# PiP HCSS Growth Opportunity — Post-Meeting Research Brief

**Prepared for:** Seniors New Zealand and PiP leadership
**Research cut-off:** 4 August 2026
**Status:** Internal strategy and evidence brief
**Meeting evidence:** Sanitized, professionally paraphrased findings only; informal personal detail is excluded

## Executive read

The strongest immediate growth route for PiP is not a direct national platform sale to Health New Zealand. It is a provider-led test of whether PiP Explore and Connected Communities can help older people living at home move from a recognised need to a real, sustained community connection.

The proposition should remain non-clinical and zero-integration in phase one. A provider retains service, clinical and care-planning responsibility. PiP supports suitable-option discovery, explicit consent, a warm handoff, response tracking, safe redirection and participation follow-up. The first evidence gate is whether that loop works for older people and providers without disproportionate burden.

The August 2026 meeting with Ondine Claridge confirmed that Health NZ's national Ageing Well function works primarily in strategic planning and system design, regional teams hold important budget responsibility, and commissioned providers are the practical delivery route. Ondine encouraged engagement with the Home and Community Health Association and providers, and identified social isolation and community reconnection as relevant to restorative support. This is useful direction, not endorsement, procurement approval or a funding commitment.

## 1. What is verified, meeting-confirmed and unresolved

### Verified public facts

- The Health NZ-commissioned Sapere assessment reported approximately **80,000 older HCSS recipients** and **$732 million of Health NZ funding, including travel, in 2022/23**.
- Health NZ's 2023 Health Status Report separately recorded about **83,000 publicly funded HCSS recipients in 2021/22**.
- The system is moving toward a nationally consistent, restorative, case-mix and bulk-funded model with revised service specifications and outcome reporting.
- An HCHA factsheet embedded in a Health NZ briefing estimated **50,000+ people supported monthly**, **27.5 million annual care hours**, **87,000 older people relying on in-home care** and **26,000 support workers**. These are HCHA estimates, not the same administrative population as the Sapere count.
- HCHA separately stated in May 2025 that **110,000 people** relied on home and community support. That broader association figure uses a different denominator and must not be merged with the monthly, older-person or administrative counts above.
- Health NZ describes services as nationally planned, regionally coordinated and locally delivered. Districts have increased delegated authority under the model operating from 1 July 2026.
- Te Waipounamu HCSS contracts were awarded to **Healthcare NZ, Nurse Maude, RDNS NZ and Access Community Health**.
- The Northern HCSS procurement closed in February 2026 and describes the clearest current operating direction: bulk-funded, case-mix and restorative contracting, digital enablement, provider–district collaboration and nationally agreed quality and outcome measures. No public shortlist or award was located by the research cut-off.
- The current nationwide Tier 2 HCSS service specification is listed as **Recommended**, not mandatory. Contract obligations must therefore be checked provider by provider rather than assumed to be uniform.

### Meeting-confirmed direction

- The practical first route is through HCSS providers and their sector association.
- Social isolation and reconnection to community support are relevant operating concerns for providers.
- Health NZ's digitisation thinking is early; a low-integration test is more credible than an immediate system-integration request.
- No suitable current tender was identified in the meeting.
- Kelsey Schwynn is a useful next conversation for digital, product, data and pilot-design challenge.

### Unresolved claims

The meeting cited approximately **74,000 people** and **$870 million** in annual HCSS expenditure. Public evidence does not confirm that exact pair or its reference year. It may reflect a different population, period or funding boundary, but that is inference only.

Use this wording externally:

> The best published Health NZ-commissioned baseline is approximately 80,000 older recipients and $732 million of Health NZ funding, including travel, in 2022/23. Other public counts use different populations and periods. Meeting-reported estimates of 74,000 people and $870 million remain unverified pending confirmation of the reference year and included funding streams.

Do not construct the $870 million figure by adding later funding uplifts to the 2022/23 baseline.

