A landmark cross-sector consultation has landed with a blunt verdict: the patient care pathways required by our national quality standards are underfunded and operating on goodwill. These critical care integration tools are being patched with bureaucratic sticky tape. It's time for health leaders, governments and funders to treat it like the infrastructure it is.
In Australian emergency departments right now, stressed junior doctors need advice from specialists that could have been pre-planned, while patients wait and ambulances ramp.
In a hospital across town, a nurse navigator is on her third phone call this morning trying to connect a newly discharged patient to community services guided by memory, PDF lists and professional wisdom.
And in Canberra, a policy committee is debating whether the health system is “well-positioned” to deliver better patient outcomes.
The answer, according to a national report released this week, is: sort of.
The Care Pathways Australia Review, commissioned by health systems improvement organisation Streamliners and independently conducted by Nous Group, synthesises a national consultation spanning 42 health system stakeholders across seven states and territories. Its conclusions are uncomfortable reading for anyone who cares about how Australia delivers care – which is to say, everyone who holds a budget, a stethoscope, or a seat in parliament.
“More than 90% of respondents agree that failing to establish effective and integrated care pathways poses significant risks, costs and missed opportunities for the Australian health system.”
This is a call to infrastructure-level action.
WHAT ARE CARE PATHWAYS, AND WHY SHOULD WE CARE?
For the uninitiated, care pathways are the agreed, evidence-based roadmaps that provide advice to clinicians on how to assess, treat, refer and transition patients through the system. When a doctor has easy in-consultation access to the best of global evidence and local agreement, patients are less likely to fall through gaps in systems or languish in waiting lists and ramped ambulances.
Done well, they are living system infrastructure – the connective tissue of a health system that is otherwise a collection of siloed professionals operating on experience and instinct.
Right now, that connective tissue is fraying. Pathways support patient journeys, and if we care about patients, we cannot keep patching that infrastructure with goodwill and short-term funding.
THE SYSTEM IS FRAGMENTED, AND EVERYONE KNOWS IT
The review’s consultation data reveals something remarkable: there is near-universal agreement about the problem, yet little has been done to fix it at a national level.
Most – 80% — respondents disagreed with or were neutral on the proposition that current care pathways effectively achieve coordination across regions and care settings. More than 70% disagreed that existing funding and governance models support sustainable pathway implementation.
The picture that emerges from the qualitative findings is one of a system running on the goodwill of clinical champions and local leaders. Pathways are developed locally, often duplicating work done identically across the country in parallel. They are funded episodically, attached to short term funding, projects and personal enthusiasm, and allowed to quietly decay when the money runs out or the champion moves on.
The clinician who built the pathway, and the junior doctor who finally found it helpful, will both eventually leave. What remains is a document that nobody owns, nobody updates, and nobody is accountable for.
“Pathways rely on short-term funding, discretionary effort or individual champions.”
THE EQUITY DIVIDEND LEFT ON THE TABLE
Here is where the case for investment becomes urgent.
Care pathways are one of the most powerful tools the health system has to deliver consistent care to populations who are most likely to fall through the cracks. This includes First Nations communities, people in rural and remote Australia, and patients navigating complex multi-morbidities across fragmented services.
About 85% of respondents agreed that the proposed principles for a national pathways system provide a strong foundation for a more equitable care system. Stakeholders were explicit: without national-level care pathway infrastructure, the equity gap widens. When there is no agreed pathway for assessment, referral and escalation in a remote community, the outcome is not “variable”, it is worse for people who were already underserved.
The Productivity Commission’s 2025 report on delivering quality care more efficiently identified scaling coordinated service delivery as a central challenge for Australia’s health system. The Care Pathways Australia result is telling us, loudly and clearly, that we have a mechanism to address this.
THE AI COMPLICATION NOBODY IS TALKING ABOUT
There is a time-sensitive dimension to this report that policy makers would do well to consider.
