Lead Author: Dr Rhonda Kerr, Committee Member

What does world-class health planning look like? For the first time, this question has been explored through an international assessment of excellence in health planning, as Rhonda Kerr, Jonathan Erskine and Jaime Bishop explain.

The inaugural Excellence in Healthcare Planning Award was presented as part of the European Healthcare Design Awards at a prestigious ceremony during this year’s European Healthcare Design Congress. But what constitutes health planning and why did the Awards merit a dedicated category in this field?

Health planners work with communities, clinicians, health service providers, architects and infrastructure development teams to deliver plans for effective health services and health facilities. A competent health plan delivers evidence-based, researched, well-informed solutions for health system issues, clinical service delivery, non-clinical supports, and the infrastructure required to improve equity, advance population health, and enhance the effectiveness and efficiency of health systems.

It was both an honour and a delight to be part of the judging panel for the Excellence in Healthcare Planning 2026 award category. Many high-quality nominees from across the globe made the shortlist in this category, with each team approaching the challenges of delivering necessary care to communities using well-developed health planning tools and exhibiting great sensitivity. Each was presented with different challenges ranging from large numbers of patients in difficult climatic conditions, to reducing unacceptable infant mortality, to preparing for an uncertain future.

All nominees addressed how the delivery of hospital care is likely to change over time with clinical improvements, technological change and innovation. A great sensitivity to workforce needs, the effectiveness of healthcare, and ongoing operational costing were all evident in finalists’ presentations. Each finalist was also well-attuned to the communities their facilities were to serve and their specific challenges. In tertiary facilities, for example, there was evidence of conduits for medical research and teaching spaces in clinical areas. The link between medical research and planning for health services was made clear by the physical connections and the space for clinical needs to influence medical research and vice versa.

What does excellence in health planning look like?

The Excellence in Healthcare Planning Award identified key elements of excellence in health planning to be interrogated and evaluated, including:

• Model of care development – examining the methodologies used to determine contemporary and emerging models of care. Responsiveness to patient need, demand changes, equity, patient safety and human dignity were also investigated.

• Future readiness and evidence-led redesign assessed how clinical pathways and clinical models anticipate future health needs, digital, workforce and population change, ensuring services can adapt, scale and remain resilient. Also explored was the strength of evidence, data, and research, including demographic, morbidity and epidemiological data, used to inform decisions and alignment with clinical priorities.

• Access, capacity and operational efficiency analysed how new models of care and clinical pathways improve access for patients, the anticipated reduction in waiting times alongside any anticipated operational and clinical efficiencies. Optimising pathways to enhance patient and clinical experience and operational efficiency in the short to medium term was also examined.

• Flexibility and system integration into planning were scrutinised for adaptable and scalable responses to future health trends, population change, digital health and technological evolution, along with integration within wider healthcare networks, communities and cross-sector partnerships.

• Stakeholder engagement processes were reviewed for effectiveness, integration, and co-design throughout the planning process – the ability to build trust and ensure the final model of care or pathway reflects the evidence and needs of users and partners while supporting timely decision-making, shared understanding and alignment of priorities.

Nominations from across the world were assessed based on predetermined criteria, which were further tested by detailed informative presentations. The judges’ questions teased out the active elements of the quality and craft of professional health planners.

Thoughtful, attentive, considerate processes defined each of the finalists. There was a high level of intellectual independence and evidence of processes to resolve health problems by invigorating health services to enable effective future service delivery.

The judges were impressed by the agile responses to some of the major challenges our health systems face, including workforce retention and the powerful effects of climate change on hospital facilities and human health. These responses were more than the clients had asked for but added to the strength of what was delivered for future effective health service delivery. And no project stood alone – each of the four finalists were intimately aware of and integrated with the broader health service context.

Managing the huge surges in patient numbers from all over the world at the Hajj and Umrah pilgrimages, while conscious of the heightened risk of infectious disease, the highly commended Al Ansar Madinah project in Saudi Arabia sought to balance the needs of an older patient group with the need to maintain a reliable local acute health service. The health planners provided clever, nuanced solutions ‘’to create an elastic, flow-based hospital capable of absorbing variability in patient volume, acuity, infectious risk, and climate-related illness without compromising safety, dignity, or operational clarity”.

Contrasting in scale was the overall winner of the category, the New Betio Hospital, described as a remote, small-scale project in Kiribati in the Pacific designed to create a safe environment for obstetric and paediatric care, as stage 1 of a new hospital. The power of health planning to improve the health of a community was most vividly displayed in this project.