## 2. System and delivery model

| Layer                           | Primary role                                                                            | PiP implication                                                                              |
| ------------------------------- | --------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------------------- |
| Ministry of Health              | Policy, regulation and system stewardship                                               | Align with policy direction; do not treat it as the operating purchaser                      |
| Health NZ national functions    | Service direction, standards, funding model, outcome expectations and national planning | Use for problem definition, evidence gates and national consistency                          |
| Health NZ regions and districts | Regional coordination, procurement and increasingly delegated local delivery decisions  | Identify the real regional owner and decision boundary for a test                            |
| Contracted HCSS providers       | Workforce, care planning, restorative goals, delivery, coordination and reporting       | Provider must co-own workflow, capacity rules, measures and operations                       |
| Community organisations         | Activities, peer connection, cultural support, volunteering and local participation     | Include only where capacity, eligibility, consent and safe alternatives are understood       |
| PiP                             | Non-clinical discovery, connection, handoff visibility and participation learning       | Avoid clinical assessment, care allocation, NHI, interRAI ingestion and health-impact claims |

## 3. Ranked outreach matrix

| Rank | Target                                   | Why now                                                                                                                           | Recommended ask                                                                                                                             |
| ---: | ---------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------- |
|    1 | Lisa Foster / HCHA                       | Sector gateway representing most of an estimated 52 providers                                                                     | Request critique, three curated introductions and member-supported access to the September forum; HCHA is not a purchaser or pilot operator |
|    2 | Nurse Maude                              | Te Waipounamu awardee with Nelson/Marlborough reach, restorative experience and public digital leadership                         | Explore a Nelson–Marlborough zero-integration pathway with participation and failed-referral measures                                       |
|    3 | Enliven / Presbyterian Support Northern  | Publishes evaluation work across home support, day services, community involvement and social interaction                         | Test an evaluation-ready cohort while keeping any live Northern procurement strictly separate                                               |
|    4 | Access Community Health / Uru Ātea       | Te Waipounamu awardee with national scale, AlayaCare, visit verification and an accessible decision-support partnership precedent | Co-design an aggregate-only community-connection workflow that does not duplicate its care systems                                          |
|    5 | RDNS NZ                                  | Te Waipounamu awardee with restorative leadership and Otago/Southland capability                                                  | Explore community participation as an optional non-clinical restorative goal                                                                |
|    6 | Te Puna Ora o Mataatua                   | Large kaupapa Māori home-support capability across Mataatua and Eastern Bay of Plenty                                             | Seek kaupapa-led co-design and data-governance direction before proposing a pilot                                                           |
|    7 | Visionwest Home Healthcare               | Large provider with digital coordination tools, dashboards and an HCHA leadership route                                           | Position PiP only as a complementary community catalogue and outcome signal, not system replacement                                         |
|    8 | Pacific Homecare                         | Pacific elder, disability and Whānau Ora services in South Auckland                                                               | Explore language-, whānau- and accessibility-led community connection                                                                       |
|    9 | Healthcare NZ / New Zealand Health Group | Te Waipounamu awardee and largest national HCSS provider, with an existing My Homecare product                                    | Approach separately from HCHA and define the non-clinical boundary before discussing fit                                                    |
|   10 | Counties Manukau Homecare Trust          | Smaller local charitable provider with an adaptable Franklin/Papakura model                                                       | Consider as a tightly supported prototype operator if evaluation and technical capacity are sufficient                                      |

**Provider-account warnings:** Geneva Healthcare is a New Zealand Health Group brand. Treat it as an operational route within NZHG, not as a separate national market account. HCHA explicitly does not represent New Zealand Health Group, so that relationship requires a direct approach. Directory membership, contract award and public digital maturity are not evidence that a provider wants a PiP pilot.

## 4. Procurement and market timing

- **Te Waipounamu:** awarded to Healthcare NZ, Nurse Maude, RDNS NZ and Access Community Health in August 2025.
- **Northern:** restorative bulk-funded ROI closed in February 2026. Its advance notice anticipated a closed RFP and contracts by September 2026; no public shortlist, invitees or final award were verified by the research cut-off.
- **Te Manawa Taki:** shown as a future opportunity awaiting approval, with an indicative Q1 2027 release. It is not an open tender.
- **Te Waipounamu in-home falls prevention:** RFP closed 30 July 2026. This is a market signal, not a current opportunity.
- **Health Digital Investment Plan:** a broad advance notice remains open until 25 November 2026. It signals future digital procurement planning; it is not a PiP tender or an invitation to submit an unsolicited product proposal.