AI-enabled clinical tools are arriving faster than the governance frameworks designed to manage them. Around 40% of US physicians already use AI-based clinical decision support tools in daily practice. In Australia, that adoption curve is accelerating. And here is the problem nobody is saying clearly enough: AI clinical tools are only as safe and reliable as the content they are built on.
Care pathways are not just compatible with AI. They are the precondition for it.
When an AI tool surfaces clinical guidance at the point of care, it must draw that guidance from somewhere. If the underlying content is outdated, ungoverned, or inconsistent across jurisdictions, the AI does not correct for that. It scales it. A sophisticated large language model layered on top of fragmented information does not produce better care. It produces faster, more confident, and harder-to-audit delivery of inconsistent care.
There is a further problem. Clinical governance requires high-influence clinical AI to have clear human accountability structures, auditable reasoning, and local validation. A care pathway, owned by named clinicians and reviewed on a defined cycle, provides that foundation. An AI system operating without that governed content layer provides none of it.
AI tools, used well, can reduce cognitive load, improve documentation, surface relevant guidance faster, and support shared decision-making. The right architecture for safe AI in clinical settings is pathway and guideline led: AI that surfaces, explains and navigates governed pathway content, rather than substituting its own probabilistic output for it.
The system that fails to invest in care pathways today is the same system that will be unable to harness AI safely tomorrow. That’s the decision being made right now, in every budget process that treats pathways as a discretionary line item rather than infrastructure.
“The system that fails to invest in care pathways today is the same system that will be unable to safely harness AI tomorrow.”
SEVEN RECOMMENDATIONS, ONE CLEAR MESSAGE
The review provides seven recommendations. They cluster around four themes: establishing a shared national framework with clear definitions and minimum standards; clarifying who is responsible for what nationally, at jurisdiction level, and locally; treating pathways as shared system infrastructure with dedicated, sustainable funding; and measuring success by real-world clinical impact rather than the mere existence of a document.
The review recommends that care pathways be treated as shared system infrastructure and funded accordingly.
This is the kind of language that should resonate in a Treasury briefing. We do not debate whether to fund the national road network on a grant-by-grant basis, hoping that a passionate local champion will maintain the bitumen on their time. We fund infrastructure because we understand that the economic and social cost of not doing so compounds over time.
The health economics of well-implemented care pathways tell the same story. Reduced unwarranted variation, fewer avoidable hospitalisations, better workforce utilisation, reduced duplication of diagnostic workup, faster and more appropriate referral. These are the dividends of doing this properly.
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WHAT HEALTH LEADERS SHOULD DO NEXT
The sector has spoken with unusual coherence. The question is whether health leaders, state health departments, and ultimately the federal government will translate this consensus into structural investment.
For health executives, the immediate task is governance – establishing or clarifying accountability for pathway ownership within organisations and advocating loudly for jurisdictional and national coordination mechanisms. Care pathways that nobody owns will continue to drift toward irrelevance.
For funders and commissioners, the message is clear: episodic funding is incompatible with the goal of durable system infrastructure. The risk of not investing is growing, particularly as the equity implications of a fragmented pathway system become impossible to ignore.
For politicians and treasury officials, the ask is to treat this like roads, not projects. Infrastructure that reduces system cost, improves workforce sustainability and advances health equity is a structural investment with compounding returns.
Australia’s health system is sophisticated, capable and full of dedicated people. It is also, as this review makes plain, operating without the navigational infrastructure it needs to consistently deliver on its promise.
The map exists. We need to fund it and reap the benefits.
Read the full report: Australian care pathway consultation highlights strong support for unified approach.
The Care Pathways Australia Review was conducted by Nous Group on behalf of Streamliners and released in March 2026. The review draws on 42 consultation responses from across the Australian health system, spanning primary care, hospitals, peak bodies, research institutions and consumer organisations across seven states and territories.
This article was sponsored by Streamliners. Rhonda Morton is Director, Strategy and Partnerships, Streamliners Australia, and the principal consultant at New Evolution Consulting.