Table 9 Review of advantages and disadvantages for revising DIAS contracts Potential change Possible advantages Possible disadvantages Co-create a national disability brand Reaffirm core purpose of service Modernise service provision Create a single neutral identity to unify the system – higher profile for ease of access Greater visibility/awareness for improved consumer access Increased support for DIAS providers and improved quality control More efficient use of resources as information, resources, seminars can be created once and shared often Lengthy process as covers all of DSS not just information Difficulty in gaining consensus Considerable process and resource required to establish new system IT considerations may overshadow quality of information requirements Requires the right “provider” to deliver a quality and future proofed service Review/replace / or update WEKA and DRCs creating more connectivity Opportunity to reconsider business/operating models and modernise Significant opportunity to harness synergies and create collaboration Consider other partnerships rather than just equipment Loss to regional/local connectivity Align national and local contracts Greater transparency of contracting requirements Increased visibility May decrease regional connections Review purpose, benefits and coverage of APEPSI and hub and spoke models Improve equity of access Improve networking linkages to wider sector Seminars and training can be recorded and shared online May decrease regional connections Contract implications As described earlier in this section the current contacting specifications and reporting requirements for DIAS are out of date and need updating. Before the contracts can be reviewed there will need to be a process of engaging with the providers about the services they deliver, who to and how. This needs to be then considered in light of the proposed changes to create an aligned modern information service that is smart about the production
even though the outcomes might vary Transparency and use of various mediums – one option being an online assessment tool and criteria so people can understand what eligibility criteria is and then investigate further if they meet it private funding if desired and possible With a more permissive and flexible system it might be difficult to clearly articulate Allow more trade-offs Link some equipment and modification services (EMS) to the NASC functions Change the purchase framework (purchasing of services) over time to allow for people to make trade-offs and use supports more flexibly Consider how EMS can be accessed by NASCs and/or budget allocators to allow for early investment and trade offs for efficiency EMS providers and NASCs, alongside DIAS providers, working together Potential efficiencies from making better decisions and meeting needs more flexibly Better outcomes for people Quicker access Depending on what level of access to EMS items, could undermine the EMS procurement and prioritisation processes Could create a two tiered system for access to EMS items Implement a system for enabling NASCs to access specialist This could entail reworking the two NASC contracts with Deaf Aotearoa and The Blind Foundation to share expert resources and skill to, enable them to provide expert advice to all access agencies Disabled people know that their specific disability needs are understood as part of the planning process Could be done remotely Stretch on limited resources May not be available in a timely manner
Impact analysis In summary we are recommending: Building on and transforming what is in Freeing up systems and some resources differently. The exception to more change being needed may be the DRCs and WEKA Implementation considerations There are various considerations to be made for implementation of any change. Change management investment and will be required including: Active and skilled project management, including risk management. Clear and regular communication. “Consulting” on preferred service change options with a further co-design approach with disabled people, families, providers and ensuring effective cultural, disability specific and non-complex and complex needs inputs – includes discussion on meaningful outcome measures. Ensure a strong approach to a bottom up process for outcome measures. Be clear re expectations of disabled people involved in governance and decision making rights of agencies going forward, especially the NASC agencies and the new disability branded service. It will be important to take a system wide approach, as just changing some will not fix the systemic underlying problems (e.g. reviewing the purchase framework). Use a range of contracting tools and levers to ensure the changes are made. For example move to outcome reporting, a range of up to date service specifications and contracts, clear communication and transparent simplified processes. Establish ongoing evaluation to ensure intended consequences are achieved. For example it may be beneficial to have a 2 or 3 year review of data to ascertain if changes made a difference to peoples’ experience and outcomes, e.g. are people with needs getting their needs met quicker, what trade offs are able to be made, are more of the solutions for people non DSS long term funded.