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Long Term Conditions Outcomes Framework

A new approach for contracting for service development and commissioning for long term conditions has been developed in co-design with the health sector. The work has pulled together common themes reflected in DHBs' annual plans, Māori health plans, the New Zealand Health Strategy and other existing Ministry work. The suite of documents includes a population outcomes framework with outcomes measures and a guide for service design. These documents will assist DHBs to move away from prescriptive transactional approaches to contracting.


Reducing the impact of long term conditions is a priority for the New Zealand health system. Service funders and providers need to be more flexible, innovative and be able to measure the difference they are making for their populations. This high level approach is people/whānau focused, not disease specific.

The developed documents provide guidance for planning and commissioning LTC services and show the collective contribution from the whole of the health system towards achieving population outcomes:

  • The National expectations for prevention and management of long term conditions services
  • LTC Population Outcomes Framework - Line of Sight (Part A)’ and ‘Measures (Part B)


We recommend the health sector moves towards using this population outcomes framework and selects appropriate measures from Part B that contribute to the desired service outcomes. There are no new reporting requirements. We have included measures and indicators that already exist in a number of plans or frameworks, such as health targets and system level measures as well as some aspirational measures.

These documents are published as working documents and we invite input for ongoing improvement and development.

The sponsor for this work is the Manager of the CVD Diabetes and Long Term Conditions team at the Ministry of Health. This team will be updating and maintaining these documents, and can be contacted at [email protected]. We look forward to working with you to develop and implement these documents.