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Forthcoming from Canterbury University Press

One
System

How relationships based on trust and a shared purpose transformed Canterbury’s health system

How do you bring a fragmented health system together around the people it serves? In One System, David Meates and Carolyn Gullery share an inside account of Canterbury’s transformation - and reflect on what it takes to make lasting change.

Foreword by Professor Sir Chris HamAfterword by Dr Graham Scott CB
Agnes, the illustrated older woman used throughout the Canterbury Health System's One System visualisation, standing with a walking stick and a shopping basket.
Agnes, the person the whole system was drawn around

“What if we designed the health system around people, not organisations?”

In 2007, Canterbury’s health system faced rising demand, limited resources and fragmented services. Meeting those pressures meant changing how people worked across hospitals, general practices and community services.

One System follows that work through progress, setbacks and crises, from the decisions made by leaders to the changes in everyday care.

Three strategic goals

One vision, held steady for more than a decade

01

Support people and whānau to stay well and take increased responsibility for their own health and wellbeing.

02

Develop primary care and community services so people are supported in a community setting, with a point of ongoing continuity.

03

Free up hospital-based specialist resources for episodic events, complex care and specialist advice to primary care.

The Canterbury Health System's integrated health and social services visualisation: a large illustrated wheel with a person-centred home at the centre, surrounded by general practice, community nursing, pharmacy, urgent care, rehabilitation, mental health, specialist hospitals and community services arranged as interlocking puzzle pieces.
Seeing the whole. The visualisation that helped 18,000 people see one system rather than competing parts - with the person, not the institution, at the centre. Based on the Redbridge Trust visualisation and developed by the Canterbury Health System.

What the system delivered

A decade of growth with fewer beds and shorter stays

14%

population growth in Canterbury between 2008–09 and 2019–20

−9%

fall in total hospital bed days for people aged 15 and over across the same period

40%

of hospital discharges occurring before midday as flow became a system discipline

4

Institute of Public Administration awards won in a single year, 2015 - a national first

Figures drawn from Chapter 13, Outcomes that drove a connected transformation, sourced from Vision 2020 outcomes reporting.

Foreword

Canterbury’s story has been told before, but this book is different, and valuable, because it offers a view from the inside on what it means to lead transformation.
Professor Sir Chris HamFormer Chief Executive of The King’s Fund

For people leading change

For leaders, clinicians, policymakers and community partners whose work depends on people acting across organisational boundaries.

Read an extract from the book

Advance praise

Praise and perspectives

The story of the 12-year transformation of Canterbury’s health system is of profound importance: its use of groundbreaking innovation processes, the centrality of a simple, powerful, inspiring and guiding vision, and a leadership that nurtures and fosters change. These are lessons for all leaders, not least for those who are searching for ways to respond to major crises and disruptions.
David AlburyFormer Principal Adviser, UK Prime Minister’s Strategy Unit; Founding Director, Innovation Unit
We need the whole system working for the whole system to work.
Canterbury Clinical Leaders
He aha te mea nui o te ao? He tāngata, he tāngata, he tāngata.
WhakataukīWhat is the most important thing in the world? It is people, it is people, it is people.
A braided river winding across the Canterbury Plains at golden hour, its many channels converging and diverging.

Many channels. One river. One system.

The authors

Written by two of the people who led it

DM

David Meates

Chief Executive

David led the Canterbury and West Coast District Health Boards, bringing the perspective of a chief executive responsible for a health system through change and crisis.

Full biography
CG

Carolyn Gullery

Planning, funding & decision support

Carolyn led Canterbury’s planning, funding and decision support, connecting the system’s ambitions with its partnerships, investment and day-to-day decisions.

Full biography