Challenged by remoteness with its impact on health outcomes, access to clinicians, limited technologies, fly-in medical services, and logistical difficulties, health planners shaped culturally appropriate health services while enabling a well-designed facility to be built.

Exquisite care and attention were paid to the needs of the community for access to clinical care, cultural safety, major workforce challenges, and rising sea levels. Betio is 900 metres wide at its widest point and 5 metres above sea level. This project has a clear pathway to deliver significant improvements for unacceptable maternal and child mortality.

Planners of the New Betio hospital overcame significant challenges in stakeholder engagement during the pandemic, by undertaking determined efforts to engage a range of community groups and laying the ground for future development of the same site to enhance services and embrace new technologies.

Reflecting the diversity of health planners’ work, Skåne University Hospital impressed the judges and was awarded a high commendation. The development of the new hospital model was guided by four core planning principles: patient safety; flow efficiency; sustainability; and knowledge and development. These principles formed the foundation for all planning decisions, ensuring that improvements in efficiency, flexibility and sustainability never compromised patient safety or quality of care. Planning was focused on patient outcomes with 100 clinical indicators identified to evaluate the project throughout its development. These indicators addressed patient safety, clinical efficiency and patient experience, and continue to inform the hospital’s ongoing post-occupancy evaluation.

New Footscray Hospital was also highly commended and added another dimension. In this project, health planners sought to embed health and wellness for a culturally diverse population, using a village green at the centre of the development. Patient journeys were mapped from community referral and emergency department presentation through inpatient care, rehabilitation and discharge. These mapping exercises informed adjacencies, circulation paths and service clustering, reducing transfers, minimising handovers and improving staff efficiency. Ambulatory services were consolidated to support an ambulatory-first approach, reducing avoidable admissions and strengthening chronic disease management.

Digital readiness underpins the model, with infrastructure supporting integrated electronic medical records, telehealth, remote consultation and data-driven monitoring. These systems enable care beyond the hospital footprint and support evolving workforce models.

Allow time to plan for success

Most of the hospital projects in the category were planned over an extended period owing to the pandemic. For many projects, the extended research and planning periods, augmented by detailed consultations, allowed health planners time to develop highly responsive, evidence-based outcomes embedded in the cultural complexities of the communities. There are clear benefits to projects – including more time to thoroughly plan health service delivery and its interface with building construction.

Conclusions

The judges were impressed with the wisdom of the responses to important health challenges. Each finalist undertook a structured, evidence-based methodology integrating data analysis, stakeholder workshops, benchmarking, co-design and operational simulation. Patient outcomes and workforce satisfaction were key to the best projects.

The power of health planning was evident in the submissions, as well as the presentations and interviews – more than justifying the introduction of the category in the Awards programme. Health planners make an important contribution to quality improvement in the delivery of healthcare to a population, and the effectiveness and function of health infrastructure. Working closely with aspirational clinicians and highly specialised architects, health planners define the change necessary to deliver effective care for patients.

In subtle ways, health planners managed to invest complex health problems with clear logic and thoughtful attention for the benefit of their project teams. Overall, this category award highlighted the powerful collaborative and knowledge-building work of health planners, often the unsung members of the health infrastructure delivery team. Moreover, the craft and knowledge of health planners have been shown to enrich a project and deliver real ongoing economic benefits for their communities.

The judges were disappointed that there could be only one outright winner of this inaugural prize, as all the projects reviewed were of high quality – and the four finalists, in particular, embodied excellence in health planning worthy of commendation. Building on this first award, the judges wish to encourage more health planners to submit their work and projects in subsequent years. Ultimately, we want to demonstrate how well-resourced health planning improves healthcare and hospital projects.

The shortlisted entries

Excellence in Healthcare Planning Award (Supported by NORR)

• Winner: New Betio Hospital (Stage 1), Kiribati
  Commissioned by Ministry of Health and Medical Services (Kiribati)
  Led and developed by Jacobs
• Highly commended: Al Ansar Madinah, Saudi Arabia
  Commissioned by Ministry of Health KSA
  Developed by RSO Architecture
• Highly commended: New Footscray Hospital, Australia
  Delivered by Plenary Health consortium, with VIDA Health and Western Health
  Developed by COX Architecture + Billard Leece Partnership
• Highly commended: NSM, New Hospital buildings, Sweden
  Commissioned by Region Skåne
  Developed by White arkitekter

About the authors

The authors of this article – and judges of the Excellence in Healthcare Planning Award – were:

• Lead author and lead judge: Dr Rhonda Kerr, executive director, Economics, Health Services and Planning, Guidelines and Economists Network International (GENI); convenor, Australasian Association of Health Planners; chair, Body of Knowledge Committee, Australasian Association of Health Planners; and honorary research fellow, University of Western Australia.

