is that money divided?


One-off direct contracts are issued by the Ministry for us to undertake specific services.  For 2009/10 we have 34 direct contracts, worth $8.3 million.  These include ‘Healthy Eating Healthy Action’, Smokefree, Violence Intervention, and ‘Boost Hospice Care’.  They are mandatory programmes which the district health board has to provide.

The Population Based Funding Formula funding pays for all services provided to people living in the Whanganui district.  The majority of this funding is spent through contracts with  Whanganui Hospital ($92 million), other district health boards ($26 million), pharmaceuticals ($17 million) and our community providers ($54 million).  Many of these contracts are uncapped, as funding is provided based on need – such as with the provision of care for the elderly and pharmaceuticals.

The allocation of our investment in 2009/10 is set out in the following pie chart:




How does it work?
Firstly, we need good information about what's really happening in Whanganui in terms of health. When the DHB came into existence, we did the first ever health needs analysis for the region, and from that we identified the areas needing the most attention. We do a similar exercise every 2-3 years, to refine the current health priorities for the region.

Once the DHB identifies the health priorities for the region, the P&F team gets on with prioritising and allocating funds accordingly. They are also responsible for selecting the providers of the services needed, setting up service agreements to make sure they deliver what is required, and monitoring the contracts to check on this. This includes the service level agreements within 'the provider arm' of the DHB—otherwise known as Whanganui Hospital and community servces. Remember, though, the hospital is only one of the many contracts managed by Planning and Funding.

Many decisions are made within the guidelines set by the Ministry, through their national strategies and priorities. P&F must also make sure we have good service coverage, that quality and safety requirements are met, that the contracts include any national service specifications, and possibly also national prices.

So what do we decide locally?

We can decide the service mix and volumes—how much, where, and for whom. We are also able to work out strategies that include all our local links, so we get better integration that better fits our local needs, and gives the best value for money on the local scene.

So how do P&F actually decide how to cut the pie?

Decisions are based on what the local population actually needs, the capacity to provide the services needed, whether a proposal fits with the District Health Board's priorities and guidelines, what the flow-on effects and linkages might be, and the service cost/price.

How can we tell if any difference is being made?

Each Health Needs Analysis shows if there are any changes in the population health statistics. On top of that, we look at many measurement indicators, like intervention rates (eg: how many people had flu vaccinations, how many caesareans we do), avoidable admissions, waiting times, consumer satisfaction and complaints, inequalities and outcomes achieved.

The nitty gritty

P&F uses Service Level Agreements to specify what is to be provided, how much/many and for whom, performance standards and quality, price, performance measures and targets, and provisions for adjustments for over or under performance.

Why do we measure and report performance?
P&F has to check that the expected services are being delivered and find out the reasons for any variances. Then they find out how actual service delivery in Whanganui compares nationally and decide if the level of funding is appropriate, or if any changes need to be made to a contract. There are lots of reasons why a contract might be changed. There might be changes in demand, changes in ability to deliver a service or changes in efficiency, inappropriate targets set, or a change in behavior by another provider.


The Planning and Funding Team


(coming soon)