The proposal would remove separate clinical departments in Otago and Southland.
In a document released yesterday, the DHB said leadership at senior management level would change under the plan.
"Clinician management partnerships" would comprise the patient services division leader, a nursing leader, medical leader, and allied health leader.
The partnerships would mean joint responsibility for operational, clinical and financial decision-making.
Five overarching departments would replace four in Invercargill, and four in Dunedin. The proposed departments are: medical/older persons' services; surgical services; diagnostics and clinical support services; women's, children's and community health services; mental health and intellectual disability services.
"The proposal is for a change to the number and configuration of the current directorates to ensure district-wide alignment and distribution of services within each proposed division," the document says.
"The main focus of the proposed change is as much about the responsibilities, accountabilities, decision-making model, behaviours, and way of working, as it is about the number and configuration of the services in the proposed divisional structure."
Nine nursing leadership roles, including the deputy chief nursing and midwifery officer, would end, and five would be created.
As services are arranged under different umbrellas in Otago and Southland, the proposal is a significant shake-up.
The document's preamble repeats the DHB's oft-stated aim of creating a more "unified" organisation. Certain "behaviours" would be changed through fostering collaboration, co-operation, and healthy competition, the document says.
Allied health leadership would be introduced at the departmental level in the form of three (2.5 full-time equivalent) new positions.
Due to the number of people affected, staff appointments would be staged, with managerial and nursing first, followed by medical and allied health. Staff in disestablished roles would be given preference for new rolesThe largest of the new departments, surgical, would have 730 full-time equivalent staff, and an annual budget of about $110 million.
The restructuring process follows a streamlining of the executive last month that reduced the number of top staff from 13 to 12.
Deputy chief executive Lexie O'Shea told the Otago Daily Times yesterday she was not claiming the proposal was "perfect" and it could be significantly changed by staff feedback.
She said clinician management partnership was already practised in the DHB, although its quality varied. The DHB wanted to build on the positive examples for its district-wide model.
Decision-making would be by consensus, and she did not think the new model risked introducing greater tensions between managers and clinicians.
Of the "behaviours" the proposal said needed changing, Mrs O'Shea said she did not want to focus on it, but "there are some negative behaviours and some very positive behaviours".
The final decision would be announced on September 14.