• Co-author and panel judge: Jonathan Erskine, honorary professor, Bartlett School of Sustainable Construction, UCL; and executive director, European Health Property Network.

• Co-author and panel judge: Jaime Bishop, chair, Architects for Health, UK; and director, Fleet Architects.

The Call for Entries for the European Healthcare Design Awards 2027 will be launched in November 2027.

European Healthcare Design - London

Author: Holly McMillan, Senior Project Manager—Clinical Planning and Service Readiness, Metro North Hospital and Health Service

It’s a sadly familiar story. After several months—and several $100,000s—of planning and design work, a major health infrastructure project is in crisis. Health service managers reject the new facility design: “This isn’t what we need!”. Design consultants lament, “But this meets the investment announcement brief and budget!” How can they both be right, but it’s all gone so wrong? In so many cases, it’s because we jumped to the solution, before really understanding the problem. In the health infrastructure project context, “understanding the problem” means understanding the health service need, and planning the best service strategy to meet it. Only then, should we start thinking about what infrastructure investment is needed. To put it simply: Form must follow function. 

Health Service Planning

So how do we determine the health services functions that health infrastructure needs to enable? By developing a health service plan (HSP). An HSP has similar elements to any good organisational plan. It identifies opportunities and challenges through demographic, epidemiological, and service delivery assessment. It identifies a desired end-state or vision. And finally, it bridges the gap, through identification of key strategies. As such, we can identify two key parts to an HSP: the Health Service Needs Assessment (HSNA) and the Health Service Strategy (HSS).

Part A: Health Service Needs Assessment

It is a process known by many names, but importantly, this is the starting point for a health services plan. To maintain a person-centred approach to health planning, a good Health Service Needs Assessment (HSNA) should begin with the population. As health service organisations (HSOs), we need to first understand the people we serve and their key health concerns, through data analysis of key demographics, health status and health service demand, as well as through consumer insights for their experiences of health and care.

The HSNA should then seek to understand how and where those health needs are being addressed. This is often done through a service mapping process across the health care continuum. Whole of continuum service demand and supply mapping is important, even if an HSO only operates in one part, understanding of service need across the continuum assists in identifying drivers of demand and can result in service partnership strategies for mutual benefit.

The HSNA is also an important opportunity to understand the opportunities to do healthcare differently. Emerging treatments and therapies, new models of care, different workforce roles, next generation medical equipment, and rapidly evolving digital technologies, all provide the chance to re-think how we address health service needs.

At the end of the HSNA process, we will understand the health service needs/gaps, and the HSO’s opportunity to address them. Most HSOs will develop base-case demand analyses for the impact of service needs on key enablers such as workforce (i.e. FTEs) and infrastructure (i.e. beds and treatment spaces/points of care).

Part B: Health Service Strategy

Health service strategy has two components: Vision and Actions.

The Vision component is important for the HSO to outline its high-level intentions as to the key features of its service organisation and delivery, after considering the challenges and opportunities from the HSNA. Simply, what is the end-state for the HSO following the implementation of the HSP? For example, what services will we provide? How will our services be organised? What high-level models of care will we use?

Service visioning likely involves the development and testing of service options. For example, if we increased our use of Hospital in The Home (HiTH) models in meeting service need, what would be the impact on hospital bed and/or outpatient clinic demand? If we increased service capability for paediatric surgery at a particular hospital, what would be the impact on patient flows across our service network, and the impact on bed demand at various facilities? As such, it is important to recognise that health service planning is an iterative, not a linear, process. Scenario demand modelling is commonly undertaken to model the impact of proposed changes in service strategy on key enablers such as infrastructure and workforce.

The Actions component details the key service actions to be undertaken by the HSO to bridge the gap between the service needs and the service vision. Example actions may include expanding Hospital in The Home services to new patient cohorts or expanding paediatric surgical services at X Hospital.

Translating Service Plans to Infrastructure Planning

“Are we there yet?”, I hear you ask.

