1. Towards Smokefree Aotearoa 2025 Tobacco Services Realignment and Re-tender Engagement Process May - June 2015

2. Programme Session 1: Where are we at? an honest review of current state Session 2: How do we get there? the realignment process Session 3: Enhance – Stop – Innovate – your input (information gathering workshop) Session 4: Service provision / Solutions for local need – your input (information gathering workshop)

3. The Realignment Process (RAP) Services included in RAP: 32 Aukati Kaipaipa stop smoking services 4 Pacific stop smoking services 6 Pregnancy stop smoking services 5 DHB purchased cessation services 7 Health promotion, advocacy and leadership services Action on Smoking and Health (ASH) National Heart Foundation -Tobacco Control -Tala Pasifika Smokefree Coalition Smokefree Nurses (AUT) Hapai Te Hauora Tapui - Maori Public Health Leadership and Health Promotion - Tobacco - Te Ara Ha Ora: National Maori Tobacco Control Leadership Service

4. Where are we at? An honest review of current state Acknowledgment of all the commitment and achievements to date Smokefree Aotearoa 2025 goal is fast approaching The Ministry of Health’s aim is to better foster innovation, maximise quality and effectiveness and to improve service delivery across all tobacco control services The Ministry has assessed how best to achieve this aim through the: ongoing implementation of the health targets programme activities of health promotion, leadership and advocacy services way services are delivered by cessation providers better harnessing of innovation through flexible and responsive service delivery

5. Current state: what do we know? SHORE/Whariki Research, Massey University Review of Tobacco Control Services 2014 Tony Blakely et al, 2014 study published in the New Zealand Medical Journal Data sources:  Census prevalence data  NZ Health Survey  Ministry of Health enrolment and quit outcomes data Stakeholder feedback DHB needs assessment While good progress is being made we are unlikely to achieve the goal if we continue with a ‘business as usual’ approach. Clearly more needs to be done in particular amongst the priority populations if the Smokefree 2025 goal is to be achieved.

6. The role we ‘ALL’ play A comprehensive set of tobacco control measures We all have a critical role to play in achieving the Smokefree Aotearoa 2025 Goal Reducing initiation Increasing supported quit attempts De-normalising smoking behaviour Opportunity to better integrate so we have a seamless joined-up system with cessation services with health promotion and advocacy services to improve outcomes for Maori, Pacific and hapu mama who smoke.

7. Interventions Tax increase Duty free restrictions Plain packaging Prevention Mass media Health care professionals prompting quit attempts - ABCs Cessation support – supported quit attempts Others? (harm reduction; alternative nicotine delivery devices; reduced nicotine tobacco)

8. Current State: Stop smoking services (face-to-face) Current services achieving volumes of 120 per FTE per annum National summary for 01 Jul 2014 to 31 Dec 2014 (6 months) No. of referrals6845 Validated abstinence rates 4 Week - total eligible4449 4 Week - not a single puff1556 Validated abstinence rate at 4 weeks35% Around 70% of people relapse between 4 weeks and 1 year - therefore the 1 year quit rates can be estimated at around 10.5% Barely 5% of current smokers use stop smoking services

9. What does this mean? The ‘business as usual’ approach will not get us to the Smokefree Aotearoa 2025 goal Current rates of stopping smoking are too slow to reach the 2025 goal Need more people making a quit attempt, preferably a supported quit attempt (increased likelihood of successful quit) Need to increase service utilisation

10. The Realignment Process 3-phase process: 15 months Phase One: Engagement and design (April – July 2015) Phase Two: Procurement management (August – December 2015) Phase Three: Transition (January – June 2016)

11. Guiding Coalition Nomination Criteria 1.Ability to work within the current New Zealand health policy settings and understand how to apply health and tobacco control policy to services 2.Awareness of the international context for the health sector and tobacco control 3.Ability to work with policy advisors, funders and providers including, but not limited to, DHBs, PHOs, NGOs, public health units, Māori and Pacific 4.Understanding of Māori and Pacific provider development including development of quality, performance and outcome measures 5.Strategy, evaluation, funding models and analysis 6.Application of Te Tiriti o Waitangi in the context of tobacco control health promotion, leadership and advocacy and treatment for addiction to tobacco 7.Understand and translate up-to-date information, research and evidence to inform developments in tobacco control policy, interventions and service delivery including international comparisons and performance benchmarking 8.Innovative and creative service delivery approaches to improve outcomes for Māori, Pacific, pregnant women and other priority populations who smoke 9.Technical and operational aspects of smoking cessation, health promotion and advocacy 10.Translation of strategy, policy, needs analysis and planning, and results based accountability, for high needs populations 11.Understand the service development requirements for the future (including necessary capacity and capability) 12.Application of tobacco control sector intelligence, political and cultural competencies to analyse, translate and summarise information – strategic and operational 13.Primary care and/or community services supply chain analysis, commercial modelling and management.

12. Guiding Coalition Margie Apa (Systems reform, strategy, Pacific development/advancement, DHB, community development, performance measures, innovations) Dr Lance O’Sullivan (Service delivery – cessation, GP/Primarycare, NGO/Māori development) Fay Selby-Law (Service delivery – cessation, whanau ora, NGO/Māori service implementation) Professor Richard Edwards(Academic, international research, health promotion, advocacy, policy) Ben Youdan(Service design and development – health promotion and advocacy, policy, implementation) Dr Ashley Bloomfield(Strategy, integration, policy, cessation technical, DHB, primary/secondary) Dwayne Tamatea(Service delivery - cessation, AKP, Maori service integration with clinical practice) Maxine Shortland(Māori advancement, AKP, results-based accountability, funding analysis) Associate Professor Marewa Glover (Service design, Māori research, hapu mama, Maori innovations) Nigel Chee(Capacity & capability, Māori development, service design and development) Papatuanuku Nahi(Service delivery -health promotion and advocacy, public health, community development, Māori service delivery)

13. Guiding Coalition Teresea Olsen(Māori service design and development, AKP, service delivery, Māori advancement) Stephanie Erick(Pacific research and development, health promotion and advocacy) Louisa Ryan(Pacific development, health promotion and advocacy) Kim Tito(Māori development/advancement, alliance modelling, DHB) Lance Norman(Commercial and funding modelling, supply chain analysis, Māori advancement) Professor Chris Bullen(Academic, international research, public health medicine, tobacco control) Tracey Wright-Tawha(Service delivery - cessation, AKP, Māori hapu mama service delivery, funding models) Dr John McMenamin(Service delivery, General practice/primarycare, health targets, clinical treatment) Joanna Houston(Service delivery, hapu mama, Māori midwifery, workforce development) Professor Janet Hoek(Social marketing, innovations, international research, policy)

14. Keeping up-to-date and continued communication Register on the Government Electronic Tenders website www.GETS.govt.nzwww.GETS.govt.nz Ministry of Health website www.health.govt.nz/tobacco-realignmentwww.health.govt.nz Queries email tobaccoservices@moh.govt.nztobaccoservices@moh.govt.nz