A Year of Impact
2024–2025

Acknowledgement

The Statewide Health Literacy Hub acknowledges the Traditional Custodians of New South Wales and recognises their continuing cultural and spiritual connections to the lands, waters, and communities. We pay our respects to all Aboriginal and Torres Strait Islander people and their cultures, their Elders past and present, and to future generations.

We recognise and appreciate consumers, patients, carers, supporters and loved ones. The voices of people with lived experience are powerful. Their contribution is vital to enabling decision-making for health system change.

Our Mission

To cultivate innovative partnerships that prioritise human-centred, and evidence-based health literacy practices. Together, we will empower individuals, strengthen organisations, and support communities across New South Wales.

Our Vision

An equitable healthcare system where every individual can easily access, understand, and use healthcare services to make informed decisions, leading to improved outcomes and community wellbeing.

Foreword

When people can access, understand, and act on health information, they are empowered to make informed decisions, avoid preventable harm, and experience care that respects their background and needs. For our workforce, stronger health literacy means clearer communication and fewer errors.

The Statewide Health Literacy Hub was established to embed health literacy across NSW Health.

Guided by our Future Health strategy and aligned as an initiative of the Elevating the Human Experience program, the Statewide Health Literacy Hub is positioning NSW Health as a leader in health literacy, embedding equity, safety, and the community voice into everything we do.

A defining strength has been its partnership with The University of Sydney’s Health Literacy Lab, which bridges global evidence, research and frontline practice, ensuring that training, digital tools, and system reforms are evidence-based, practical, and impactful.

In just its first year, the Statewide Health Literacy Hub has reached remarkable milestones, setting a strong foundation for the future, including:

• Creating shared learning for clinicians, frontline staff, executives, and consumers through a dynamic seminar series
• Building research knowledge and skills through mentoring and masterclasses
• Advancing the Electronic Patient Communication Portal (ePCP) from pilot to statewide rollout, to deliver clear, safe, and accessible patient information; and
• Building strong communities of practice through shared knowledge networks that will sustain this work for years to come.

These achievements reflect not only dedication and vision but the collective commitment to making health literacy central to safe, equitable, and person-centred care.

Looking ahead, I encourage every leader to champion health literacy as a system priority, integrating it into governance, workforce development, digital transformation, and models of care. Together, we can make health literacy a core capability of NSW Health in delivering safe and equitable care for the diverse communities we serve.

Susan Pearce AM
Secretary, NSW Health

Our impact at a glance

675+ Attendees at official launch in October 2024

725+ Foundational Health Literacy training registrations

A year of impact

Dana Mouwad, Director, Statewide Health Literacy Hub

From statewide training, our seminar series, a program of translational research, pilot grants, and consumer and NSW Health partnerships, to our official launch in October 2024, we have reached thousands of staff and community members. These activities reflect not only strong engagement but a cultural shift. Health literacy is becoming central to how NSW Health communicates in an increasingly digital environment that risks exclusion.

With more than 60 percent of Australians experiencing low health literacy, our purpose is to empower every person, regardless of background or circumstance, to access, understand, and use health information with confidence. Pioneered in Western Sydney Local Health District, we now operate as statewide infrastructure, connecting frontline services, consumer voices, and translational research to improve health communication.

Health literacy is integral to safe, person-centred care and is progressively being integrated as a requirement through the National Safety and Quality Health Service Standards, and the forthcoming National Health Literacy Strategy. We are building organisational capability and translating research into practical solutions that can be scaled across the system.

A key example is the rollout of the Electronic Patient Communication Portal (ePCP), with six NSW Health organisations leading the first phase. The ePCP will provide a consistent, evidence-based process for creating clear, reliable information that patients can trust and understand. Our research program is producing practical solutions in priority areas such as digital health literacy, parenting support, and care and transition pathways that are critical to safety and quality.

The strength of the Statewide Health Literacy Hub lies in the breadth of our partnerships across health, academia, and the community. Together we are co-designing solutions and embedding health literacy at the heart of NSW Health. Our priority is to build on these foundations and scale what works, embedding a culture where health literacy is the norm, strengthening safety, quality, and equity so every person who interacts with NSW Health can better understand, navigate, and act on their health.

Building capacity

By equipping staff and leaders with the capabilities to support health literacy they can better align organisational goals with the diverse needs of the communities they serve. This approach reduces the risk of system failure, addresses inequities in care, and ensures people can access, understand, and act on health information with confidence

Foundational health literacy training

Communication is the number one complaint, according to NSW Health patient experience data. The Statewide Health Literacy Hub is building system-wide capacity and capability by embedding evidence-based foundational training across NSW Health.

Our foundational training module What is Health Literacy and What Does It Mean for Me?, launched in March, saw more than 600 registrations with an average of 130 clinical and non-clinical staff completing it each month. Uptake has been the strongest in the Hunter New England, Western Sydney, and South Western Sydney local health districts.