Yes. Following the development of a robust HSP, HSOs should have a clear view of future health service strategy and its impact on infrastructure demand. You are now ready to put pen to paper on your Gate 0 Investment Concept Brief, or similar. And, thanks to your HSP, you have all the evidence you require to demonstrate that the proposed significant infrastructure investment is based on current and future health service need. You’re welcome.

In the words of your favourite informercial, “But wait! There’s more!” Don’t cut your health planning experts loose just yet. Health planning expertise is an absolutely essential part of any health infrastructure project team. In the early stages of an infrastructure project, health planners develop the strategic/high level models of care (MoCs) and functional design briefs (FDBs) that inform facility design. They provide the essential link from architects, engineers and other technical consultants

to frontline clinical stakeholders during detailed design and service readiness phases, to ensure that the built facility meets clinical operational requirements.

As the project progresses, health planners develop detailed MoCs to identify how health services will operate in the new building context. Importantly, detailed MoCs identify change impacts for service delivery processes, workforce, equipment and technology; thus, providing the essential blueprint for service and operational readiness and change management activities throughout operational commissioning.

Form Follows Function

Across Australia and New Zealand, there is $42 billion worth of health infrastructure projects in the capital pipeline.¹ The vast majority is government-funded. The health infrastructure sector has a collective responsibility to ensure that these significant investments achieve best value for the taxpayer, in terms of meeting the health service needs and health outcomes for all in our communities. Robust, evidence-based and future-focussed health service planning must provide the basis for health infrastructure investment. Health service planning must come first, and it must continue to inform facility development across the length of the infrastructure project. Health infrastructure projects provide the opportunity to RETHINK care, not just REBUILD it.

Author: Rhonda Johnson: AAHP Secretary

The Australasian Association of Health Partners (AAHP) has been announced as an official event partner for the 12th European Healthcare Design Congress, strengthening global collaboration in the design of better, more equitable health systems and infrastructure.

Taking place from 15-17 June in Westminster, London, the Congress will convene international leaders across healthcare, design, research, and policy to explore how evidence-based design and planning can transform care delivery and improve patient outcomes. AAHP’s involvement brings a vital Australasian perspective to the programme, highlighting the region’s leadership in integrating research, clinical practice, infrastructure, and system innovation.

AAHP’s contribution extends to the European Healthcare Design 2026 Awards, an integral part of the Congress programme recognising excellence in healthcare infrastructure, research, innovation and design. Dr Rhonda Kerr will represent AAHP both as a member of the congress programme committee and as lead judge for the new Excellence in Healthcare Planning category. This award recognises outstanding planning that improves access, efficiency and patient outcomes through integrated, future-focused approaches.

As an event partner, AAHP’s participation underscores the importance of international partnerships in tackling shared global health challenges. AAHP members are also invited to participate in the Congress through an exclusive event partner discount, supporting greater participation from the Australasian region.

With its strong focus on collaboration, knowledge exchange and real-world impact, the 12th European Healthcare Design Congress offers a unique platform to connect global expertise. AAHP’s partnership, and Dr Kerr’s leadership on the programme and awards committees, further strengthens the Congress as a truly global forum shaping the future of healthcare design.

https://www.europeanhealthcaredesign.eu/

Contact:

Marc Sansom
Managing Director
SALUS Global Knowledge Exchange
marc@ salus.global
www.www.europeanhealthcaredesign.eu

Author: Rhonda Johnson - AAHP Secretary

The Australasian Association of Health Planners (AAHP) has recently refreshed its vision, reaffirming its commitment to supporting and advancing the health planning profession across Australasia.

To be recognised as the peak professional body that strengthens and leads the health planning profession, advancing excellence in planning to shape equitable, resilient health systems across Australia and Aotearoa New Zealand.

This updated vision reflects the evolving role of health planners in shaping more integrated, sustainable, and future-focused health systems. It also reinforces AAHP’s focus on fostering collaboration, building capability, and strengthening connections across the sector.

As health systems continue to respond to growing demand and complexity, AAHP remains dedicated to enabling better planning outcomes through leadership, knowledge sharing, and professional development.

We look forward to continuing to work with our members and partners to elevate the profession and contribute to improved health system performance across Australia and New Zealand.

Author: Dr Rhonda Kerr - Committee Member

This article reviews the recent Australian Climate Service report on risks associated with climate change and considers the implications for planning health services and health infrastructure.

Background

On 15 September, Australia’s first National Climate Risk Assessment was released, reporting on expected changes in climate and their impacts on people, services, and infrastructure.

