Public health service specification questions and answers

What are the public health service specifications?

The tiers 1–3 public health service specifications form a hierarchy, with each tier describing a service to be funded and delivered at a different level of detail. The tiered approach is intended to avoid repetition of the content and elements that are common to a range or group of services. For further information on what service specifications are, how they are structured and what they are used for, please see About Service Specifications.

The tier 1 public health and tier 2 core functions service specifications must be included or referenced in Ministry and DHB agreements. When referencing the tier 1 and tier 2 specifications in agreements instead of including the full document, please include the date the specification was published for version control.

The public health service specifications are published at Public health service specifications.

Tier 1

The tier 1 public health specification contains high level principles and context and is common to all public health contracts.

Tier 2

The five new tier 2 service specifications are based on core functions and are used when purchasing public health services. Some of the tier 2 specifications outline broad approaches that can be applied to many health issues and service areas as best practice. The table below identifies the approach that is expected to be taken. 

Tier 2 Core Function How to purchase services

Health assessment and surveillance

(Understanding the health status, health determinants and distribution of disease)
Outlines broad approaches that can be applied to many health issues and service areas. The range and scale of activities to be delivered, will form part of negotiations.

Public health capacity development

(Building a capable workforce and developing effective programmes)
Outlines broad approaches that can be applied to many health issues and service areas. The range and scale of activities to be delivered, will form part of negotiations.

Health promotion

(Enabling people to increase control over and improve their health)
Outlines broad approaches that can be applied to many health issues and service areas. The range and scale of activities to be delivered, will form part of negotiations.

Health protection

(Protecting communities from public health risks)
The services include the implementation of legislation and therefore the need for national consistency and meeting statutory requirements, these specifications are relatively detailed.

Preventive interventions

(Population programmes delivered to individuals)

Immunisation - Service description for immunisation services is defined in the tier 3 Immunisation service specification.

National Screening Programmes – Service descriptions are defined in the individual agreements with DHBs and other providers

Note: the old issues based public health specifications will continue to be available on the NSFL website with a non-mandatory status. Funders can use or amend these documents (or use local or unique equivalents) as they see fit.  The issues based service specifications can be found at Public health service specifications to be retired. Current policy, priorities, best-practice evidence and any legislative changes for the issue should be taken into account.  The issues based service specifications will be retired as they are replaced by core-function associated tier 3 service specifications.

Tier 3

The tier 3 service specifications are more detailed descriptions of the services that are to be funded. A tier 3 service specification may be linked to one or more tier 2 specifications to meet the service requirements.

The table below lists the tier 3 specifications that are associated with the tier 2 core functions approach, still under development and includes the closest corresponding tier 2 issues-based specification that can be referenced.

Tier 3 specification still under development Corresponding tier 2 issue-based specification Expected date of availability of new tier 3 specification
Environmental Health Physical Environment Health Services (doc, 330.5 KB) From January 2017
Sale and supply of Alcohol

Prevention of Alcohol And Other Drug Related Harm (doc, 163 KB)

Refer to the corresponding service component of this specification.

From January 2017
Communicable Diseases

Communicable Diseases Services (doc, 116.5 KB)

The new tier 3 Immunisation specification should be used when available.

From July 2017
Smoke-free Environments

Tobacco Control Services (doc, 104.5 KB)

The new tier 3 Stop Smoking Services specification should be used in place of the Smoking Cessation Services component.

To be confirmed
Illicit Drugs and Psychoactive Substances

Prevention of Alcohol And Other Drug Related Harm (doc, 163 KB)

Refer to the corresponding service component of this specification.

To be confirmed

These documents will be published on the NSFL website with a non-mandatory status. Funders can use or amend these documents (or use local or unique equivalents) as they see fit.

Where the core functions tier 3 specifications are not yet available, guidance for the subject area can be derived from the ‘Service Components’ section of the tier 2 specification and where more information is required, content can be referenced from the closest corresponding retired tier 2 issues-based specification (these documents can be found at Public health service specifications to be retired). 

The issues-based specifications will be retired as they are replaced by core-function associated tier 3 service specifications.

Purchase units

New purchase units

A new purchase unit coding structure was developed to align funding of public health services and programmes to each of the five new core public health functions and has been available to use from 1 July 2016. The structure of the new codes is built on a matrix of the public health issue or programme and corresponds with a core function. The new codes start with the same prefix 'RM' as the retiring codes.  

The new purchase units are listed in the purchase unit data dictionary (PUDD) and on the Public health service specifications webpage.

Transition Period 01/07/2016 to 30/06/2017

There will be a one year transition period for funders to move from the issues based purchase units to the new core functions purchase units. The suite of issues based purchase units will be retired from the PUDD on 30 June 2017.

During the transition period the new purchase units are to be used for new agreements based on the tier 2 core functions service specifications and the retiring issues based purchase units can be used to vary existing agreements.  If one of the retiring purchase units has been used in an agreement beyond 1 July 2016, this code will be available to use for the life of the agreement.

When moving from a retiring purchase unit to a new purchase unit, please check the purchase unit mapping table in tab b of the PUDD. For further information please email (nsfl@moh.govt.nz).

What is the core functions approach?

The Ministry of Health introduced a core functions approach to its purchase of public health services in 2016. This approach references each activity to a core function. Core functions can be combined to produce the public health services needed to support an excellent health system. This approach is a different way to describe the public health services purchased by the Ministry, DHBs and public health units, rather than a change to the services themselves.

The core functions approach will also provide the Ministry with relevant data to guide future policy and investment, using an appropriate mix of public health services.

Background

In 2011, the Public Health Clinical Network report recommended changes to how public health services were purchased, and recommended changing from a focus on diseases or issues (such as mental health) to a core functions approach. The report recognised the need for public health services to evolve in response to changing population needs and priorities, as well as changes in best practice, such as setting-based health promotion (eg, in a community or school).

This led to the revision of the tier 2 public health service specifications, which are based on the five interconnected core functions for use from mid-2016. In general, strategies from several core functions are combined to make progress in one or more public health issue or setting.