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					Clinical Training Agency Nursing
          Advisory Group
             Toolkit
         Guide to CTA
Postgraduate Nursing Funding




             OCTOBER 2009
          REVIEW OCTOBER 2011
          Clinical Training Agency (CTA) Coordination for
          Postgraduate (PG) Nursing Education Funding.

Welcome to the role of Clinical Training Agency (CTA) Coordinator -PG Nursing for your DHB. Every
DHB has someone in this role. In some DHBs the CTA coordinator manages all the CTA nursing
contracts which may include Nurse Entry to Practice (NETP), NETP Expansion, Midwifery and PG
Nursing contracts. This toolkit has been developed to help you in your PG Nursing coordinator role,
and the information is, in the main, applicable to the other funding contracts.

The PG Nursing coordination role works across and outside of the DHB and therefore you will need to
be able to work also with your Primary Healthcare Organisations (PHOs), Non-Government
Organisations (NGOs) and Aged care facilities in your area.

There are also some specific nationally agreed activities that are related to this role and covered in this
document.

Head Agreement-
This is the overarching agreement that covers all of the CTA contracts for your DHB- Medical, PG
Nursing, Midwifery, NETP and NETP Expansion. You need to be familiar with this document. This
document is probably held at DHB level and usually has been signed by the Chief Executive Officer
(CEO). You will need a copy- ask your Director of Nursing (DON) or go to the CTA website for a
standard copy- www.moh.govt.nz/cta . The Head agreement is an ongoing contract
and not usually changed. It has definitions in it that you will need to know and so it is
strongly recommended you read this document carefully.
The head agreement covers:
 Quality requirements- trainee selection and feedback processes
 Invoicing and payments- calculation of actual trainee numbers etc
 Privacy-collection of trainee information
 Reporting- complying with CTA reporting requirements

Service agreement-
This is the specific agreement for NETP, PG Nursing, and Medical etc. This agreement
specifies the contracted training units and timeframes purchased on an annual basis. It is usually sent
to you after confirmation of your funding template (see below). NETP and PG Nursing have different
contracts. Each DHB can only receive funding up to the contracted amounts. If you go above this
amount you will need to apply for a contract variation which is subject to CTA approval- avoid this if
you can as it can take a number of weeks to finalise. You do not receive any payments until the
service agreement is signed off by all parties. Every DHB has different processes for this so you need
to find out how this works from your DON or Business Analyst.


Post Graduate (PG) Nursing Specifications
The PG nursing specifications describes what nursing study will be funded and outlines what the
funding can be used for. The PG nursing specifications were last reviewed in July/ August 2009 and
also include the trainee and training programme eligibility. All registered nurses working in the DHB
provider and non-provider arm and Ministry of Health (MOH)-Vote Health funded nursing workforce
are eligible. For example- this may include registered nurses working in schools funded through the
Ministry and DHB.

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The non-provider arm services include NGOs, PHOs, Maori/Pacific/Aged Care facilities. You need to
check who funds some health providers to ensure nurses working there are eligible.

The PG nursing specifications covers only qualifications at level 8 on the New Zealand Qualification
Authority Framework that are Nursing Council approved. These include Bachelor of Nursing (Honours)
Postgraduate Certificate, Postgraduate Diploma and Masters of Nursing.

Your DON is responsible for the PG Nursing Specifications and any emails related to the specifications
are sent to the DON. Sometimes the CTA coordinator is included in the emails but not always.
However you can ask CTA to copy you into any emails. All contracts and letters are sent to the DON.
CTA assumes that the DON is aware of what is going on in relation to these specifications within your
DHB.

 What the funding covers

Please read the specifications along with this page. The funding covers programme coordination,
tuition fees, compulsory clinical mentoring, clinical release of staff, and subsidy towards travel and
accommodation.

 ‘This includes full reimbursement of paper costs (tuition fees and compulsory fees), a subsidy towards
travel and accommodation to a maximum of $2000 and also clinical release costs incurred by an
employer, ONLY when the staff member is paid to attend compulsory study days." (CTA Via email-
7.10.09)

Programme coordination

A maximum of 9% of your allocated funding can be used for programme coordination. Please note that
the 9% can be taken off the ring fenced funding but it must be spent specifically on these areas.
Programme Coordination should not be taken from the Travel Assistance or Cultural Supervision
funding for Maori and Pacific peoples. The programme coordination includes completing all CTA
requirements, and advertising availability of funding to all nurses. The specification outlines the
programme coordination requirements i.e. all the parts of the coordinator role.