Read the full report HERE

From an economy and society wide perspective, health risks are at the forefront of government concern. Key risks include:

• Risks to human health, medical, and emergency services from damage and disruption to critical health facilities and supporting infrastructure (energy, water, transport), particularly in regional and remote communities.
• Risks to health and wellbeing of individuals and communities in exposed and vulnerable situations that increase inequity as a result of impacts on the wider determinants of health and reduce access to health and social support services.
• Risks to health and wellbeing from slow onset and extreme climate impacts including increasing temperatures, heat extremes, storms, floods, and bushfires.
• Risks to mental health and wellbeing including post-disaster trauma, climate anxiety, and a lost sense of belonging and connection to Country.
• Risks to delivery of health and social support services and the health workforce that are caused by increased demand, cost and disruptions.
• Risks to health and wellbeing from aeroallergens and worsening indoor and outdoor air quality.
• Risks to health and wellbeing from the emergence and increased transmission of communicable diseases.
• Risks to health and wellbeing from compromised ecosystem services that support food and water security.
• Specific risks to Aboriginal and Torres Strait Islander peoples, including food, water, energy and housing insecurity, and impacts on connection to Country.
• Risks to physical health and care infrastructure that affect the accessibility of healthcare and social support resources
• Risks to buildings and building liveability that reduce building life expectancy and increase maintenance and running costs.
• Risks to energy production and distribution infrastructure that increase outages and reduce energy supply reliability.

The report also highlights that extreme heat will significantly strain hospital access (page 21) and increase admissions (page 42). It stresses the need for health systems infrastructure including hospitals, clinics, and other facilities to be equipped with resilient technology and resources.

Managing Risks in Service Delivery

To deliver required healthcare during times of climate change and a cascading series of climate events the Report advises that the health “system’s infrastructure includes hospitals, clinics and other healthcare facilities equipped with the necessary technology and resources.’’ (page 128).  How do we manage these risks into planning for effective service delivery?

Hazardous conditions with high risks of injury and death are increasing across Australia. With high certainty, the report projects:

• Heatwaves will cause more deaths and hospital admissions nationwide, especially in northern Australia.
• Tropical cyclones in the north will increase in frequency and severity, leading to more injuries and fatalities.
• Droughts will become more frequent and prolonged in many regions.
• Bushfires in southern regions will become more common, compounding air quality issues and respiratory illness.
• Flooding (riverine and flash) will increase in prevalence.
• Mental health burdens will rise across affected populations.

Table 11 (page 132) quantifies these effects in terms of increased mortality, while page 137 identifies heightened risks of communicable diseases, including waterborne and vector-borne pathogens such as cryptosporidium and cyanobacteria.

Integrity of Planning

Health service and facility planning must incorporate the increased demand for acute care associated with climate change. Unexpected risks from outside Australia may also arise (e.g. COVID). Risks from climate change are described as ‘’cascading and compounding’’ rather than one-off events.  They represent a new and evolving normal.

Prudent planning requires:

• Provision for additional beds, ED bays, ambulances, pathology (including mortuary), procedural areas, and equipment to meet surges in demand.
• Testing hub-and-spoke acute care models for access during heatwaves, fires, and floods.
• Mental health service provision should be calibrated against projected demand under climate stress to ensure services and facilities are evidence-based and robust.
• Ensuring workforce reliability, including clinician travel arrangements.
• Expanding stores and supplies in case of disrupted supply lines.
• Strengthening ICT systems and ensuring medical record access during climate events.
• Assessing the integrity of facilities (fabric, energy, air and water supply) to ensure continuity of care.

Conclusion

The Australian National Climate Risk Assessment makes it clear that demand for hospital services will rise as climate-related events increase.  Provision must be made when planning hospitals to respond to the risks outlined, to ensure that health infrastructure is robust, adaptable, and fit for purpose.

It is widely held that improved prevention of illness, personal responsibility for health and affordable primary care can reduce the demand for hospital care. While this may one day be proven, the current demand for acute healthcare, coupled with the certainty of increasing climate-related demand, requires professional health planners to prepare expanded services that can meet the risks outlined in the National Climate Risk Assessment.  Hospitals and health facilities must be designed and resourced to withstand climate impacts and deliver care reliably under stress.

Author: Dr Rhonda Kerr - Co-Chair AAHP

In a report released on 15 August 2025 the Australian Productivity Commission recommended major changes to the way healthcare is planned, delivered and evaluated. Importantly the Report also recommends the Australian government should fund planning and collaborative commissioning. Funding will be dependent on achieving agreed outcomes.

