Population health

CESPHN’s Healthy Ageing Hubs program supports older people to maintain independence, health and wellbeing through access to locally delivered education, health promotion and social connection activities. Delivered in partnership with community organisations, local councils, health providers and aged care services, the hubs provide a place where older people can access information, build confidence in managing their health, connect with services and participate in activities that promote healthy ageing. The program is designed to address social isolation, improve health literacy and support older people to remain active, connected and engaged within their communities.

During 2025-26, CESPHN’s Healthy Ageing Hubs continued to strengthen community-based supports for older people across the region. A significant milestone was the commissioning of CESPHN’s fourth Healthy Ageing Hub at The Junction Neighbourhood Centre in Maroubra, expanding the program’s reach and complementing the existing hubs delivered by Kai’Mia Community (Gymea), Newtown Neighbourhood Centre (Newtown) and 3 Bridges (Summer Hill). This expansion has increased access to locally delivered healthy ageing programs and support for older people living in Sydney’s eastern suburbs. Over the 12-month period, the four Hubs delivered a broad range of activities focused on healthy ageing including more than 70 health education sessions covering topics such as falls prevention, chronic disease prevention and self-management, and digital literacy training, and information sessions on navigating aged care services. The Hubs have also assisted to link more than 1700 older people with local social connection activities and information on navigating aged care services.

During 2025-26 the program expanded partnerships with local councils, neighbourhood centres, multicultural organisations, primary care providers and aged care services, increasing opportunities for older people to access trusted information and early intervention supports close to home. Particular emphasis was placed on reaching people at risk of social isolation, those from culturally and linguistically diverse backgrounds, and older people experiencing barriers to accessing health and community services. As demand for preventative and community-based ageing supports continues to grow, the Healthy Ageing Hubs have become an important component of CESPHN’s commitment to supporting older people to age well and remain connected to their communities.

The CESPHN Care Finder program provides intensive support for older people who face significant barriers to accessing aged care and community services. Care finders help people understand and navigate My Aged Care, complete assessments, connect with suitable services and remain engaged with the support they need.

During 2025-26, the Care Finder program supported more than 1,350 vulnerable older people to access aged care, health, mental health, housing and social support. The program helped older people who may otherwise fall through service gaps to connect with care, maintain in dependence and improve health and wellbeing. CESPHN supported care finder staff to prepare for aged care reforms, including changes to My Aged Care and transition to the new Support at Home program. The program also strengthened partnerships across hospitals, aged care providers, primary care, community organisations, advocacy services and government agencies. Client outcomes remained strong, with more than 85% of clients staying connected to services three months after care finder support ended, and more than 95% of surveyed clients reporting high satisfaction with the service.

The Community Diabetes Education Program and Diabetes Education in Pregnancy Program improve access to culturally appropriate diabetes education. Delivered by Diabetes Australia with community and hospital partners, the programs help people understand, prevent and manage diabetes in a language and format that meets their needs.

During 2025-26, the Community Diabetes Education Program engaged 425 community members through 18 workshops delivered in Mandarin, Cantonese,  Bengali, Nepali, Arabic and English. The program reach edits intended audience, with more than 60% of survey respondents reporting limited English proficiency and many participants living with, or at risk of, type 2 diabetes. Participants reported high satisfaction, increased knowledge of type 2 diabetes prevention and management, and greater confidence and motivation to take action to support their health. The Diabetes Education in Pregnancy Program engaged 148 participants across 15 sessions co-located with the St George Hospital antenatal clinic. All survey respondents reported satisfaction with the program, 96% reported increased knowledge of diabetes risks in pregnancy and 100% felt more motivated to look after their health and knew where to seek support.

CESPHN commissions child health programs that improve early identification, intervention and care coordination for children and families. Programs include early intervention speech pathology, culturally responsive speech pathology for Aboriginal children, and the Schools, Health and Community Together collaborative program supporting children and families with complex needs.

During 2025-26, the early intervention speech pathology program delivered communication screening for 662 children and direct assessment for 150 children. Short-term support helped participating children achieve 95% of family-centred goals. The First Nations Speech Pathology program engaged 187 Aboriginal families and delivered 1,175 occasions of service. Educator training and coaching strengthened language-rich environments in early childhood settings, with educator confidence in identifying communication concerns increasing from 36% to 94% following training. The Schools Collaborative program supported 73 families and delivered 649 occasions of service. All clients received follow-up care coordination, with the program supporting families experiencing increasingly complex child development, parenting and financial concerns.

CESPHN works with general practices, local health districts, community organisations and peak bodies to improve cancer prevention, screening and early detection across the region. Activities include primary care education, quality improvement, promotion of national screening programs and targeted initiatives to improve access for priority populations.

During 2025-26, CESPHN supported activities to increase cancer screening participation and improve early detection. This included promotion of Breast Cancer Awareness Month, BreastScreen NSW mobile screening vans, the National Lung Cancer Screening Program and Cervical Screening for Mob resources to support Aboriginal and Torres Strait Islander women. A key achievement was implementation of the Hep B Home base program, funded by the NSW Ministry of Health. The program supported general practices to use data tools to identify patients living with chronic hepatitis B who require ongoing monitoring or liver cancer surveillance, recall patients, improve surveillance rates and facilitate referrals to specialist services when needed.

The Endometriosis and Pelvic Pain program supports coordinated, multidisciplinary care for people experiencing persistent pelvic pain, including suspected or confirmed endometriosis. The program supports early recognition, referral pathways and access to evidence-based care through commissioned services and collaboration with general practice, specialist and allied health providers.

During 2025-26, the program supported more than 200 clients through more than 380 clinical contacts. This included face-to-face consultations, telehealth appointments, and clinical nurse contacts. The service engaged younger people, with 69% of new clients aged under 25 years. The program improved access to multidisciplinary care, with new clients referred to allied health, specialists and diagnostic imaging. Treatment was initiated for 84% of new clients between July and December 2025, demonstrating timely access to care. All surveyed clients reported that their views and concerns about pelvic pain and endometriosis were listened to and acknowledged. The program also delivered education for general practitioners and allied health providers to strengthen primary care management of pelvic pain and endometriosis, as well as five group sessions delivered to patients to educate and build capacity for self-.management.

During 2025-26, CESPHN continued to deliver the Greater Choice for At Home Palliative Care program, supporting people with life-limiting illness to access coordinated care in the setting of their choice. The program works with general practitioners, specialist palliative care services, residential aged care homes, hospitals and community providers to strengthen care coordination and build primary care workforce capability.

During 2025-26, CESPHN strengthened palliative and end-of-life care capability across general practice, residential aged care, disability group homes and the community. Twenty-one general practices participated in quality improvement activities and 90 general practitioners, practice nurses and primary care professionals completed training, with 91% reporting increased confidence in providing palliative and end-of-life care. CESPHN supported clinical capability-building across 22 residential aged care homes and commissioned palliative care training across 47 disability group homes. This training reached 128 disability support workers and supported end-of-life care planning for 45 clients with disability. Community engagement was also a strong focus. More than 1,400community members attended education sessions on advance care planning, estate planning, grief and bereavement and end-of-life care conversations, with 93% reporting greater confidence discussing their preferences. CESPHN also supported an Aboriginal and Torres Strait Islander Yarning Your Wishes event attended by 76 community members. The event resulted in 109 legal and advance care planning documents completed, including wills, powers of attorney and enduring guardian appointments.