Why Join

We believe that current settings and existing PHO structures have led to a number of challenges which impact upon patient care. thePHO will aim to address these challenges, which include:

1. Excessive and avoidable bureaucracy for Health New Zealand Te Whatu Ora in dealing with approximately 30 individual PHOs;
2. Lack of economies of scale with many small PHOs;
3. Excessive funding being diverted to management & administration costs (including approximately 30 separate governance boards, administrative headquarters and an overly-populated national contracting process);
4. Accumulation of reserves at local PHO level from resources otherwise intended to directly fund front-line patient services and support contracted providers;
5. Significant conflicts of interest and unintended consequences as many PHOs have developed competing and inequitable commercial interests such as direct ownership of contracted providers and the for-profit development of services (e.g. IT, registry management and telehealth services) sold to their own member contracted providers;
6. A lack of transparency in how funding for primary health is being used by PHOs entrusted with it;
7. Significant variations in approach and services resulting in an avoidable and unwarranted postcode lottery for patient care;
8. A deterioration in relationships as disenfranchised contracted providers lose trust and confidence in their PHO which they no longer deem to be acting in the best interests of their general practices or the local enrolled population.

thePHO will be a national PHO offering a new PHO paradigm. National economies of scale across larger number of ESUs will be further complemented by a PHO which 

• Is exclusively for general practices that are members of GenPro
• Aligns with GenPro’s purpose “to promote and enhance the health and wellbeing of all individuals, families and communities within New Zealand”
• Recognises that the government funding it receives is intended for the benefit of local communities and the general practices which serve them
• Provides full transparency (to the extent possible under data protection legislation and contract confidentiality) to general practice contracted providers on the use of funding received through the PHO Services Agreement (PHOSA)
• Is not-for-profit (charitable status pending), will minimise its infrastructure and management costs, and which will not use general practice funding to develop its own commercial business interests or interests which compete with those general practices it is funded to support.
• Is owned and governed by a holding company formed exclusively of GenPro members.
• Is lean and minimises its own administration, bureaucracy and infrastructure to maximise funding for front-line service providers.
• Will minimise the burden of bureaucracy upon providers to the extent possible by the PHO Services Agreement and the requirements of Health New Zealand | Te Whatu Ora.
• Will work with GenPro to influence national policy and funding frameworks to support accessible, high-quality and sustainable general practice for all New Zealanders.

Yes. The PHO application, initially sponsored by GenPro, was submitted to Health New Zealand on 18 September 2025 in advance of the annual deadline date of 1 October. This followed earlier discussions to test potential support with the Minister of Health and separately, officials within Health New Zealand and the Ministry of Health. 

The Health New Zealand review process for the PHO application aims to give conditional approval, and subsequent final approval for thePHO to commence funded operations on 1 July 2026. There is a comprehensive implementation process underway to ensure that is the case. 

It hasn’t been a big secret but we acknowledge that we have not be promoting or publicising our application. That was a deliberate strategy and one which we agreed, in good faith, with officials at Health New Zealand. That was in recognition of thePHO becoming a national PHO with a large number of ESUs and which could, potentially, undermine current PHOs and cause disruption and uncertainty in the sector. 

Until we had more certainty to be able to share with GenPro members, we have progressed the application within just a small group of stakeholders. We sincerely acknowledge, and apologise, that this has meant some providers may have felt initially excluded from the process. 

The Constitution and governance arrangements will be set up to prevent this. The governance and decision-making arrangements will be aligned with the principles of GenPro. thePHO’s Board will be directly appointed by the HoldingCo – which will be owned and democratically governed by GenPro members (see below for more governance information). 

Admin and infrastructure will be kept at a minimum and from the outset, thePHO will base its functions on the PHOSA minimum requirements. It will not build its own commercial empire or use PHO funding to purchase practices or commercial suppliers that compete with or profiteer at the expense of existing practices.

The establishment principles under which thePHO has been established include aiming to get as much funding as possible to the front-line through member practices. This will include keeping PHO admin and infrastructure to a minimum while still meeting the requirements of the PHOSA. 

Whilst it is too early to give specific commitments about the exact level of funding being passed through to practices, the intent and the governing rules of thePHO will aim to maximise that funding as much as the PHOSA minimum requirements allow.

Yes, PHOs have a contractual responsibility to support workforce development.  We will accredit and endorse appropriate suppliers of CME to meet college and direct patient care needs. This will include, for example, current CME activity which is provided via BPAC NZ to the general practice sector. 