The Productivity commission Interim Report on Delivering quality care more efficiently recommendation says “Governments should embed collaborative commissioning, with an initial focus on reducing fragmentation in health care to foster innovation, improve care outcomes and generate savings.

In the next addendum to the National Health Reform Agreement, governments should agree to governance and funding arrangements that support better collaboration between Local Hospital Networks (LHNs), Primary Health Networks (PHNs) and Aboriginal Community Controlled Health Organisations (ACCHOs). New joint governance arrangements to support collaboration are needed.

• LHNs and PHNs should be required to plan together to identify areas for collaboration, including joint needs assessments, agreed plans of work and joint monitoring and reporting of outcomes.
• LHNs and PHNs must work in partnership with ACCHOs and other organisations to inform planning and shared decision making. Partnering with ACCHOs should be consistent with the principles set out in the National Agreement on Closing the Gap to ensure relevant needs are appropriately and respectfully assessed and key decisions are shared.
• There needs to be stronger requirements for formal joint collaborative commissioning committees and the development of data-sharing arrangements to underpin joint needs assessments and evaluation of outcomes. Changes to funding arrangements are also needed to embed collaborative commissioning.
• Barriers to pooling funding or other forms of joint commissioning should be removed. The Australian Government should make funding for PHNs more flexible. State and territory governments need to ensure that service agreements provide flexibility in the services and programs that LHNs can fund.
• LHNs, PHNs and ACCHOs should be sufficiently resourced to undertake comprehensive joint governance.

The Australian Government should provide LHNs and PHNs with sufficient dedicated funding to embed collaborative commissioning programs once they submit a joint plan. The joint plan should clearly link agreed shared outcomes to enhanced productivity in the form of quality improvements or more services that lower potential future costs. Initially, the focus should be on reducing potentially preventable hospitalisations. Future funding should be adjusted based on whether agreed shared outcomes have been achieved at the local level.’’

Identifying that Australia’s care system is fragmented, ‘’care services is siloed, and complex governance and disconnected funding arrangements produce inefficiencies, cost shifting and discontinuity of care ‘’ the commissioners hold that Collaborative commissioning can support more integrated care by helping to align the planning and provision of services between different organisations and types of care, contributing to a more seamless experience for care users, particularly people with chronic or complex conditions. ‘’

There are systemic barriers they found including the difficulty in moving beyond trials, rigid and short-term funding, capability constraints, a lack of formal joint governance architecture, misaligned incentives and data an evaluation constraint. These are the challenges.

Health planners have a role to play in navigating the collaborative environment.

If you would like read more about the findings or to comment on the Productivity Commission draft recommendations go to https://www.pc.gov.au/inquiries/current/quality-care/interim/quality-care-interim.pdf

Alternatively, you can forward your advice to the admin@aahp.online for inclusion in our AAHP Submission to the Productivity Commission.

Author: Dr Rhonda Kerr - Co-Chair AAHP

Australia’s largest health system, New South Wales, has just undergone one of the most comprehensive reviews in its history. Over 18 months, a team led by highly qualified legal professionals undertook a rigorous examination of healthcare funding in NSW. This involved extensive submissions, hours of testimony, and careful interrogation of the issues facing health service delivery.

Many challenges were well described. Clinicians, managers, researchers and non-government organisations gave compelling accounts of the obstacles to delivering equitable, timely and quality healthcare across the state. Insightful evidence was gathered and made publicly available. https://healthcarefunding.specialcommission.nsw.gov.au/documents/

At a cost of between $15.7(1) million and $25.5 million, the Special Commission’s report (2) identified major funding gaps in areas largely under Commonwealth responsibility: general practice, Medicare, aged care, primary health care, mental health, dental services and First Nations health. It also highlighted weaknesses in shared funding arrangements between the state and the Commonwealth.

Many of the report’s recommendations such as a sugar tax and a whole-of- government approach to prevention have been heard before. The importance of preventing chronic disease, particularly among socioeconomically disadvantaged populations, was once again reinforced.

The report acknowledges funding constraints across Local Health Districts (LHDs) and proposes a familiar solution: better planning. It calls for improved systems, workforce, and service planning grounded in a robust understanding of local and specialty needs.

