Toitū Takata FAQs


Below are questions and answers that you might find helpful. We will keep adding to these and if you have any questions, please don’t hesitate to contact your primary care relationship manager.


What is Toitū Takata – the long-term conditions programme?

Toitū Takata allows practices to provide additional support to patients who have long term health conditions. The goals are to maximise equity, improve health outcomes and allow those with long term conditions to live well.


Which conditions have we focused on, and why?

Chronic health conditions are responsible for the majority of ill health in New Zealand. Māori and Pacific people experience higher rates of chronic health conditions and develop these conditions 10 - 20 years earlier than non-Māori and non-Pacific populations. The conditions which make the greatest contribution to this inequity are diabetes, gout, cardiovascular disease, respiratory disease, and stroke. Cardiovascular disease and diabetes rates are particularly high in those with severe and enduring mental illness and are a leading cause of death within this population.

These are the conditions that Te Pae Tata / Interim New Zealand Health Plan 2022 have identified as a priority in improving health outcomes across Aotearoa.


Allocation and eligibility

Toitū Takata has defined eligibility criteria which will focus on those with these conditions;  those with the highest needs. Click here for further information.

While many patients are eligible for the programme based on the criteria, the national funding for this programme has not increased for several years. We have had to limit the funded ‘spaces’ for each year.  Like previous programmes, WellSouth has allocated these spaces to practices based on the individual practice population demographics i.e. the percentage of enrolled patients who will meet the criteria for Toitū Takata. We have also considered how the programme addresses the inequity of health outcomes that exist for many New Zealanders.

There has been a recent increase in the total number of spaces and increased available on Toitū Takata. This means that more than 10,000 patients can access either Toitū Takata or Hāpai Atu in a 12-month period. To put that in context, in the biggest year of CLIC there was 8481 CLIC and Quick CLIC claims in total, so this is nearly a 20% increase in access overall. Next year we will be introducing a separate funding stream for advance care planning as well. So, we are increasing the funding available for long-term conditions care in the region, meaning more people can access the care they need.


Why is equity important?

Equality (treating everyone the same) is often considered to be the ‘fair’ approach, but it fails to consider the different levels of advantages within New Zealand. By treating everyone the same, we perpetuate inequities.

Focusing delivery of services on equity acknowledges the different levels of advantage in New Zealand Aotearoa and treats everyone according to their need to ensure equitable outcomes for all.


Why is WellSouth committed to equity?

WellSouth’s commitment to equity is aligned with national, regional, and local aspirations to improve outcomes for those who have unfair and unjust differences in health. It is also a legislative requirement under the Pae Ora (Healthy Futures) Act 2022 for all primary health organisations to facilitate the provision of equitable services in primary care.


What does that have to do with my practice?

The position of the Royal New Zealand College of General Practitioners is that appropriate and accessible primary health care is a key aspect of reducing health inequities in New Zealand. General Practices are in a unique position to take a population health approach, focused on proactive and preventative care. The college also supports the concept of General Practices working alongside community health services to support whānau.

Click here for our equity resources. There’s a very good video you can watch here.


When does the programme start?

Toitū Takata is available for use in practices from January 31st, 2024.


What can you expect from WellSouth as we roll this out?

  • Support to provide best practice clinical care

  • Clinical Education & programme training

  • Equity and cultural safety training

  • Guidance on how to use funding

  • Best practice behavioural health approaches to LTC management through Tōku Oranga

  • Support to make connections with community providers

  • An LTC outcomes framework

  • Improved Thalamus Dashboards

  • Links to useful, local community services/programmes


How do patients benefit?

  • Patients should receive best-practice clinical care via some funded appointments

  • Appropriate care planning

  • Connections with Tōku Oranga and other WellSouth-funded services

  • For Māori or Pacific patients, connecting with and working alongside the Community Provider


How do we identify patients?

The thalamus dashboard will support you, along with your knowledge of your patients, to identify those who may benefit from being on the programme.
The dashboard is available here: Thalamus 
Recording of a webinar about the Toitū Takata dashboard is here:

What kind of support can I offer those who don’t meet the criteria?

The components of Toitū Takata can be made available for non-eligible patients, however, these patients will have to pay for the service, as they would for standard appointments. Hāpai Atu is available for all patients with an LTC, regardless of demographic criteria. Patients, if eligible, can also avail of other funded programmes such as diabetes annual reviews, POAC services, women’s health, and sexual health.


Who designed this programme, and how?

WellSouth has designed this with input from patients and whānau, general practice, and community providers. A working group was established in November 2022 to support the re-design, and is made up on primary care clinicians, secondary clinicians, and non-clinicians. The programme has been reviewed by WellSouth’s Clinical governance Group, Clinical quality Committee, and the WellSouth Board.


How do I keep up to date?

Our fortnightly Clinical Director’s update, written by Dr Carol Atmore, includes an update in most editions. Email to sign up.

All the latest Toitū Takata news can also be found here.


Where can I find out about training and education?

Recordings of the Toitū Takata webinars are available here


What are the expectations of the level of care provided on Toitū Takata for the funding?

Patients enrolled on Toitū Takata should receive additional support to help them improve their health outcomes and allow them to live well, for example, working to improve health literacy and self-management of their long-term condition. Patients should also engage in patient-led care planning.

WellSouth’s minimum expectation for patients who are enrolled on Toitū Takata is that they receive two Practice Nurse visits, one GP or Nurse Practitioner visit and one care plan throughout the year.

This care may be delivered in a variety of ways; traditional face-to-face consultations, telehealth, group appointments etc.