Gateway Assessment Review Findings

Gateway was introduced in 2011 as a joint programme between Child, Youth and Family (now Oranga Tamariki) and the Ministries of Health and Education. Gateway provides a specialist assessment that aims to comprehensively identify the health, disability and education needs of children and young people engaged with Oranga Tamariki, and ensure there is a coordinated, cross-sector plan in place to meet them.

A Gateway Assessment is expected for every child entering or in care. It is available for some children who are higher risk of entering care (i.e. referred for a care and protection Family Group Conference) depending on the social worker’s initial assessment of needs. Each year, 3,698 children on average are expected to receive a Gateway and on average 2,443 are delivered.

The Review involved over 80 engagements and two national surveys with cross- sector professionals, care partners, community providers, and care-experienced young people. This was a joint effort between Oranga Tamariki – Ministry for Children, Manatū Hauora – Ministry of Health, Te Whatu Ora - Health New Zealand, Te Tāhuhu o te Mātauranga – Ministry of Education, Whaikaha – Ministry of Disabled People, and Te Aka Whai Ora – Māori Health Authority.

The Review has found several significant issues with the current delivery model, accountability, and a high degree of local and regional variability. As a result, children may not have their needs met in a timely way, feel like they do not have a voice in decisions that are made about them, and feel unsupported once a Gateway Assessment is completed. 
 
Key themes included: 

• Lack of involvement of children, family/whānau and caregivers, and 
• inconsistent information-sharing. 
• Over-reliance on health specialists and lack of alignment to the primary health system. 
• Lack of cultural responsiveness. 
• Assessments are one-off and do not capture evolving need. 
• Inconsistent approach to following up on assessments. 
• Inconsistent involvement from education providers. 
• Assessments can be too slow to meet the needs of the child.

Despite these issues, the original intent for Gateway to provide dedicated interagency coordination and multidisciplinary collaboration for the wellbeing of each child remains sound. These functions need to be updated and strengthened to meet the legislative obligations of children’s agencies and Oranga Tamariki for this group of children. 
 
The Review saw several examples of innovation which respond to identified issues in some regions. These are driven by dedicated and experienced kaimahi and can continue to be built on.  
 
Key examples of innovation and good practice included:  

• Supporting families/whānau to engage and meet needs earlier, often led by nurses and whānau navigators 
• Greater integration with Māori, Pacific, and community providers to deliver a greater range of culturally responsive wrap-around services 
• Improved child development service responses to meet developmental and disability needs (e.g. speech language therapy) 
• Community-based and inclusive locations for assessments and meetings. 

In early June, the Ministers for Children, Health and Education noted the Review’s findings and agreed to redesign the service. 
 
A cross-agency project team is currently undertaking detailed service design. The design will be tested with frontline kaimahi from relevant agencies, communities, partners and providers over the coming months. 
 
A report back to Ministers with a proposed service design and options for implementation is planned for later this year