(1) NSW Parliamentary Budget Office Report 20 March 2023
/NSW%20Parliamentary%20Budget%20Office%20Report%2020%20March2023https://www.parliament.nsw.gov.au/pbo/Documents/2023OppositionCostingsandRequests/C1411%20-%20Costing%20-%20Special%20Commission%20of%20Inquiry%20into%20the%20funding%20of%20healthcare%20in%20NSW.PDF

(2) NSW Special Commission Inquiry into Healthcare Funding - 16 May 2025 
special-commission-inquiry-funding.pdf

And yet, strikingly, nowhere in the 1,000+ page report is there any substantive recommendation to invest in health systems or health service planning. The foundational work of Health Needs Assessment, strategic planning, and service model design at the local level, often delivered through partnerships with health planners, remains unfunded and unrecognised.

If “form follows finance,” as the adage goes, how can this level of planning occur without dedicated investment?

The report also critiques current infrastructure-led planning approaches, stating: “Because LHDs and SHNs have traditionally delivered facility- based services, planning processes have had a tendency to be driven by capital needs... The ‘real planning need’ or the needs of [a] community [have] nothing to do with a facility.”

It recommends shifting focus from "bricks and mortar" to service models delivered through general practice, nurse-led care, or allied health. While this shift is well-intentioned, the idea that diverting capital funding from acute care infrastructure to preventative and primary services will resolve current and future demand is, frankly, naïve.

Anyone working in healthcare understands the long lead times required for prevention initiatives to take effect. Even the most successful anti-smoking campaigns (arguably the gold standard in preventive health) have not eliminated the burden of lung cancer. In 2024, 66 per 100,000 men are still diagnosed annually. The need for acute treatment services remains and will for the foreseeable future.

Obesity prevention was identified in the report as a priority, yet no funding was recommended for targeted campaigns. This disconnect between analysis and investment is concerning.

The report’s Finding 2.107 rightly notes that decisions about acute services are driven by funding, workforce constraints, political realities, and legacy commitments. It calls for system wide service planning responsive to local community needs and local decision-making. But again, the resourcing remains centralised, and the LHDs remain constrained.

How, then, can localised, strategic, community-informed planning occur without funding, support or recognition for the health planning profession?

It is deeply disappointing to see the work of NSW Health Infrastructure Planners and Health Service Planners so lightly dismissed. AAHP members engaged in this work are committed professionals dedicated to improving community health outcomes through evidence-informed planning.

Equally concerning is the report’s lack of attention to future demand. There is little meaningful exploration of service projections or demographic trends. The very elements the report calls for - population health analysis, demand forecasting, socio-economic profiling - are core competencies of professional health planners.

Too often, those without a health planning background overemphasise population size and overlook the importance of epidemiology, age and gender profiles, socio-economic determinants, fertility trends, and local patterns of morbidity and mortality.

Despite the high quality of the submissions and testimonies, the report fails to grapple with the true complexity of the health landscape, and the growing demands on acute services.

The solution lies in health systems planning. But planning to the standard required (the standard AAHP members deliver) needs appropriate recognition and resourcing.

Author: Dr Rhonda Kerr - Co-Chair

During election cycles, public and political opinions on healthcare—especially emergency and hospital services—are strongly expressed. While access to health services is a recurring theme, are popular solutions always the right ones for long-term hospital and health service planning?

Recent state and federal elections in Australia, and the national election in New Zealand, have seen commitments to fund hospitals, expand emergency departments, and build new facilities. In Queensland and New Zealand, new governments have reviewed existing health plans, identifying new priorities while removing previous ones.

Planning Beyond Bricks and Mortar

Health planners understand the complexity of delivering appropriate, timely, and effective care. Health planning principles go far beyond infrastructure alone. They are grounded in a thorough understanding of population health trends and current and future service needs - ensuring that services are designed with both present demands and future shifts in mind.

Effective planning considers interdependent factors such as:

• Workforce availability and sustainability
• Clinical relationships and service adjacencies
  
• Patient flow and continuity of care across the system
  
• Technological and digital infrastructure to support care within and beyond hospital walls.

Beyond the Headlines: What Political Promises Miss

Despite their good intentions, many political commitments don’t address the deeper, structural challenges that determine the success of healthcare transformation:

• Adapting service configurations to meet changing population needs - not just scaling up, but right-sizing services to ensure the right care is provided in the right place
  
• Building integrated networks that optimise workforce capacity and clinical collaboration
  
• Incorporating new technologies to enhance care delivery, patient experience, and system efficiency
  
• Navigating the ever-present challenge of finite budgets, which require thoughtful prioritisation.

