How NSW is planning for state wide health infrastructure growth

When Chief Executive of Health Infrastructure, Rebecca Wark took on Australia’s second largest infrastructure portfolio in 2019, she wasn’t anticipating an onslaught of bushfires, floods, and a pandemic. But despite the difficulties these events presented when planning for state-wide health infrastructure, they helped cement a strategic foundation. With upended supply chains, workforce pressures, and more people needing care than ever before, Ms Wark had little choice but to infuse sustainability into every aspect of her $10.8 billion portfolio.

“Sustainability has been at the forefront of conversations surrounding all of our future plans, including the record $10.8 million we are investing into health capital works to 2024-25,” Ms Wark said, following her presentation at the SMH Infrastructure Summit.

“By this we, of course, mean environmental sustainability – embedding good design principles and solar-orienting or green-powering our buildings to reduce energy consumption and minimise upkeep. But it’s so much more than that. It’s also about ensuring the infrastructure we are designing and building is agile to respond to future technologies and the newer models of care Australia has begun to experiment with.”

Sustainable design

Virtual care is one such model. While a transition to in-community and at-home treatment was underway pre-pandemic, COVID-19 has spurred its development, with hospitals like rpavirtual in Sydney tending to thousands of locked down patients from their homes. In terms of sustainable hospital planning, the rise of virtual care has prompted Health Infrastructure to think small – not big – in infrastructure design.

“Even without a pandemic to grapple with, there has been a drive to provide innovative healthcare options that support our existing health facilities and hospitals but also enable treatment for people within community healthcare settings and the comfort of their homes,” Ms Wark said.

“Thankfully, new technologies like rpavirtual, which provides integrated hospital and community care using digital solutions, is helping with this transition – and it’s only a matter of time before clinics like this become more mainstream. It’s leading to better health outcomes and providing an alternative, sustainable solution to increasing demand for healthcare.

“With this shift underway, we’re thinking beyond building big hospitals. People tend to think bigger is better, but it’s not always true. When you make hospitals more compact and configure spaces to achieve good ergonomics and visibility, then you make it easier for clinicians to monitor patients and resources go further. We’re also focusing on laying the groundwork for incorporating digital health solutions.”

As part of these efforts, NSW Health is embedding virtual care and telehealth capability in future health infrastructure projects. “Future-proofing facilities to take advantage of emerging technologies and keeping spaces flexible is key. Digital operating theatres, for example, provide the visual and digital information integration to support minimally invasive and image guided surgery,” Ms Wark said.

Ms Wark is also overseeing the growth of health ‘precincts’ – large-scale health facilities co-located with education, training and research partners. This strategic initiative promotes health innovation, commercial opportunities, and health, economic and social outcomes for NSW communities, she says.

“The hospitals we need for our future need to do more with less, and the precinct model helps achieve this vision. We’re planning for healthy, sustainable and liveable places that broaden and strengthen research, innovation, strategic partnerships and investment to deliver better outcomes for communities.”

As part of this effort, Health Infrastructure is collaborating with commercial investors, local health districts, and other government agencies to bring precincts across the state to life.

Sustainable workforce

Initiatives to prioritise the safety and well-being of construction workers and make the sector more attractive to workers has been at the centre of workforce sustainability efforts.

Health Infrastructure – in partnership with the Australian Human Rights Institute at UNSW Sydney and contractor Roberts Co. – recently released a two year study which highlighted the success of a five-day work week pilot program at the $341 million Concord Hospital Redevelopment.

“We are committed to driving cultural change that can lead to a healthier, safer and more sustainable construction sector,” Ms Wark said. “For many, Monday to Saturday work, and increasingly Monday to Sunday work has become an entrenched practice in Australia’s construction sector – many assume it’s the only way to finish a project on time and on budget.

“The findings of this new study highlight the success of providing a weekend for workers in the construction industry and the positive social benefits of innovating as a sector to improve their work/life balance, while ensuring economic viability in delivering our projects.

“We are working with Government and industry to set the standard. We’ve updated our tender assessment criteria to drive positive wellbeing outcomes across our programs and now we’re asking industry to put forward innovative initiatives in their tender submissions, just as Roberts Co did with Project 5, so we can attract, develop and retain workers in our thriving sector.”

Social sustainability

A further priority for NSW Health has been making hospital environments welcoming and supportive spaces for patients and their families. As one key example, its Arts in Health program has seen various hospitals incorporate artwork that celebrates local culture and community, including Aboriginal artworks.

“This is about more than simply hanging art on walls. We work very closely with local communities and culture groups with a view to making our healthcare settings more welcoming and calming – whether in a mental health, birthing, or general hospital space – and have achieved some great outcomes.

“Incorporating artwork and cultural references into building design gives our healthcare settings a distinct identity in keeping with the local community they support. We want people – especially minority groups – to come into hospital and feel less frightened when they receive care or give birth,” Ms Wark said.

Rebecca Wark is Chief Executive of Health Infrastructure. She recently presented at The Sydney Morning Herald Infrastructure Summit, hosted by Informa Connect.

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