PiP should develop evidence and relationships with providers now while monitoring GETS. Informal engagement must never be represented as a substitute for the published procurement process.

## 5. The concrete participation gap

The 2025 national HCSS experience survey received **6,545 responses** after nearly 28,000 invitations from 15 providers. Its respondent-profile table uses **n=6,540**, and the report gives a 25% response rate. Providers opted into the survey and provider response rates ranged from 9% to 44%; the received and analysed denominators must not be used interchangeably.

- Only **28%** of respondents who wanted or needed community, hapū or iwi activities said they were definitely able to attend, down from 32% in 2024.
- Only **8%** said their needs assessment definitely included support to attend those activities.
- A further **16%** said it included that support to some extent.
- **14%** said the support was absent but they wanted it.
- Response rates were lower for Pacific and Asian respondents than for European/Other respondents, strengthening the case for phone, paper, proxy and assisted participation.

This identifies a material participation gap. It does not establish that PiP will close it.

The survey is credible quality-improvement evidence, not a census. Its participation percentages must not be multiplied by the national HCSS population to estimate the number of isolated people.

## 6. Social connection and institutionalisation boundary

New Zealand interRAI research found that living alone, perceived loneliness, negative social interactions and carer stress were associated with later aged-residential-care admission after adjustment. Association is not causation.

Intervention reviews show heterogeneous and often modest effects on loneliness, and home/discharge interventions have not established a reliable reduction in institutionalisation. PiP should therefore be evaluated as an enabling and coordination layer—not as a loneliness treatment or evidence of delayed residential care.

Acceptable first claim:

> PiP will test whether an older person can find a suitable option, consent to a handoff, reach a human and participate, and whether providers can operate that loop safely and efficiently.

Claims to exclude from phase one:

- Reduced hospital admissions or emergency-department use.
- Prevented or delayed residential-care entry.
- Improved clinical outcomes.
- Treatment of loneliness.
- Fulfilment of HCSS clinical or care-planning responsibilities.

## 7. SNZ reviews and PREM/PROM boundary

The national HCSS survey is a standardised experience instrument. Its 2025 wave also added EQ-5D-5L as an actual patient-reported outcome measure.

SNZ's review corpus may provide qualitative themes, lived-experience context and early signals. It is not currently a validated PREM or PROM because its sampling frame, denominator, recall period, response mode, case mix, moderation effects and repeated-person structure have not been established.

Meeting-reported SNZ figures—more than 25,000 reviews, approximately 95% facility coverage, roughly 96% positive ratings and around 10,000 reviews in the past two years—require an internal analytics audit before external use. “Facility coverage” must be defined; directory coverage is not respondent or HCSS-client coverage.

Required review-data work:

1. Separate retirement-village, ARC, HCSS and other review populations.
2. Document invitation, verification and moderation rules.
3. Establish denominators, missing fields, repeat-review handling and date coverage.
4. Check consent and privacy grounds for secondary thematic research.
5. Determine whether ethnicity, disability, channel and locality can be analysed safely.
6. Use historical reviews as discovery data; collect pilot measures prospectively with standard questions and explicit follow-up points.

## 8. Proposed provider-led pilot

### Shape

- One Te Waipounamu district or tightly bounded service area.
- One awarded HCSS provider and two or three community organisations.
- One regional Health NZ observer or service owner.
- 12–16 weeks live after discovery, readiness and synthetic-data testing.
- Participant volume set by provider and community capacity, not a marketing target.
- Phone and assisted access as core channels.
- No NHI, interRAI feed, clinical record, diagnosis, triage or care allocation.
- Provider-approved referral links or identifiers and aggregate reporting only.
- Explicit exit, export, deletion and safe-alternative rules.

