Joining the dots: Reflections on CEDA’s Health Delivery NSW conference

New South Wales is asking more of its health system than ever before, as an ageing population, workforce pressures and rising demand test models of care built for another era. In November, Nous attended CEDA’s Health Delivery NSW conference, which convened government and health sector leaders to explore practical, system-level solutions for building a more connected, adaptable, and future-ready health system for New South Wales.

Discussion ranged across workforce, regional service delivery, infrastructure, aged care integration, health equity, and digital transformation. Running through it all was a question: How can smarter health system design improve outcomes, lift productivity, and deliver a wider economic and social impact for the sector and for the state? Below, Nousers who attended the conference reflect on what they heard and what stayed with them.

The NSW Health eco-system performs very well, with excellent clinical outcomes from highly skilled and caring clinical staff. However, despite $80 billion spent by federal and state governments annually just in NSW, we often leave it to patients and their families to navigate across a fragmented and complex collection of services. As the characteristics of our population have changed to an older, multi-morbid cohort – there is now a significant mismatch between the design of the system and what the community needs. As Minister Park said, “we can’t build our way out of this issue”. A much greater emphasis on home and community-based solutions, including HITH, virtual care, support at home, and prevention and early intervention services will be needed.

It was great to hear such a common set of themes across the day: the need for co-commissioned and co-accountable services filling in the gaps between silos, the great opportunity for digital and AI to support and enable the joint care required, a focus on equity and inclusion, and the need to be much more innovative in the ways we train, recruit, and retain care staff across the state.

Wicked problems cannot be solved by a single player in the health system. There was a sense of optimism and willingness to make the brave decisions and further improve our health care system across NSW.

Raj Verma, Principal

The conference didn’t shy away from the hard questions. The strongest thread was a shared recognition that more beds, more programs, and more training of our workforces won’t solve today’s challenges. Speakers and panelists were willing to say what the system has long avoided: doing more of the same is failing, and it will keep failing if we’re not willing to make some big changes.

There was a clear theme that to lift the performance and sustainability of the NSW health system, we need a different way of thinking, one that puts patients and consumers at the centre and treats them as partners at every stage. That means consumers and people with lived experience hold real decision-making power. Consulting them after the decision is made isn’t partnership. The discussion was candid that this will challenge our governance and accountability structures, and how clinicians see patients.

It was equally candid about where the problem sits. The barriers to accessing care are structural, so the fix has to be structural, too. We need to take on funding models, governance, and incentives directly, rather than tinkering with service design at the margins.

The next big gain in system performance will come from primary and community care, and from serious investment in prevention and earlier intervention. There was recognition that the evidence on the social determinants of health is strong. The question now is whether the health system will act on it. That means funding that follows the person rather than the provider.

It was encouraging to hear about St Vincent’s plan to deliver 50 per cent of its care at home or virtually by 2030. It’s a clear signal of where care is heading, and a test of whether funding and accountability settings will keep pace or hold it back.

We also have foundations to build on. NSW Health has invested heavily in data and digital, including the Single Digital Patient Record (SDPR) and the ADHA shared their focus on the enablers of interoperability. Those investments give us the foundations to achieve a more seamless experience of care, and patients with access to their own data. 

The direction is clear. What the conference put squarely on the table is the harder question: Are we willing to change the structures and ways of working that keep the old model in place?

Monique Jackson, Principal

Meeting growing demand will require more than simply adding more resources to the existing health system. NSW needs to think differently about how services are designed and delivered, how we build and use our workforce, where care occurs, and how infrastructure, data, and digital capability enable rather than constrain new models of care. A common thread was the need for a more connected and adaptable health system, with a greater focus on funding that follows the patient and care pathway (rather than provider), and designing care around the person and changing community needs

The other takeaway for me was that the different parts of the system cannot be solved independently. New health infrastructure does not create capacity without the workforce and operating model to activate it; digital does not transform care without service redesign and adoption; and hospitals cannot address growing demand without stronger connections to primary, community and aged care, and greater attention to equity. 