The Cost of Planning Disruption

One overlooked consequence of politically driven health planning is the stop-start cycle of project revisions. These changes can:

• Disrupt and disperse committed workforces
  
• Undermine trust among clinicians and project stakeholders
  
• Delay the implementation of critical technologies and service improvements
  
• Ultimately, reduce timely patient access to appropriate care.
  

Every delay or cancellation represents lost momentum and missed opportunities for innovation.

Planning Beyond Politics

AAHP members play a vital role in navigating these complexities - without partisanship. They work to ensure sustainable improvements in healthcare access and effectiveness, at local, regional, and national levels.

But lasting progress requires more than planning expertise. It requires stability. Can we create a planning environment where healthcare transformation continues—even through political change?

As we reflect during this election period, it’s worth considering the value of consistent, evidence-based planning that transcends electoral cycles. The Australasian Association of Health Planners exists to support this long-term vision, enabling better healthcare for both patients and policymakers.

Author: Isabelle Mansour - AAHP Secretary and Committee Member

The Healthcare system nationally and globally is challenged by multiple issues from rising costs, workforce shortages, health disparities pandemics and natural disasters to name a few. A study published in the ‘Medical Journal of Australia’; in July 2024 shows that containing hospital costs by limiting bed availability and reducing the length of stay using new models of care may no longer be a viable strategy.

The research found that the burden of Australia’s ageing population and the prevalence of comorbidities will continue to push increased demand on healthcare systems. For the first time in history, there are more people aged 65 years and over than there are aged under 5 years.

Add to it, Australia’s vast geography makes healthcare access a persistent challenge, particularly for rural and remote communities. Yet, our current funding models still disproportionately favour the delivery of bricks and mortars, leaving many regions underserved.

Building more physical beds doesn’t seem to alleviate solely the increased pressure on the healthcare system. As with more physical hospital beds comes further pressure on the

workforce, more impact on the environment without necessarily solving the issue of healthcare equity and access block. Digital health has the potential to play a pivotal role in emerging models of care, but its impact depends on effective implementation, monitoring, and evaluation.  There is a need to start identifying other strategies that will help ease pressure on the acute care sector.

While digital health has the potential to bridge this gap, it remains inefficiently implemented - not because of a lack of technology, but because we lack the right models of care to integrate it effectively.

The Misconception: Digital Health is Just About Convenience

Many assume that digital healthcare is simply about making access more convenient. But in reality, it’s about improving efficiency, equity, and patient outcomes.

The Challenge: Silos & Slow Collaboration

Despite the potential, Australia’s fragmented healthcare system is slowing progress. Health services remain siloed, and state and commonwealth systems struggle to collaborate on sustainable, scalable models of care. Meanwhile, international examples show that integrated digital healthcare models can work when designed with the right incentives and structures.

What’s Holding Us Back?

We have the technology. We have global case studies proving success. Yet, digital transformation in Australian healthcare is lagging. Is it funding? Policy inertia? Resistance to change? A lack of coordination?

Author: Eleni Naude - AAHP Treasurer and Committee Member

As healthcare needs evolve, so must the way we plan, design, and deliver services. Health service planners play a pivotal role in ensuring that our healthcare systems are not only equipped to meet today’s demands but are also prepared for the challenges of the future.

By leveraging health data, population demographics, and service demand projections, planners provide critical insights that shape strategic decision-making. Their expertise bridges the gap between clinical needs and system-wide infrastructure planning, ensuring that resources, technology, and workforce strategies are aligned with patient and community needs.

A core part of health service planning involves large-scale infrastructure projects. These developments require deep analysis, scenario modelling, and extensive stakeholder engagement—from frontline clinicians to government bodies—to create healthcare environments that enhance service delivery and improve patient outcomes. 

And, the role of a health service planner extends beyond hospital walls. Increasingly, planners are involved in health precinct development, integrating healthcare with research, education, and community services. This holistic approach fosters innovation, supports workforce sustainability, and builds resilient healthcare ecosystems that improve the overall health and wellbeing of communities.

Over time, we have seen health service planners transition into infrastructure project management roles, supporting and leading the planning and delivery of health development projects. Their understanding of the service- and system-level outcomes and benefits enables the project to be delivered as intended, as well as influence key processes such as model of care development, operational commissioning and post occupancy evaluations. 

With a commitment to evidence-based planning, innovation, and collaboration, health service planners are shaping the future of healthcare—creating adaptable, efficient, and patient-centred systems that will serve generations to come.