Co-designing Care for Ōpōtiki
Primary care delivery in Ōpōtiki was under significant strain. Whānau could not enrol with local GP practices, after-hours services were stretched, and casual clinics were carrying overflow without a sustainable model. Te Whatu Ora had signalled that the existing contract was unsustainable, creating real risk of service loss. Community voices were clear: whānau wanted local solutions, timely access, continuity of care, and services that felt connected and proactive. At the same time, General Practices, the Primary Health Alliance (EBPHA), and Te Whatu Ora needed confidence that any new model would reduce pressure on practices, improve system efficiency, and remain financially viable
Our Approach
Under the banner of Toi Rāwhiti, CoLEAD was engaged to bring diverse perspectives together and guide a participatory design process. Our role was not to provide the answers, but to create the conditions where solutions could be co-created across community and system partners.
Our facilitation included:
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Whānau Hui: Creating safe spaces for whānau to share lived experiences, from struggling to enrol with a GP, to relying on the medical hub for urgent care. These sessions surfaced priorities of access, timeliness, and holistic care.
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Practice Engagement: Supporting GPs and practice managers to articulate pressures, such as closed enrolments, workforce shortages, and administrative burdens, while also exploring opportunities to reopen books and stabilise patient flows.
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System Alignment: Convening Te Whatu Ora, EBPHA, and community providers to test scenarios against data, funding parameters, and clinical safety standards.
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Collaborative Tools: Patient journey mapping, outcomes matrices, and options analysis helped translate stories and data into shared decision-making.
Outcomes
Through facilitated dialogue, the project team and leadership group co-designed a proposed model for after-hours and primary care that:
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Redirects acute casuals to the hub in the evenings, reducing practice burden.
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Supports whānau access with extended hours and pathway to enrolment planning.
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Integrates services by connecting community providers, practices, and secondary care.
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Provides opportunities for clearer data and accountability to inform continuous improvement.
For General Practices, this will mean reduced prescribing burden and a pathway to reopening enrolments. For Te Whatu Ora and EBPHA, it creates a more sustainable funding picture with reduced duplication. For whānau, it offers the promise of timely, culturally appropriate, and locally led care.
The new model of care was presented to and accepted by Te Whatu Ora | Health New Zealand in May 2025. Implementation work is currently underway.
Reflections
This project demonstrated the power of facilitation in holding both tension and possibility.
Community members spoke of long waits, costs, and disconnection; practices shared fears about viability, Te Whatu Ora emphasised accountability. Alone, each perspective risked reinforcing siloes.
Together, through structured and values-driven facilitation, these voices shaped a pathway toward a more connected and equitable system.
As one participant reflected, “If we don’t come up with the solutions, we will be told what to do.”
CoLEAD’s role was to ensure those solutions were co-designed, owned by whānau, trusted by practitioners, and supported by the system.