Bula Sautu – HQSC

Health Quality & Safety Commission

Learn how HQSC and their Pacific community partners co-developed the Bula Sautu Report by getting comfortable with radical uncertainty, working to each other’s strengths, and establishing shared values and trust.


Every year HQSC creates a report on the state of health care with a particular focus. In 2021 the focus was Pacific health which has specific systemic inequities. HQSC needed to create a useful analysis of the health status of Pacific people in New Zealand.


HQSC, with Pacific community partners, co-developed and co-produced the Bula Sautu Report, which brought together local insights, expert opinions and national data sets in service of improving Pacific health outcomes.

Observations and lessons learnt

Innovative know-how

Enabling senior leadership

The team had trust from their manager to pursue the tasks they thought made sense. Their manager was a sounding board, constant supporter and enabler, even when they weren’t sure. There was trust in both directions as they’d built a relationship over time.

Minister as advocate

Involve the minister from the start so they are active in driving implementation post publication. In this project, having ministerial backing gave partners confidence that change would be possible. The report received deserved publicity, with a launch at parliament in July 2021.


Parameters to encourage innovation

There was a clear end goal but the process for how to get there wasn’t set. There were defined boundaries on the outer limit - what the report was not to include - with freedom to innovate within that. This required radical openness from the team, a difficult skill to teach but one that can be learnt over time through a supportive working environment. Radical openness is about embracing transparency as a means to foster trust and effectively work together. Where partners pool resources, leverage each other's expertise and have a clear shared vision.

Processes and adaptability

Progressing a project with radical uncertainty

Different points in a project require different approaches; from the early organic phase of building trust and open minded brainstorming, through an unprescribed discovery phase, to a defined conclusion that needs to be steered meets requirements and deadlines.

“You have to be radically open, radically flexible and listen to see how you can provide value to them [Pacific partners]. It takes real emotional intelligence from both sides of the table.” 

Adapting for different collaborations

There isn’t one collaborative process that works for different communities and sectors. Flexibility to adjust is needed in working to each partners’ strengths. In this case, the partner’s strength was in their broad insights and knowledge. The HQSC team’s strength was in analytics and providing data sources as evidence for their insights. Partners would suggest an area of significance and the HQSC team would provide the current and historical data to support it.

“What you bring to a project will be different from what you brought before. The project determines what role you play in it.” 

Collaboration with the public and non-government entities

Common values to ground the partnership

Establishing common values helped to grow trust which is needed to effectively work together towards the common goal. They shared our values during unstructured conversations in-person at the beginning of the project, communicating why they were doing this work. The organic brainstorming process is more successful when the team has built trust based on shared values. 

A Pacific consumer group was convened by the Commission’s Partners in Care team to provide valuable insights into what’s working well in the health system for Pacific peoples and where improvements could be made to ensure the system is working at its best. The group provided a strong Pacific consumer voice to accompany Bula Sautu.

Thanks to Dr Debbie Ryan, Dr Corina Grey, and Dr Api Talemaitoga, our leading partners in this work.

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