Tuition fees

Full tuition fees are paid for all trainees. It does not matter if the trainee works part-time or not; the
expectation is that FULL tuition fees will be paid including compulsory fees.

                   Clinical release:

                   Clinical release covers the cost (per hour) of releasing the trainee to attend their
                   course study days during their working hours. The costing model completed by
                   CTA gives an indication of how much money is available for clinical release time.
                   The trainee may or may not need to be replaced. CTA expects that the trainee will
                   complete all the formal components of the course. If the trainee is required to take
                   the study day as annual leave or leave without pay then the employer is not
                   eligible for clinical release funding. If the trainee is undertaking a paper that is
                   online, they are still eligible for study leave and clinical release for the compulsory
                   components of the paper, at the same level as an equivalent point paper. You do
                   need to have a process by which this clinical release time is paid out- either outside
                   the DHB workforce and internally too.



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Clinical mentoring

This part of the funding is available to cover ANY additional requirements for clinical mentoring that are
not provided by the tertiary provider. Papers that might require clinical mentoring include the clinical
assessment papers. Sometimes the tertiary provider expects the trainee to have some specific
mentoring and coaching hours in addition to what is provided in the course. Not all tertiary providers
have this expectation. Again you need to have an understanding with your tertiary provider about their
requirements for all their papers. You may be asked to assist in identifying appropriate mentors for
trainees and it is a good idea to develop a process to manage this and the funding payouts.

Some examples of papers that require clinical mentoring include (not exhaustive-please check with the
tertiary providers)

Auckland University of Technology (AUT):
 588679 Advanced nursing practice
 588624 Clinical assessment for advanced nursing practice
 588580 Clinical decision making for advanced nursing practice
 589656 Practicum without prescribing

Massey University:
 Post Graduate Certificate in Long Term Conditions Management
 168.759 Practicum (non-prescribing)
 168.757 Prescribing practicum
 168.728 Clinical assessment and clinical decision making
 168.729 Neonatal and family assessment and practice
 168.763 Advanced neonatal nursing practicum

University of Auckland (UoA)
 N702A/B Developing Nursing Practice
 N714 Nursing Practicum 1
 N719 Specialty Nursing Knowledge & Practice
 N730 Knowledge & Science in Specialty Nursing
 N735 Clinical Education Practicum
 N738 Long term condition management in Primary Health Care
 N739 Advanced Rural Nursing
 N740 Prescribing in Advanced Nursing Practice
 N753 Specialty Practice in Mental Health Nursing 1
 N756 Specialty Practice in Mental Health Nursing 2
 N762 Rural Nursing Practicum- Initial response
 N765 Nursing the client with breast cancer
 N770 Clinical Practice development (NETP Funded)
 N771 Chronic Care Interventions
 N773 Advanced Assessment and clinical reasoning
 N776 Assessment and clinical decision making in Mental Health Nursing
 N743 Advanced Nursing Practicum

Eastern Institute of Technology (EIT)
 Clinical assessment paper (Note: apparently EIT will pay up to $60/hr for a mentor for these
  trainees und therefore will not be eligible for CTA funded clinical mentoring funding)

Southern Institute Of Technology (SIT)
 HS401 Assessment and Diagnostic reasoning
 HS412 Advanced Practicum


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Travel and accommodation

This is a subsidy of up to $2000 towards the actual costs of the trainee who is required to travel more
than 100kms one way from their usual place of work to the place of study. You will need to ensure
trainees are aware that this is a subsidy only. It also needs to be applied for with the yearly application
for funding, so can not be done retrospectively. Again the costing model will give you an indication of
how much is available for this, so you can make it clear to your trainees.

