Shaping the System Together – Clinician Engagement: Recommendation Report

Summary

Shaping the System Together is exploring how clinician engagement works across NSW Health, including what is working well, where challenges exist, and opportunities for improvement. The initiative aims to strengthen routine engagement practices and support a better experience for people working across the NSW Health system.

The Shaping the System Together consultation engaged more than 1,700 participants across NSW local health districts (LHDs), specialty health networks (SHNs), pillars and statewide health organisations from December 2025 to May 2026.

This Recommendation Report outlines the identified themes, recommendations and practical action areas. They are designed to support action in three complementary ways:

Local reflection and improvement planning
Using evidence to prioritise action
System stewardship and alignment with existing priorities

A companion Practical Actions Guide translates the action areas into practical examples, behaviours, supportive tools and suggested measures that can be adapted across local, statewide and specialty settings.

Key findings

The consultation findings are consistent with available evidence. They emphasise the role of leadership, communication and workforce conditions in supporting meaningful and sustainable clinician engagement.

Five key themes were consistently observed across metropolitan, regional, rural and remote settings:

how engagement structures are used in practice
when engagement leads to action
feeling safe to speak up
alignment between authority and accountability
workforce wellbeing under sustained pressure.

There is an opportunity to build on what already works to support sustainable clinician engagement across NSW Health, aligned with key initiatives. This includes strengthening support for existing engagement arrangements as core business, with more consistent decision-making, feedback, protected time, implementation support and leadership capability.