How it Works
The two main roles in Te Tumu Waiora are Health Improvement Practitioners (HIP) and Health Coaches (HC). They provide free, 15-30 minute sessions for anyone who is enrolled with the practice and eligible for public health services in New Zealand. The aim is to give people tools to manage whatever is causing their distress, and if needed, link people with services or organisations that may also be able to help. Often people will have only one or two sessions, but they can have more if needed.
GPs and practice nurses introduce people to the HIP or Health Coach, either in person or virtually. Ideally, people see the HIP or Health Coach the same day, but if this is not possible, people can make another time that suits them, usually in the next few days. HIPs and Health Coaches record notes on the session in the general practices’ patient management system.
Health Improvement Practitioners
HIPs are experienced and registered mental health clinicians based in general practice. HIPs see people whose thoughts, feelings or actions are impacting on their health and wellbeing. They work with people (of all ages), whānau, and groups to:
understand the problem;
develop a plan to achieve their goals, including ideas about actions and tools that can help; and
provide advice and support.
HIPs divide up their day with booked sessions, as well as time for people introduced by their GP or practice nurse. This means people can always be seen quickly.
The model puts mental health and wellbeing at the heart of general practice
Health Coaches support people to improve their health and wellbeing. They work with people to:
understand their health and wellbeing goals, whether it be mental, physical, emotional or social
Create a plan and set goals
provide advice and information on how to manage their health and motivation to do so
support people and whānau to access other services or organisations that may be able to help.
Health Coaches support people to make positive changes to their lifestyle - it may not be a medical issue, but something that is affecting their wellbeing that they want to address. As behavioural change can take time, Health Coaches are able to see people a number of times and will help people through the ups and downs of making changes.
Health Coaches are not registered health professionals but have comprehensive general health knowledge and provide advice drawing from reputable sources such as HealthInfo or Health Navigator. In addition to information, the value Health Coaches bring is their ability to support and coach people to change their behaviour and to connect them with the services they need.
As part of Te Tumu Waiora, a small number of Support Workers are also available to help people to make changes that will improve their health and wellbeing. Support Workers are based in the community and can visit people in their homes or help with linking people with services or organisations.
Usually people are introduced to Support Workers by HIPs or Health Coaches if people need support in the community.
Integrated Primary Mental Health and Addictions Services, known in Canterbury as Te Tumu Waiora is a relatively new service in New Zealand. Health Improvement Practitioners (HIPs) and Health Coach roles were first developed in the United States. The idea was adapted for New Zealand and piloted in Auckland in 2017 and other regions, including Canterbury in 2018 and 2019.
The model is evidence-based, drawing on international experience and what has worked well in the New Zealand pilots. The purpose is to provide additional mental health and wellbeing support within general practices. General practice teams are focused on helping in the early stages of mental distress or challenges to wellbeing, with HIPs and Health Coaches supporting people to manage their health and prevent more serious illness.
The Government inquiry into mental health and addictions, He Ara Oranga, found there was a need to make access to wellbeing and mental health support easier, with earlier intervention and closer to home. One of the actions to try and achieve this was to fund the expansion of Integrated Primary Mental Health and Addictions Services/Te Tumu Waiora to other areas, including Canterbury.
Since starting in 3 pilot practices in late 2019, Canterbury District Health Board, local Primary Health Organisations and community mental health and addictions services have been working with general practices to add HIPs and HCs to their team. The number of practices with HIPs and Health Coaches has increasingly grown since then, and now over 270,000 people in Canterbury can see a HIP or Health Coach through their general practice.
It was good to set goals and it made me accountable. It's like going to the gym, even if I don’t want to do it, having someone else involved means you are committed to going. I couldn’t just report back that I had done nothing! So that was helpful.