Maori and Pacific Support Funding

This funding is for mentoring, cultural supervision and cultural development. It is NOT for tuition fees,
clinical supervision or clinical release. The idea of this funding is to help Maori and Pacific nurses
successfully complete their qualification. The applicants must be of Maori or Pacific descent and have
established cultural links. The applicants will need to find a mentor and a cultural supervisor. It can be
the same person. The DHB can assist the trainee in finding their mentor. To make this funding
successfully you will need to work with your Maori and Pacific health units. The actual specifications for
Maori and Pacific Support funding are available on the CTA website. Again you will need to read these.


 Who the CTA PG Nursing funding covers

This funding covers registered nurses working in the following (not exclusive):
 DHB
 Primary Healthcare Organisations
 Rural nurses
 Maori and Pacific Providers
 Plunket
 Hospices
 School nurses (if funded by DHB or MOH, not covered if paid by Ministry of Education)
 Aged Care facilities e.g. Private Hospitals or Rest Homes

It   does not cover:
     Private surgical hospitals
     School Nurses if employed by Ministry of Education
     Enrolled Nurses or Nurse Assistants
     Registered Midwives.
     Prison nurses employed by the Justice department


 General versus Ring Fenced Funding

General Funding
Covers staff from in-hospital, aged care facilities, hospice etc. You can put anyone into the general
funding band regardless of where they work.

Primary Health Care
Includes staff working in the community setting (including DHB staff e.g. District nurses, community
based nurses), school nurses, PHOs, NGOs (including Plunket).

Rural
Includes nurses working in rural communities. (See Statistics New Zealand definitions of rural
http://www.stats.govt.nz/publications/businessperformanceenergyandagriculture/urban-rural-
profile/defining-urban-rural-nz.aspx ).


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Long term condition management (LTCM)
Includes nurses working in chronic care management, who are doing a specific certificate in long term
conditions management. All nurses especially practice nurses are eligible for this funding. There are
some other criteria for this funding. Only three universities are able to run this certificate- University of
Auckland, Massey University and University of Otago. The funding is for this postgraduate certificate
only, is for part-time study, and the trainee must work more than 0.4 FTE. The funding for this
particular certificate also includes extra funding for the provision of clinical mentoring and two
additional days of clinical release (eight days per paper).


 Application form information

Your application form should include all the information required for CTA’s report one. You will need to
complete this report every semester. Depending upon the number of trainees accessing PG nursing
funding it may be a large report and takes time to complete. Report one does have a glossary to help
you.

The following information is required:
 Full name of applicant-first and surname as it appears on the nursing registers (the CTA database
  will reject any names that do not match the record on the Nursing register)*
 Date of birth*
 Nursing Council Annual Practising Certificate (APC)number*
 Employer especially if outside the DHB*
 Clinical service area*
 Employed FTE*
 Ethnicity*
 Gender*
 NZ resident or citizen.* If born outside NZ get a photocopy of residency or citizenship
 University and papers planned to complete their qualification*
 Qualification planned e.g. BN (Hons), PG cert, dip or Masters*
 Specific paper number and name for each semester * and points value of the paper (this is needed
  to work out the training units you require)
 Date commencing and ending qualification(the dates for the specific paper(s) are acceptable)*
 Line manager approval
 Career plan- what they want to do in the future
 A statement that the applicant signs, indicating that the DHB can get the applicant’s results from
  the tertiary provider. You will need this for report 2. NB-Not all tertiary providers will accept this
 A statement saying the applicant is happy for you to release the information to CTA under the
  Privacy Act
 Applicants signature
 If the applicant wants Maori and Pacific support funding*
 If clinical mentoring is required*
 If travel and accommodation is required*

* required for report one


 Application Rounds

You need to work out how and when you want to do the application rounds so that to suit your DHB.
You will certainly need to do at least one round just before the yearly funding template is due. Some
DHBs have one application round a year while others have 2 rounds. The second round (if you have


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one) is usually held just before semester 2. Remember that you can only apply for the funding once a
year so if you plan to hold a second application round your funding application will be an estimate of
second semester funding. Note: if having a second application round, ensure that you utilise your
funding fully and do not go over- as you will need to apply for a variation of contract which is subject
to CTA approval. This is not desirable as it is not equitable for a few DHBS only to access additional
funding where available. Any funding for summer school is applied for in the funding round just before
it commences.
You will need to advertise widely for your application round especially for the PHOs, NGOs and Aged
Care providers. It is a great idea to have a webpage on your DHB website so that non-DHB employees
can access the information readily. Most coordinators have a couple of weeks between the end of their
application round and when the funding template is due in order to allow enough time to do all the
data entry and work out the funding they need to apply for. You will need to advertise widely your
application round especially for the PHOs, NGOs and Aged Care providers.

