Planning for sustainable health services Report 16: 2020–21

Report on a page

We audited how effectively the Department of Health (the department) and the hospital and health services (HHSs)—collectively known as Queensland Health—work together to plan for a sustainable health system. We performed detailed work at the department and four HHSs.

We concluded that Queensland Health needs to take further action to ensure effective planning for sustainable health services. It has started to address many of the issues we raise in this report, with some HHSs more advanced than others. The Minister for Health and Ambulance Services’ response to this report (at Appendix A) outlines some of Queensland Health’s recently started and planned initiatives.

Working together

The separate parts of Queensland Health can work better on long-term plans and short-term initiatives. The HHSs have been established as independent entities, but they are dependent upon the department for most of their funding and staff. They can achieve more if they work across boundaries when planning how to best meet Queenslanders’ needs.

Effective planning is hampered by the lack of a consistent understanding of what a sustainable health system is and how the statewide and local level priorities complement each other. In October 2019, Queensland Health published its Queensland Health System Outlook to 2026 for a sustainable health service, which provides a framework to build this understanding.

Queensland Health generally consults well with its clinicians and communities when planning, but there is a lack of a consistent approach on how, with whom, and when it takes place.

Planning for the long term

In 2016, Queensland Health designed My health, Queensland’s future: Advancing health 2026 as a 10-year strategy to guide the Queensland Government’s long-term investment in health. It does not have a clear implementation roadmap of how its health service plans and enabling plans (for example, workforce plans) contribute to achieving the objectives in this strategy.

Workforce plans are not in place for all critical roles. For example, Queensland Health does not have a statewide nursing workforce plan but is in the process of preparing one. HHSs have only recently started to strategically plan for their future workforce needs.

The department has not developed statewide plans for all services that have a large number of patients. Without these plans, there is a risk that planning by HHSs will be fragmented.

Queensland Health has a growing and ageing asset base. It has identified that it will need significant further investment to renew these assets and acquire new ones. However, it needs to improve its approach to decide the relative priority of future investments. The department now requires HHSs to improve their asset management data and reporting.

Monitoring success

While Queensland Health monitors its short-term initiatives against clear performance measures, it is not systematically collecting information on the impact of its long-term plans. Nor is it monitoring whether its strategies are contributing to the development of a more sustainable health system.

We made seven recommendations to Queensland Health to improve integrated planning, the capacity and capability of staff, priority setting, and evaluating a plan’s success.

For more information

For more information on the issues and opportunities highlighted in this summary, please see the full report.