November 2011
let’s get real pilots … two years on
What:
In 2008, the Ministry of Health released the Let’s get real framework, comprising the seven Real Skills. Since
then, Te Pou has released a range of enablers and resources to assist services to implement Let’s get real.
Three of the Let’s get real enablers (Team Planning Tool, Human Resources Tool and Education Tool) were
tested between March and August 2008 across 16 pilot sites. These pilot sites included services from district
health boards, non-government organisations (NGOs), tertiary education institutions and training
providers, in rural and urban settings, and in both the North and South Islands.
Why: In 2011, as part of the overall evaluation of the Let’s get real enablers, Te Pou approached several of the
original pilot sites and invited them to provide feedback about the achievements in their organisations in
terms of the specific Let’s get real enabler that they had tested during the last two years. Four organisations
provided feedback.
How: People who were either working for or receiving services from the organisation were interviewed. The key
purpose of this feedback was to establish the usefulness and effectiveness of Let’s get real and its enablers.
The organisations were asked key questions about approaches, lessons learned and next steps in terms of
Let’s get real.
Target: Organisations interested in implementing Let’s get real
Where: The organisations were:
 Connect Supporting Recovery Inc.
 Isa Lei
 Mental Health services for Older Persons
 Progress to Health.
“This has been a really useful process from the pilot to where we are today. The Team Planning Tool is
awesome for business planning as it makes us focus on what’s important and brings us back to reality…Let’s
get real is embedded in our day-to-day workings. We’re thinking about it all the time, and we look to the
tools to find simple processes to achieve our work.’’
Ruth Williams, business development manager, Connect Supporting Recovery Incorporated
introduction
In 2011, as part of the overall evaluation of the Let’s get real enablers, Te Pou approached several of the original 16
pilot sites and invited them to provide feedback about the achievements in their organisations in terms of the specific
Let’s get real enabler that they had tested during the last two years. Results from four of the pilot sites are presented
below.
Three organisations were involved in piloting the Team Planning Tool.



Connect Supporting Recovery Inc. – an NGO in the Northern region, Connect chose Poutama Dual Diagnosis
Service to pilot the Tool and provided dedicated support to facilitate the pilot process.
Isa Lei Community Mental Health Service, including Malaga a le Pasifika – Pacific Mental Health Liaison,
from Waitemata District Health Board.
Mental Health Services for Older Persons – Bay of Plenty District Health Board.
The Team Planning Tool is designed to help services to include and use Let’s get real in service planning, and develop
a team profile and a workforce plan to upskill team members in the seven Real Skills. Teams were brought together
to develop a workforce plan, taking into consideration such things as:




stakeholder engagement and involvement in service planning and continuous quality improvement
feedback from key stakeholders about service delivery
staff profile and mix in terms of matching the needs of service users
skills assessment against the seven Real Skills for individuals and/or teams.
The fourth organisation, which tested the Human Resources Tool, was Progress to Health, an NGO in the Midland
region.
Of particular significance is that all four participating organisations found it challenging to limit their feedback to the
achievements arising from just the one Let’s get real enabler with which they had been involved in. In fact, all
organisations described how they had gone on to adapt and utilise some or all of the suite of enablers. Because of this,
material presented here encompasses more than just feedback about the Let’s get real enabler that had been tested
two years earlier.
All of the teams have continued to use the Team Planning tool, in some form, for business planning, workforce
planning, team building and service-user/whanau/family feedback.
The four organisations were asked questions that addressed outcomes, unique approaches, lessons learned and next
steps in terms of Let’s get real. The organisations responded by various means, as described below.