It is strongly suggested that you have a wait list of applicants. Most DHBs find that there is usually
approximately a 10-20% withdrawal of registration of interest prior to enrolling. You will need to
replace them to ensure you allocate all your funding. If you need to move funding between Purchase
Units (PU) codes then you may need to apply for a variation of contract (which usually takes about 6
weeks to come through).

As part of the application round you need to prioritise how you allocate the funding and therefore you
need to develop a strategy for this. You need to base the strategy on your DHB District Annual Plan
(DAP), District Strategic Plan (DSP), and the workforce action plan (WAP) of the 21 DHBs. You will
need to run this past your DON to ensure they sign this off. As a suggestion the priority framework
should be placed on a website.

Another useful idea is to have road shows from the different tertiary providers that your DHB uses to
provide postgraduate education. Most tertiary providers are willing to come to your DHB and present
their programmes they are offering for the following year. Most DHB’s offer this at the end of year
application round. This can be done in many different ways. Some have the tertiary providers came
down on the same day to one area. Other DHBs have the different providers come at the different
times to several different venues. Basically it is what works best for you and your DHB.



 Advertising CTA funding

A very important part of your role is ensuring all eligible trainees know about CTA funding. So you
need to advertise widely and in many forums especially with non-DHB employees. Part of the
programme coordination allocation helps fund this. You will need to develop advertising
materials. This is where it is very helpful to email and talk to other CTA coordinators who
have this in place. Some ideas on advertising include:
 Website- internal and external
 Brochures
 Handbook
 Visiting areas especially non-DHB organisations
 Speaking in several different forums/meetings


 Prescribing practicum

The prescribing practicum funding is a significant amount of funding made available by CTA as a
subsidy for those nurses in the final year of a masters degree with the prescribing option. This funding


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enables the nurse to have the required supervision and clinical release time in order to meet the
prescribing practicum requirements.
Each DHB develops its own process for the management of this funding, and it is highly recommended
that a thorough process is developed for both the application round as well as the management/
invoicing of the actual practicum and funding. Experience has shown that having this process etc in
place will prevent a number of problems from developing.
Areas to be thought about include
    How the prescribing practicum fits into the individuals practice role
    How the development of the advanced practice roles (such as NP) fits into your DHB and/or
     service strategies and future workforce development
    What supervision/ supervisor is available for the specific clinical area
    How clinical release time etc will be arranged and reimbursed
    How supervision time will be arranged and reimbursed
    Whether the service/ organisation is fully supportive of the prescribing practicum
    How the progress of the nurse will be monitored


 CTA Audits

CTA audit DHB programmes on a regular basis. The audit is not a punitive process but an opportunity
to improve the quality of your programme. Many DHBs have been through the audit process and have
all survived. The CTA subcontracts a private organisation to undertake the audit. The auditors review
all the documentation as per the Head Agreement, service agreement and PG nursing specifications.
Talk to the CTA Coordinators to find out what was covered in the audit.




  Important Relationships

It is important that you develop relationships with all the organisations as
per page 7 of the PG nursing specifications. You need to go and meet
people to promote the CTA funding especially those organisations outside
the DHB. You will need to demonstrate how you work with PHOs, NGOs,
and the aged care sector especially when an audit is undertaken.



 Important dates

August/September

This is usually when your DON will receive the letter that indicates the amount of funding your DHB
will be allocated. Usually a copy of the new funding template is usually included.

Funding template- due to CTA on the third Friday of November

The funding template is sent to you by CTA- initially by letter (August) then later electronically
(October). This template is used to allocate funding. No names go on to this template. Every year CTA
allocates some funding to your DHB. This funding is worked out on population based funding- the
same way that your DHB is allocated it’s funding. We can ask for more funding (additional funding),
but the additional funding should not be taken for granted. This is where it is very important to have
your application round before the due date of the funding template. Once the funding templates from


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all the DHBs are in, CTA makes a decision on whether or not the DHB can be approved the additional
funding. The DHB is notified before Christmas of the confirmed amount of funding so that the
applicants can be informed of the outcome of their application. It is a good idea to encourage them to
enrol early into their universities.