Our initial intention is to develop an on-line platform for member practices which collates multiple existing tools and providers of training rather than duplicating or competing with those providers. 

The PHO wants to avoid directly employing staff to undertake its own provision whether that be training or direct patient services.  

Where feedback from member practices identifies a gap in training and education provision, we will address that gap and, where appropriate, seek relevant accreditation.  

Membership of thePHO will only be available to practices which are members of GenPro and therefore support the values and objectives which GenPro and thePHO have both adopted. 

The large corporates (e.g. Green Cross Health, Tamaki and Tend) already have their own PHOs and will not therefore be part of thePHO. 

The practice mix is anticipated to be predominantly small-to-medium size GP-owned practices alongside a small number of group-owned practices which may include small corporates and charity-trust owned practices (e.g. Southlink Health owned practices – noting that this organisation is a not-for-profit charitable trust). 

thePHO board will be appointed by a holding company formed by all the practices who join thePHO (shareholders).  thePHO board will then be responsible for contracting a Chief Executive whose terms and conditions will explicitly require delivery of the objectives and principles under which thePHO has been incorporated. 

We are registering as a charitable and not-for-profit organisation to support and enhance general practices and the health of the populations they serve. We will not duplicate or compete with those same practices. 

An interim establishment board and establishment Chief Executive are currently developing thePHO and our operating model. That team includes previous PHO Chief Executives, GPs, Practice Managers and Accountants. They have been specifically selected for the establishment phase based on their expertise and track record – which we believe you will recognise on our website. 

thePHO will have to meet the minimum requirements as set out in the PHO Services Agreement and that is likely to look similar in many ways to your current PHO.  However, there may be activities and approaches that your current PHO undertakes which do not fit with our proposed approach – these may include ensuring we do not use reserves or flexible funding to directly develop our own competing services (such as buying neighbouring practices which undermine your own patient base).  

Where your current PHO directly funds additional services or health professionals within your practice, we will aim to ensure such arrangements are ultimately equitable, sustainable and available consistently across our member practices.    

There will be no change to capitation – which will flow fully to practices. We will aim to minimise any changes to claiming arrangements – but where there are changes we will work with practices to ensure you have the support required to make the transition as seamless as possible. 

For additional funding streams, we aim to maximise the funding which reaches practices. We will avoid providing any patient services directly ourselves and we will avoid employing additional members of the primary health care team where they are better placed and employed within individual practices or consortia of local practices. We do not believe PHOs should be competing with the practices they are there to support.  

Our focus will be on transferring the components of the PHO Services Agreement from your current PHO. That will include capitation funding, flexible funding pool and additional management funding. We will also focus on the transfer of additional contracts and funding with as little disruption as possible.  Our desire is that all additional services and any members of the primary care team are funded directly within general practices rather than within thePHO. Where practices may not have the capacity or desire to undertake those functions themselves, we will be happy to help facilitate local consortia arrangements with other practices.   

Where your current PHO directly funds additional services or health professionals within your practice, we will ensure such arrangements are equitable, sustainable and available consistently across our member practices.    

Our initial focus will be on transferring the components of the PHO Services Agreement from your current PHO. That will include capitation funding, flexible funding pool and additional management funding. 

In addition, we will ensure the transfer of additional contracts and funding such as the examples given in the question. These services will continue to be provided by the current provider but are outside of the PHO Service Agreement.   Over time, we will aim to secure the funding for these services from Health New Zealand and to be able to contract for them through thePHO. 

Our desire is that all additional funded services are provided directly within general practices rather than within thePHO. Where practices may not have the capacity or desire to undertake those functions themselves, we will organise/facilitate local consortia arrangements.    

Practices have a contractual responsibility to provide afterhours care. We do not anticipate any changes to current afterhours arrangements. Over time we will be happy to work with practices and localities to help improve any services and arrangements if practices would like us to do so. 

You do not need to change PMS. Our systems will be flexible and will interface with all the current PMS providers. We will aim to make the transition as seamless as possible and we are already engaging with an advisory group of practice managers to assist with this.  

thePHO is totally owned by a holding company (HoldingCo) via a single shareholding. 

Practices which join thePHO will become individual and equal shareholders in HoldingCo. 

The shareholders of HoldingCo will elect the HoldingCo Board in a totally democratic election process. 

The HoldingCo Board will be responsible for appointing thePHO’s Board.  The structure and membership of thePHO’s board will need to meet the PHOSA minimum requirements. Therefore, this will be done via a skill-based appointment process and not an election.