Connect Supporting Recovery Inc. – feedback from the manager who facilitated the original pilot.
Isa Lei – feedback from a focus group involved in the pilot, which included the quality manager, the service
manager, a consumer advisor, peer support workers and clinical staff
Mental Health Services for Older Persons – feedback from the service manager who facilitated the original
pilot.
Progress to Health – feedback from a consultation group of 20, including service users, whanau members, staff
and management.
what has happened two years on . . .
connect supporting recovery incorporated
Connect Supporting Recovery offers a wide range of services including attaining goals in
employment and accommodation to people experiencing mental health issues..
Employment Support helps people set goals in line with their career hopes and dreams,
find work experience and prepare for applications and interviews. Connect Supporting Recovery work strongly from
a values base, which underpins recruitment, decision-making, planning and evaluation of services. Their priority is
people development. This includes stakeholder development –(service users, family/whanau and Maori) so that
people can work more actively in partnership with the organisation both in individual service delivery and in
organisational development.
What they did
Connect utilised the Let’s get real Team Planning Tool for its annual business-planning template. All staff were asked
to do their individual assessment against the seven Real Skills and prepare a Personal Development Plan. These plans
were then aggregated to prepare a team and organisational profile to inform business planning and workforce
development.
The Human Resources Tool was used as a benchmark to make the organisation Let’s get real-compatible. Since the
pilot, Connect has come together with two other organisations and is using the Human Resources Tool as a
framework to align job descriptions, recruitment processes and other human resource processes across the three
organisations.
What changed as a result of Let’s get real?
From a strategic point of view, Let’s get real helped Connect become more values-based and they realised attitude is
much more important than skills training alone. Connect has fully embraced Let’s get real, and utilises and adapts all
of the tools to support organisational development. They found the tools user-friendly, adaptable, and helpful in
planning at an organisational and individual level. The tools helped Connect to identify the need to appoint new
staff, becoming more values-based, and improve internal quality audit processes. As a result of using the Let’s get real
tools, Connect appointed a family participation coordinator, who supports families, two community liaison roles, a
service user learning and development coordinator, and a Māori development coordinator.
Where to next?
Connect is now embedding Let’s get real into every individual staff member’s practice as well as team practice.
isa lei
Takanga a Fohe – Waitemata DHB Pacific Mental Health and Addictions Service, is a by-Pacific,
for-Pacific service, which comprises Isa Lei Community Mental Health Service, (including Malaga
a le Pasifika – Pacific Mental Health Liaison), and Tupu –Alcohol & Other Drug & Gambling
Service.
Service delivery is based on the principles of holistic, recovery and strengths-based approaches,
which include family focus, relationship focus, Pacific languages and cultural practices.
What they did
Participating in the Team Planning Tool pilot required Isa Lei to look at how their service engaged across the district
with families, service users and their communities. As a result, they utilised the Shared Vision forum and targeted the
churches to facilitate mental health awareness sessions. Shared Vision meets monthly and links mental health and
addictions service providers with service users, their families, NGOs and the community. Isa Lei uses the monthly
meeting to run mental health awareness sessions, and once a year, they have a Pacific flavour event on the Shared
Vision calendar.
The original plan from the Team Planning Tool pilot kick started Isa Lei to
work with primary health and NGO sectors to develop a Pacific Plan across the
sector. They have also set up a GP clinic with a Pacific focus, forged a
relationship with Te Pou, improved access to managers for consumers, and
linked with Māori services (including managing a staff exchange system with
them). They found the tool detailed and adjustable.
What changed as a result of Let’s get real?
The focus group reported that there has been a big difference in staff values and attitudes. Other changes include:







stakeholders involved in planning days is an accepted norm
establishment of a northern region Pacific consumer and family forum
consumers and staff have more functional relationships - the inclusive attitude of the team is ‘amazing’
staff now challenge the service delivery culture, and demonstrate improved ‘wellness’
team communication has really improved, peer support is the norm, and there is good staff retention
there has been significant improvement around the use of recovery
clients now move through the service, whereas before ‘we held on to them’, and referral management has
improved.
Two years on, the service development plan that was developed as a result of the Team Planning Tool pilot is still
alive and, to date, Isa Lei have:





developed a process for advanced directives
introduced training for staff in talking therapies
employed a clinical psychologist and established a clinical psychologist internship
set up and established therapeutic groups, including a group for women with depression
received more complaints because consumers are more confident. In turn, staff feel less threatened by
complaints and are less defensive. Overall this is a very positive change, a sign of improved relationships.
Let’s get real did not have a strong enough Pacific focus for Isa Lei. However, Le Va filled in the gap for working with
Pacific people with the Real Skills plus Seitapu Framework based on the cultural competence work done by Takanga
a Fohe and the Pacific community.
Where to next?




Work more closely with the NGOs in our district.
Incorporate Real Skills plus Seitapu into our competencies.
Focus on ‘challenging stigma and discrimination’.
The Learning Modules need to be integrated into the performance
development cycle.
‘Let’s get real has been great!’
mental health services for older persons – bay of plenty district health board
Mental Health Services for Older Persons (MHSOP) provides community-focused care, underpinned by recovery
and harm reduction models. The services are supported by a 24-hour seven-day a week acute/crisis service and acute
admission inpatient services.
What they did
Without needing any adaptation at all, the Team Planning template was used as the organisation’s Business Plan
template. MHOSP found that utilising the Team Planning Tool kept them focused on their actual business. By doing
Part One of the Tool, everyone got to know the service specification and what was expected in terms of service
provision. They were able to find out what needed to be done and where to find it. It was found to be a clear process,
aligned to what the Ministry of Health required, and there was good buy-in from staff because they could see results.
There was high ownership and staff responded to the opportunity to develop themselves. Weekly team business
meetings were used to do the work from the business plan and then the team day could focus on celebrating
achievements.
What changed as a result of Let’s get real?
As part of their business-planning process, MHSOP now categorises all their goals under each of the seven
stakeholder groups: service users, families/whanau, Māori, communities; law, policy and practice; challenging
discrimination and stigma; and professional development. They find that keeping the focus under the stakeholder
groups keeps them on track and it works very well.
MHSOP’s annual consultation morning involves up to 50 people, including service users,
families/whanau, caregivers, Māori, NGOs, other community services and hospital
services. At these events, they present what has been achieved over the last year, and their
plans for the coming year – these are developed from needs identified by the group from
the previous years.
The consultation has assisted in maintaining excellent relationships and the entire group feeling that they are all part
of a larger team assisting their client group and their families. While they have enough to do from the plan completed
in the pilot two year ago, they refer back to the original list of strengths and areas for development, and the group is
asked to add anything for the next 12 months as well.
Every July, they have a half-day service review, including key stakeholders (service users, families/whanau, caregivers,
Māori, NGOs, other community services and hospital services). Then, in the afternoon, they do a team-building
exercise.
All of the business planning activities are displayed on the reception area walls so they are visible. It is a priority to
keep this updated as it is a key tool for measuring and demonstrating achievements against the business plan.
MHOSP have expanded their contracts, and using the Team Planning Tool, they found that the business-planning
template was a very good way to keep staff up-to-date and to orientate new staff. When the new dementia service was
launched, all of the MOH strategic documents were pulled out to present back to the teams/NGO groups. It was very
useful to keep healthcare staff updated and to orientate new staff.
Where to next?