Rob Sutherland, Principal

Digital transformation and AI came up in almost every conversation today. Whether as opportunity or risk, their impact will be far-reaching and demands proactive attention. Three reflections:

• The Single Digital Patient Record (SDPR) will be transformative for hospital care NSW. It should end the burden of patients repeating their medical histories, give clinicians complete information for better decisions, and enable more integrated and connected care across systems. But we must be realistic: delivering a system of this scale will take significant time, change management and sustained effort. A key open question is whether, and how other parts of the health system will be able to connect.
• Consumer access to generative AI is shifting the balance of power in health care, often adding to the burden on professionals and providers. Patients are using tools like ChatGPT to self-diagnose and challenge clinical decisions. At the same time, patients and staff alike are using GenAI to draft increasingly articulate and complex complaints, creating a heavy administrative load for providers and employers. Services will need to consider how they respond, and how to support employees who are managing the response.
• Despite the risks, AI offers significant opportunities when applied with purpose and planning. Live examples, such as non-intrusive falls detection technology improving resident safety and outcomes in aged care, show that when AI is directed at specific clinical and care delivery challenges, the payoff can be substantial for care recipients and the wider system.

Taken together, these themes point to the same conclusion: success will depend on deliberate, well-governed adoption rather than reactive responses.

Jenny Cleary, Principal

What struck me today was the breadth of challenges, and the optimism shared across a diverse and deeply experienced group of speakers and panellists. There was no shying away from the pressures facing the NSW health system. The conversation was overwhelmingly solution-oriented. We heard practical examples of innovation, service and system redesign, and new ways of thinking about workforce, infrastructure, data and technology, including AI, to deliver better care. Effective solutions cannot be executed by any one part of the system alone and sustainable change needs to consider how funding models, technology and culture work together to enable new ways of delivering care.

Beneath the complex challenges and possible solutions, people sit at the centre. Trust and agency are the most important enablers of change. Communities need to trust their health professionals, providers, and public institutions to try new things, as well as the digital systems that increasingly hold and connect their information. Equally, health professionals and staff need the agency to challenge established ways of working, solve problems, and make decisions that allow them to focus their time and expertise on delivering the best possible care.

That makes listening to patients, consumers, communities, staff, and clinicians, and genuinely involving people with lived experience in policy, system, and service design, fundamental to building trust and creating the conditions for change. A stronger and more equitable health system needs to be designed with people, not for them.

Heidi Wilcoxon, Principal

The conference was a good reminder that many parts of our health system work very well for many people. The challenge is often what happens between them, particularly when people need to move between services, sectors, or settings, or when their circumstances do not fit neatly within the way services are organised. This is where fragmentation can create barriers, inequities, and a poorer experience of care.

Addressing this requires changes across models of care, infrastructure, funding, workforce, and ways of working, as well as better use of data and technology, including AI. These things cannot be considered separately. They need to work together around the needs of the person, rather than expecting people to navigate a system organised around its individual parts.

More funding, infrastructure and workforce would help, but workforce constraints and pressure on budgets mean we cannot rely on simply adding more capacity. What was encouraging today was hearing about approaches that are already working. The solution will require is making better use of the capacity we have and finding ways to take those good examples to scale.

Steven Hodge, Director

Productivity is a big conversation right now. But in healthcare, productivity shouldn’t mean getting more out of people. It should mean getting more out of the system around them.  

The event really highlighted what is at the heart of a productive health system: its people. It isn’t about asking an already stretched workforce to do more with less. It’s about making it easier for people to deliver great care. 

Leaders raised the idea of identifying the “pebbles in the shoe,” the everyday barriers that take time away from care or make it harder to work differently. This also goes for how we think about and transcend constraints: How do we move beyond the traditional jurisdictional walls to better coordinate care? How can we better connect primary, hospital and social care around the person? How can innovation help us shift towards prevention rather than waiting until people need acute care? How can AI and technology free up our workforce to focus on what they do best? 

We saw during the COVID pandemic how quickly innovation can happen in healthcare when people come together around a shared challenge. With an ageing population, growing demand, and a constrained economic environment, the challenge now is to bring that same mindset to productivity: removing barriers, embracing innovation, and enabling our workforce to deliver better, more connected care. 

Emily Ryan, Manager

Get in touch to discuss how these insights apply to your organisation and how we can help you build a more connected, adaptable, and future-ready health system.

Connect with Raj Verma, Monique Jackson, Rob Sutherland, Jenny Cleary, Heidi Wilcoxon, Steven Hodge, and Emily Ryan on LinkedIn.