There is an interim Establishment Board only. This is to ensure we can meet the requirements of the Companies Office in setting up the organisations and subsequently applying for Charitable status for thePHO. The Establishment Board also means we have an initial decision making and accountable forum for the decisions required in establishing and setting up the PHO (including the important PHO application process with Health New Zealand). 

The desire to create thePHO with its specific objectives came from GenPro in response to enquiries from their members. Therefore, 4 of the initial 6 Establishment Board(s) members were selected from the GenPro Board to ensure that the vision was maintained in the establishment of thePHO.  The GenPro Board members selected were those who were able to give an immediate commitment-in-principle for their own practice to transfer to thePHO. 

In addition, the Establishment Board(s) includes 2 general practice owners who, in initial conversations, were able to commit multiple practices to thePHO and support the minimum number of ESUs required to submit a viable PHO application to Health New Zealand. 

It is emphasised that the Establishment Board(s) are only in place temporarily to ensure the initial application process with Health New Zealand and the establishment of thePHO.

This mirrors how we previously established GenPro and the need for expediency. We think, overall, the GenPro process worked out quite well. 

Once we have confirmed practices moving towards Back-to-Back contracts with thePHO (we anticipate between March and June 2026), we will hold fully democratic elections for the substantive Board of the HoldingCo.  It is the HoldingCo who will ultimately be responsible for the annual appointment/rotation of positions on thePHO’s Board. 

However, to meet the PHOSA minimum requirements set by Health New Zealand, we will need to ensure a skills-based and compliant PHO Board is in place before that date. Therefore, for expediency, the Establishment Board will be agreeing a framework for the composition, selection and appointment of the first substantive PHO Board members. In line with good governance practice, these will be time-limited appointments which will also ensure the subsequent elected HoldingCo Board ultimately has the ability to appoint its own skills-based PHO Board (subject to meeting the minimum requirements of the PHOSA with Health New Zealand).  

Absolutely, yes. The HoldingCo nomination and election process will run like that operated by GenPro. Once we have more certainty about those practices which will have Back-to-Back contracts with thePHO, we will confirm their respective shareholding in the HoldingCo. We will then openly call for nominations to the [maximum 9] HoldingCo Board Directors and run a fully democratic election process across thePHO’s general practices as the only shareholders in the HoldingCo. 

Each general practice with a single Back-to-Back contract will have a single vote of equal weighting. Due to the rapidly changing number of enrolled patients and general practice ownership landscape, it is too difficult to apply any weighting based on the size of individual practices. 

No. We have been very careful to ensure that the legal structures, ownership and governance arrangements for thePHO (and HoldingCo) are separated from GenPro.  Whilst thePHO and GenPro will strategically work together to achieve similar aims, GenPro will ultimately have no say in the decision-making processes of thePHO and vice-versa. 

This will ensure that GenPro retains full independence and freedom to advocate directly on behalf of general practice and urgent care owners. It will also ensure that it remains unfettered in its ability to negotiate solely on behalf of those same owners (for example at PSAAP). 

Similarly, thePHO will have specific responsibilities as listed in the PHOSA to secure a PHO contract, and associated funding, from Health New Zealand. Some of those responsibilities (e.g. broader population health, performance management of providers) need to be done without interference from individual providers or the organisation that represents them.

PHOs must meet the requirements of the PHOSA. By signing up to the Contracted Provider Agreement (the Back-to-Back), constituent practices are expected to abide by the same requirements. thePHO will however be looking at the most cost-effective way of fulfilling those requirements and is keen to work with member practices to maximise the funding which reaches the front-line and therefore patient care. Similarly, thePHO will be avoiding any unnecessary or unfunded activity (e.g. development of commercial interests not required of the PHOSA or against the interests of its member practices). 

Whilst the operational arrangements of the organisation are for agreement through the governance of thePHO, the requirement to comply with the PHOSA and Back-to-Back is not for negotiation. Membership of the PHO will be subject to agreement of a Back-to-Back contract as with all other PHOs.  

It may be helpful to note that thePHO will have a seat at the national PSAAP negotiation table and it will work very closely with GenPro to influence future PHOSA and Back-to-Back contract/funding changes in the best interests of sustainable providers, high-quality patient care and minimising bureaucracy.

Subject to meeting the requirements of the PHOSA, the PHO will aim to maximise funding and flexibility for its practices.