### Primary evidence gate

1. Can eligible people reach at least one suitable, capacity-aware option?
2. Does explicit consent lead to human contact and participation?
3. Can the provider operate the loop without disproportionate workload?
4. Which groups require assisted or non-digital access?
5. Why do referrals fail, and is a safe alternative offered?

### Measures

| Domain                   | Measure                                                                                             | Timing                |
| ------------------------ | --------------------------------------------------------------------------------------------------- | --------------------- |
| Reach and equity         | Enrolled participants divided by eligible people invited, reported by agreed safe groupings         | Recruitment           |
| Accessible participation | Phone, print, proxy or trusted-person assisted use; accessibility barriers and abandonment          | Recruitment and use   |
| Suitable option          | At least one option matching geography, eligibility, accessibility and capacity                     | Each journey          |
| Consented handoff        | Explicitly accepted handoffs divided by users shown a suitable option                               | Each journey          |
| Referral disposition     | Accepted, redirected, declined, waitlisted, no response or withdrawn, with standard reason          | Event level           |
| First human contact      | Median time to contact and percentage inside the provider-agreed service level                      | Event level           |
| Successful connection    | First attendance or service received within an agreed window, provisionally 14 days                 | 7–14 days             |
| Continuity               | Still participating or appropriately connected                                                      | 30 and 90 days        |
| Failed-referral recovery | Recorded reason and safe alternative offered for unsuccessful handoffs                              | By day 14             |
| Community participation  | Ability to attend community, hapū or iwi activities if wanted                                       | Baseline and endpoint |
| Navigation experience    | Comprehension, confidence, completion, effort, respect, cultural safety and trust                   | After journey         |
| Partner burden           | Staff minutes per referral/successful connection, capacity-update workload and duplicate referrals  | Weekly                |
| Safety and quality       | Complaints, privacy events, urgent escalations, missed follow-ups and incorrect service information | Continuous            |
| Cost                     | Cost per consented handoff, successful connection and 30-day retained connection                    | Endpoint              |

Do not use EQ-5D-5L without EuroQol registration and applicable licensing.

## 9. 2026 visibility calendar

| Opportunity                      | Date and location                    | Action                                                                                                                         |
| -------------------------------- | ------------------------------------ | ------------------------------------------------------------------------------------------------------------------------------ |
| NZAG Conference                  | 2–4 December, Christchurch           | Submit a practice/service-design or pilot-protocol abstract by the final 14 August extension; do not imply uncollected results |
| HCHA Forum                       | 16 September, Te Papa, Wellington    | Seek access through Lisa Foster or a provider member; no public open speaker call was found                                    |
| Alzheimers NZ Conference         | 29–30 September, Auckland and online | Approach only with a dementia partner or complementary community-participation contribution                                    |
| Alzheimers NZ political panel    | 1 September, Wellington and online   | Attend for intelligence and networking, not as an assumed speaking opportunity                                                 |
| Aged Care Association Conference | 28–30 October, Wellington            | Lower priority for the HCSS-first route; exhibition access is costly and constrained                                           |

## 10. Action register

### Immediate

- Send Ondine the promised overview, pricing information and PiP demonstration links.
- Ask Ondine for the promised Kelsey context and appropriate HCSS introductions without describing them as endorsement.
- Contact Lisa Foster/HCHA and request critique plus introductions to two suitable providers.
- Approach Nurse Maude and Access first; prepare an NZHG/Healthcare NZ corporate route in parallel.
- Submit a carefully bounded NZAG abstract before 14 August if an honest protocol-stage submission is possible.

### High

- Produce a two-page provider proposition, service blueprint, data-flow map and measure table.
- Audit SNZ review statistics and methodology before external use.
- Define provider capacity, throttling, waitlist, decline-reason and safe-alternative rules.
- Ask Hannah to validate one Te Waipounamu workflow and regional decision boundary.
- Ask Kelsey to challenge the zero-integration design and name the national evidence gates.

### Medium

- Add the proposed connection and participation measures to current pilots where appropriate.
- Develop a provider-readiness checklist and synthetic-data rehearsal.
- Identify a formal consumer co-design route through Health NZ or the provider.