Report ONE- usually due mid March (semester one) and mid-end August (semester two)

Report one is a spreadsheet that has all the data required by CTA for their database. It has many
columns and every column needs to be completed. The easiest way is to develop your own
spreadsheet that is set up similar to the CTA Report One template. Ask Esther or another CTA
coordinator for a blank Report One to help you set up your own. You are unable to alter the Report
One Template and it is best to leave Report One to the last minute and then copy column by column
the information from your database into the template. It is possible to copy invalid entries into the
Report One so you need to make sure that your database matches the entries used in the Report One
template.

Report 2- usually due mid-end July (semester one) and mid-end November (semester two)

Report Two has two components- Report Two Outcomes and Report Two Evaluative.

Report Two Outcomes

At the end of every semester you will need to get the results from all students. It is strongly suggested
that on your application form you have a section where the applicant signs a statement that you can
access their results directly from the tertiary providers. This is where having a good relationship with
your tertiary providers is so important. NB: some tertiary providers do not accept this but most do. If a
trainee is doing a double semester paper then the outcome is just “in training’. Withdrawal dates and
the reason for the withdrawal must be entered so make sure you make a note of these when a trainee
withdraws.

Report Two -Evaluative

This report is completed on line. Every PU code has its own section to complete-all with the same
questions. At the end of every semester you will need to get some feedback from all the students in
order to complete this report. This can be done in a way that suits your DHB. Some DHBs do this
electronically via email, others use questionnaires. You will need to find out if the students had any
issues while they were studying. Also included in the evaluative report is information about issues that
the clinical mentors have had, so again you will need to have a process to collect information on this.
You will then need to indicate on the evaluation report what you are going to do to improve the
situation. These processes should be part of your quality plan.

Monthly reports

Every month you need to complete an electronic report. This is available on the
CTA website but you will be sent the link to it by CTA. Read the CTA guidelines on
how to do this. You need to remove any trainees who have withdrawn in this
report. A trainee who is in the programme on the 15th of the month should be
reported on. All monthly reports are to be completed by the end of the month in
order for the DHB to be paid as per the payments table in the Service Agreement

An example of how this works is: April report covers 1 to 30 April but if a trainee
withdraws prior to 15 April then they should not be reported in April i.e. the trainee will not be rolled
over from March into April when you submit your April report. If they withdraw after the 15th, they
remain in the April report and you will not roll them over in the May report”

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If you are having problems with this report contact the CTA.

Monthly Payment Schedules

Your schedule for payment is based upon your monthly report so it needs to be accurate. The
schedules are sent to your DHB (either to the DON, you or to the business analyst) by Sector Services
in Dunedin. In most DHBs the coordinator will check the schedule before it is invoiced. Carefully check
your schedule against you funding templates, monthly reports and the data on the website. If there is
an error you can email sector services and/or CTA to make corrections. Once the schedule has been
verified as correct you will need to organise for an invoice to be emailed (cta@moh.govt.nz) from your
DHB to Sector Services so that you can receive payment. Again you will need to be familiar with how
this process works for your local DHB.

University academic dates- see your local tertiary provider for these

It is important to find out the following dates:

 Semester start and end
 Last day for enrolments and withdrawals
 Dates the next years prospectus are out.


 Helpful hints

CTA coordinators group
Other CTA coordinators have developed a support network to share information and resources. We
also have two monthly teleconferences. We try and have a yearly meeting with all the tertiary
providers. This is a great resource for you especially while starting in your new role. You can contact
them through Dianne Barnhill, CMDHB. Email: dianneb@middlemore.co.nz .
Generally most coordinators are willing to share information and resources such as
polices, handbooks, processes and flyers and this is done regularly.
Dianne is also the CTA coordinator representative on the CTA Nursing Advisory
Group (NAG) and therefore is important to share with her what is going on in your
DHB.
It may also be helpful (if possible geographically) to meet regularly with those
coordinators from other close DHBs- after all “a problem shared is a problem
halved”.

