Whanganui District Health Board has approved a plan that would see its staff working more closely with counterparts in Palmerston North.
Board members approved the centralAlliance strategic framework at a recent board meeting.
Whanganui and MidCentral DHBs have worked closely together for a number of years, including representation on each board.
In 2009, the close relationship was formalised with the centralAlliance, aimed at furthering the common interests of the two boards and their communities.
In their joint report to the board, the two board chairs, Dot McKinnon (Whanganui) and Phil Sunderland (MidCentral) said feedback from clinical staff in both DHB areas was that working together was not always easy.
"Having a common strategic framework would act as a pillar to support service development," Ms McKinnon and Mr Sunderland said.
WDHB chief executive Julie Patterson said the report laid out "the how, rather than the what, of our work".
The report looks at how the two district health boards can work together more efficiently and effectively for the benefit of both communities.
It includes providing many services jointly rather than individually; appointing staff to work for both DHBs; aligning technology to make it easier for patients to move between the two DHBs; and combining resources where possible.
"Two small teams are less flexible, and more prone to disruption, than one larger team," the report notes.
Mr Sunderland said that the MidCentral board had already approved the strategy by a unanimous vote.
Several board members spoke in favour of the strategy.
Stuart Hylton said the strategy had been a long time coming, and he was looking forward to its implementation.
"This is a comprehensive report - and it needs to be. I'm wondering if we need a one-page document that we can refer to, as we won't remember all the detail in this report."
Mr Sunderland said a memorandum of understanding between the two district health boards would be developed that would contain the key principles of the strategy.
The strategy was passed unanimously by the board.