We are having detailed commercial discussions with providers of registry management and associated data/reporting/payment services. thePHO does not want to reinvent the wheel or directly provide support services which are already established and successfully meeting the needs of practices.  

We will aim for minimal disruption whilst seeking a single national solution. We will be requesting that potential suppliers detail their change management/implementation support (where practices may not already be using their service).  

Firstly, as detailed above, thePHO and GenPro are separate legal entities with separate governance arrangements. They have distinctly different contractual and functional responsibilities. However, thePHO has been established in a way which better aligns with the objectives and values of GenPro – without undermining thePHO’s responsibilities to Health New Zealand. 

As a national PHO, it is intended that thePHO and GenPro work alongside each other in national fora such as PSAAP, to help deliver their respective, and mutual, objectives on behalf of contracted providers and local communities.   This will be a strong partnership with GenPro formally representing general practices while thePHO will act for the relevant populations through its PHOSA with Health New Zealand.

Additionally, thePHO and GenPro will, where appropriate, work closely together to influence funding, policy, share resources and meet regularly to align strategic positions. 

We agree that there may be some change alongside the significant opportunities offered by a national PHO which seeks to consistently maximise front-line funding. We also want to ensure continuity and minimum disruption for practices.

We are already working with a group of practice managers (through GenPro and associated members of PMAANZ) to ensure general practice input to our establishment and operational plans. We are operating a weekly Implementation Action Group (IAG) which, again, has practice management input as well as general practice clinical leadership and operational expertise. 

We will continue to be transparent and fully collaborative with contracted providers (including general practice and urgent care). 

Please see the comments above regarding the registry management service and the involvement of practice managers. We will try and adopt the same principles for other areas of the implementation, and the operational arrangements will be developed and agreed in liaison with practices. This will include clear change management approaches which ensure continuity and minimise disruption. 

If you have specific examples or suggestions in this regard we would be delighted to receive them.

We will ensure support is available to help individual practices.

As mentioned above, we will work with our practice managers advisory group to help ensure we provide the right level of guidance and support for any changes.

As well as our national email help point, we will also have a nominated development manager for each region - and that includes for you as individual practices too. 

Yes. Practices are required to give six months’ notice to their current PHO advising of their intention to change PHO (e.g. that would be 31 December 2025 for contracts commencing 1 July 2026).  We have provided a template to assist here.

When giving their six months’ notice, practices do not need to tell their current PHO which PHO they intend to move to. However, as we start to negotiate and agree the transfer of contracts for 1 July, both PHOs will need to work together to facilitate that transfer. Therefore, the current PHO will ultimately need to be made aware of the new PHO. 

Practices must give six months’ notice but they are not then obliged to leave their current PHO. If new contractual arrangements cannot be made with an alternative PHO (for whatever reason), practices retain the right to remain with their current PHO – as per advice from Health New Zealand

No. Our PHO systems, such as Registry Management, will be configured to automate with all existing PMS systems. Our technical team will ensure the change happens as required.  However, we will require some advance information from you to assist with this process (including Practice HPI Org ID, HealthLink EDI, bank account details etc). But don't worry, once we have accepted your initial simple application/expression of interest, we will forward the data requirement sheet and work through the details with you.  

Health New Zealand advise that approval for a new PHO only covers the funding streams through the PHOSA. Any additional regional funding streams (e.g. Access & Choice) will be for separate discussion with the relevant regional Health New Zealand team. We absolutely anticipate these transferring to thePHO and will be working with practices and Health New Zealand regional teams to agree a managed process which again ensures continuity and minimum disruption. This may not ultimately happen to the same timescale as the main transfer of the PHOSA and Back-to-Back contracts but we will aim to do so.

Our starting point for that will be a simple mapping exercise of all such contracts/funding with general practices.

thePHO is confident of meeting all the requirements to successfully start operating from 1 July 2026. However, that does remain subject to approval by Health New Zealand. In the very unlikely event that approval isn’t secured thePHO may defer its start date. Practices who had already given notice to their existing PHO, can remain with that PHO (post 1 July 2026) in the meantime. 

Quite simply, no. 

You are fully entitled, under the terms of the back-to-back agreement, to apply to change PHO without needing to pay a fee or give a reason.  However, as already mentioned, you are required to give formal notice to your current PHO at least 6 months' in advance of your anticipated move. e.g. You must give written notice by 31 December 2025 for a 1 July 2026 PHO change.

Please just ask us if you have any concerns or additional questions.