Review our vision statement and values to align with those of Mental Health and Addiction Services and the
DHB as a whole. This process will be done via email and as a competition.
Do a full team assessment against the seven Real Skills, particularly as we now have new staff members
By June 2012, the whole of BoP DHB Mental Health and Addiction Services will have implemented Let’s get real.
‘The initial time and energy investment was worthwhile as we now have a well-established
business planning process that works.’
Sharon Linwood, service manager
progress to health
Founded in 1995 in Hamilton, Progress to Health is a non-government organisation that provides recovery, Like
Minds Like Mine, youth transition, and consumer advocacy services within the Midland region. Progress to Health
supports the principles of recovery and anti-discrimination of people associated with mental illness. The community
worker team is there to walk beside consumers and assist them to create better and brighter futures for themselves
and their whanau.
What they did
Progress to Health utilised Let’s get real Human Resources Tools comprehensively and
adopted the tool to enhance their existing human resource processes. Let’s get real provided a
framework for Progress to Health to evaluate its systems and processes and the level of
knowledge and skills held within the organisation. Gaps were identified and Let’s get real then
provided the resources, such as templates and processes, or a body of knowledge, to address
that gap. The Human Resources Tool provided quality resources and processes to assist with
human-resource processes and procedures, particularly for professional development, career planning and workforce
development.
What changed as a result of Let’s get real?
There was a notable increase in confidence in staff learning and communication along
with expressed desire to undertake higher qualifications. Staff members reported the
following.




‘Orientation is really important, and Let’s get real is part of that.’
‘Most of us (staff) are doing the Let’s get real Learning Modules.’
‘We have training on recovery, and managing conflict and risk.’
‘We can identify when they need extra training from the
Let’s get real assessments.’
Recovery education course
The people who use the service are provided with practical support to gain skills to take back to their whānau. In
turn, the whānau are also supported, leading to a more resilient and helpful community. One service user said,
“Progress to Health are my whanau and I get my family support from here. I’ve completed the recovery course for
the first time as I was allowed to try again until I completed it. I will stand up for myself now. I’ve really learned to
talk. I’m passionate and I’m thankful for what Progress to Health has given to me and I can now give back to others.
We visit people and support one another. I was accepted and wasn’t pushed away.”
A whanau member said ‘We were so scared – we didn’t know how to deal with what was happening to our brother.
Now, the main thing is that we understand his illness more; we are involved and are now closer to him. At the sports
day, we saw how much more he could do and it’s the first time we’ve seen somebody touch him. The good thing is
that we can support my brother anytime.’
Where to next?


Start investigating the ‘practitioner’ level for staff who have been with the organisation for two years or more,
and for whom the additional knowledge/higher level of practice would be beneficial.
Continue to embed Let’s get real into the organisation.
“I’ve been in Progress for Health for two years. I can now open up to others.
With the programme, I’m occupied and I’m safe.”
Client from Taupo
conclusion
These ‘storieswere compiled from feedback from four of the 16 Let’s get real enabler pilot sites. They provide a
snapshot of the varying ways in which the Let’s get real enablers have supported organisations in change
management and quality improvement processes that support workforce development. Three of the organisations
were involved in piloting the Team Planning Tool and the fourth organisation tested the Human Resources Tool.
Key aspects of the stories include:









improved relationships with service users and family/whanau through consultation, participation and
involvement in business planning and workforce development planning
increased awareness of staff in regard to the importance of key stakeholder involvement
heightened awareness of individual staff about other team members
useful templates that can be adapted and utilised within individual services and/or organisations
business-planning process that is consistent and sustainable, and which provides a mechanism for measuring
service improvements
improved processes for recruitment, selection, orientation, performance development and performance
management
greater acknowledgement and inclusion of Māori and Tikanga Māori
greater awareness of and focus on recovery
greater confidence by organisations that they can articulate what they are actually providing in their service
delivery.
more information
Name
Apollo Taito
Karen Covell,
chief executive
Sharon Linwood,
service manager
Ruth Williams,
business
development
manager
Organisation
Isa Lei,
Waitemata District
Health Board
Progress to Health
Contact details
[email protected]
Website
http://www.waitematadhb.govt.nz
[email protected]
www.progresstohealth.org.nz
Mental Health
Services for Older
Persons,
Bay of Plenty
District Health
Board
Connect
Supporting
Recovery Inc.
[email protected]
http://www.bopdhb.govt.nz/
[email protected]
www.connectsr.org.nz