Tertiary Providers:
It is essential in your role as CTA coordinator for you to develop good working relationships with your
local tertiary providers and postgraduate educators. You need to understand their postgraduate
programmes and which programmes are accredited by the Nursing Council. See Nursing Council
website- education- postgraduate programmes http://www.nursingcouncil.org.nz/educa.html#pg You
will need to find out what papers can be cross credited towards a Nursing Council approved Masters
degree. It is also a good idea to have an understanding of the specific enrolment processes.
Understanding overall qualification structures is helpful as paper and points may differ from one
provider to another. As a general rule students must enrol in either a postgraduate certificate (1/4 of a
Masters programme), postgraduate diploma (equivalent to ½ of a Masters programme) or a full
Masters programme.

CTA
Esther Docherty is the monitoring analyst and is the person to contact if you have any particular
database, schedule and report queries.


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Daria Martin is the contracts manager and you should contact her with contractual queries. Both are
very helpful. No question is a silly question.

Quality plan
You will need to have a quality plan and a policy to meet CTA requirements. The policy will need to
reflect how your DHB manages the PG nursing funding in terms of a ‘fair, equitable and transparent”
process. Your quality plan should include how you evaluate your programme and make improvements.

Other Funding options for staff:
Te Pou is New Zealand's National Centre of Mental Health Research, Information and Workforce
Development. Our key objectives are: to build a strong and enduring workforce to deliver mental
health services to all people; and to develop a culture of continuous quality improvement in which
information and knowledge is welcomed and used to enhance recovery and service development.
Funded by the Ministry of Health, Te Pou is charged with creating a mental health hub for New
Zealand. Its work is performed within four distinct, but interrelated, programmes - Workforce
Research Information and Le Va - Pasifika within Te Pou. For more information is their webpage-
http://www.tepou.co.nz/page/23-Welcome

Study Link: or student loans- available through the tertiary providers. As your staff to discuss study
link funding with the tertiary providers directly. Most have links on their webpage’s.

Self-Funding: of course staff have the option to fund themselves.


Miscellaneous Information

Unsuccessful Completion
Occasionally people do not successfully complete their papers. You need to find out who failed and
why. CTA does not expect DHBs to repay any fees of people who fail. Therefore CTA does not expect
us to ask for any money back either. Most DHBs just want to find out what the reason for the failure
was and how it can be improved. It is really important that you ask people to seek help early if they
are struggling and that you have some sort of support network for trainees. There are multiple ways to
do this. Sometimes the tertiary provider will help with tutorials around assignment writing–Often the
Student Learning Centres are really helpful.


Withdrawals
People withdraw from funding and their papers for a variety of reasons. If they withdraw from the
funding then this is where a wait list is important.
If they withdraw from the papers after the semester starts then it is vital that you make sure the
trainees informs the tertiary provider through the proper channels of their withdrawal especially if it is
early in the semester before the provider’s set dates. Otherwise the trainee may have to pay full fees
and if you have removed the trainee from the reports you may not have the money to cover the fees
through CTA funding.
Another funding issue that can occur when the applicant withdraws after the tertiary providers cut off
date and the fees still need to be paid. CTA has loaded the monthly payments so that we get a larger
monthly payment at the beginning of the semester when the fees are due. We do need to report it and
we need to report the date of withdrawal and a general reason why, for example, personal illness or
bereavement. Note:CTA does not expect us to ask for any money back.




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Tuition Fees Payment
Full tuition fees should be paid as well as all compulsory fees. You will need to ascertain how your DHB
wants to pay the tertiary providers fees. Your DON, Business Analyst or financial people should know.
There are several ways this can occur:
 Trainees pays invoice, DHB re-pay the trainees
 Trainees send you the invoice and you organise payment
 Some tertiary providers are happy to have a bulk invoice system set up. Usually this involves you
   sending the tertiary provider a list of people you are funding for each semester. The tertiary
   provider places some sort of note on the trainees file to note this. The tertiary provider then sends
   you one invoice for all your trainees, and then you pay the invoice. University of Auckland is one
   such provider.




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