### Ongoing

- Monitor GETS, especially Te Manawa Taki and any new regional HCSS/digital opportunities.
- Maintain a source-dated provider and event tracker.
- Keep Ondine informed with short evidence updates, without implying sponsorship.

## 11. Explicit unresolved questions

1. What reference year, population and funding streams produced the meeting's 74,000/$870 million estimate?
2. Which national owner is accountable for HCSS community-participation outcomes?
3. Which Te Waipounamu role holds the relevant delegated service and budget authority?
4. Which awarded provider has real capacity and leadership sponsorship for a pilot?
5. What reporting is already required, and where would PiP duplicate or reduce burden?
6. What minimum assurance applies to a provider-led, zero-integration non-clinical workflow?
7. Which SNZ review populations and fields can be analysed validly and ethically?
8. What evidence would justify moving from discovery to a funded evaluation?

## Source register

- [Health NZ — A review of aged care funding and service models](https://www.healthnz.govt.nz/publications/a-review-of-aged-care-funding-and-service-models)
- [Sapere strategic assessment](https://nzaca.org.nz/wp-content/uploads/2024/12/Sapere-2024.pdf)
- [Health NZ — HCHA Forum briefing](https://static.info.content.health.nz/docs/publications/17-10-2025-event-briefing-home-and-community-health-forum-hnz00098036.pdf)
- [Health NZ — regions](https://www.healthnz.govt.nz/about-us/what-we-do/our-regions)
- [Health NZ — devolution](https://www.healthnz.govt.nz/publications/devolution-at-health-new-zealand)
- [GETS — Te Waipounamu HCSS award](https://www.gets.govt.nz/HEALTHNZ/ExternalTenderDetails.htm?id=31571657)
- [GETS — Northern HCSS ROI](https://www.gets.govt.nz/HEALTHNZ/ExternalTenderDetails.htm?id=33318138)
- [GETS — Northern HCSS advance notice](https://www.gets.govt.nz/HEALTHNZ/ExternalTenderDetails.htm?id=33179328)
- [GETS — Health Digital Investment Plan advance notice](https://www.gets.govt.nz/HEALTHNZ/ExternalTenderDetails.htm?id=33099110)
- [HQSC — HCSS survey overview](https://www.hqsc.govt.nz/our-data/patient-reported-measures/patient-experience/about-our-patient-experience-surveys/home-and-community-support-services-experience-survey/)
- [HQSC — national HCSS results 2025](https://www.hqsc.govt.nz/assets/Our-data/Publications-resources/Surveys/HCSS-Survey-Report-2026.pdf)
- [HQSC — HCSS survey methodology](https://www.hqsc.govt.nz/assets/Our-data/Publications-resources/Surveys/Home-and-community-support-services-experience-survey-Methodology-and-procedures.pdf)
- [Ministry of Health — National Framework for HCSS](https://www.health.govt.nz/publications/national-framework-for-home-and-community-support-services-hcss)
- [NZ interRAI social-factors study](https://doi.org/10.1016/j.jamda.2019.02.005)
- [HCHA](https://www.hcha.org.nz/)
- [HCHA provider directory](https://www.hcha.org.nz/find-a-provider)
- [Nurse Maude homecare and CREST](https://www.nursemaude.org.nz/home-care-services)
- [Access Community Health](https://access.org.nz/home-support-care/)
- [New Zealand Health Group service map](https://www.nzhealthgroup.com/map-of-services/)
- [RDNS NZ support at home](https://www.rdns.org.nz/our-services/support-at-home/)
- [NZAG 2026](https://tcm.swoogo.com/nzag2026)
- [HCHA events](https://www.hcha.org.nz/events)
- [Alzheimers NZ 2026 conference](https://alzheimers.org.nz/explore/events/save-the-date-for-our-2026-conference/)
- [Aged Care Association Conference 2026](https://aca-conference-2026.eventsair.site/)

## Research boundary

This brief uses public organisational and professional information plus sanitized, professionally paraphrased meeting findings. It excludes informal personal discussion and unconfirmed partnership details. Meeting feedback is not Health NZ endorsement, procurement approval or permission to use Health NZ branding.