Western Sydney University has been among the first to express interest in adoption the Statewide Health Literacy Hub’s foundational training module, recognising its value in preparing future clinicians to communicate effectively and deliver safe, high-quality care. Work is progressing with the Health Education and Training Institute (HETI) to include health literacy training modules on the NSW Health online learning and development platform My Health Learning.

Early insights

Key outcomes and metrics have been overwhelmingly positive. On a scale of one to 10, participants’ knowledge ratings increased to eight-plus from a base of one to five. And confidence in identifying best practice tools such as shared decision-making and teach-back doubled from 47 to 97 percent. Building on this success, two modules shaped from staff feedback are scheduled for release in early 2026:

• Written Communication will teach how to create clear, accessible information for all audiences using best practice, evidence-based tools; and
• Verbal Communication will further build on health literacy tools that check understanding and the intention to act on information. Encouraging safe person-centred conversations builds knowledge for decision making.

These modules, with future foundational modules, equip staff with practical techniques and evidence-based strategies to communicate effectively. This strengthens every health interaction making care clearer, safer, and empowering for consumers, patients and their families.

Health literacy in leadership

Planning is underway to co-design training for executives and boards to embed health literacy into governance, planning, and strategy across NSW Health.

Short, targeted modules integrated into leadership forums and programs will equip leaders with practical tools and knowledge to strengthen organisational health literacy. For senior leaders, a clear understanding of financial and performance impacts is imperative.

Low health literacy is directly linked to increased emergency department (ED) presentations, higher rates of hospital readmission within 28 days, and poorer health outcomes. Building system-wide capacity reduces the risk of failure by helping executives align their organisations with the needs of the people they serve.

This involves enhancing workforce capability, organisational structures, data governance, financial resources, partnerships, leadership, technology and innovation, and creating people-centred services and environments grounded in genuine user engagement and co-creation. Investing in system-wide health literacy capacity provides a future-proof approach. It delivers lasting impact that multiplies across services, organisations, and communities, shifting the focus from individual behaviour change to whole-of-system transformation. Advancing this work directly supports NSW Health’s priorities around safety and quality, effective communication, efficiency, and improved patient experience.

Manager development

At Western Sydney Local Health District, more than 100 managers completed Health Literacy and Cultural Competence training through its Manager Capability Development program. Managers are equipped with the skills to communicate with clarity and inclusivity, while fostering culturally responsive teams.

The Health Communication Reflective Tool supports managers to lead safer, more person-centred interactions. By integrating these skills into everyday leadership practice, managers are building teams that communicate with trust, empathy, and credibility, ensuring care that is safer and more responsive to the diverse needs of NSW communities.

Seminars

Our seminar series attracted more than 2,000 healthcare staff, building health literacy capacity by linking evidence to practice and showcasing opportunities for translation. The series featured national and international academics, healthcare leaders, and consumer voices, exploring rural, regional, and priority health literacy issues, with a strong interest in applying health literacy to artificial intelligence (AI) in healthcare.

Each seminar is designed to showcase the evidence base, present practical applications and case studies, and inspire deeper thinking on how to adapt, scale, and embed insights into innovative initiatives and everyday strategy.

Shared knowledge networks

Shared knowledge networks (SKNs), or communities of practice, bring staff and consumers together around shared expertise and interests. They build knowledge through collaboration to shape a safer, more inclusive health system for the future. SKNs are transforming how NSW Health strengthens health literacy by sharing knowledge and co-designing solutions that are practical, relevant, and embedded across the system.

A shared knowledge network community of 2,100+ people has grown from our seminar series, while the Research SKN continues to connect teams through forums. The Electronic Patient Communication Portal (ePCP) SKN worked alongside staff through 30 co-design sessions to develop user-focused solutions.

A Digital Health Literacy SKN, aligned with the Single Digital Patient Record (SDPR), is in development. It will position health literacy at the heart of digital transformation, ensuring consumers, especially vulnerable groups, are supported in navigating new technologies.

Ambassador program

Health literacy ambassadors are key to capacity building. We are exploring a system-wide model aimed at developing practical, sustainable and scalable strategies for integrating health literacy ambassadors across the NSW Health workforce.

Communication unlocking safer care

Clear, consistent, and inclusive health information drives safer care, better adherence, and stronger patient engagement.

Across NSW Health, patient communication has often been developed without standardised approaches or meaningful consumer co-design. The electronic Patient Communication Portal (ePCP), a digital platform, is a statewide evidence-based quality and safety initiative that standardises how health information and communication is developed, designed, reviewed, approved and shared.

The statewide rollout of the ePCP will enable healthcare staff to create, adapt, and share information to patients that is clear, consistent, culturally appropriate, and accessible. The built-in guidance, practical tools, templates, and plain language support of the ePCP help staff to create clear, accessible, trusted and credible resources that support safer care.

Case for rollout

A world-first, system-level scalability assessment confirmed the ePCP as a practical, evidence-based solution to:

• Reduce safety risks through standardised health communication
• Support compliance with the National Safety and Quality Health Service Standards and the NSW Health Accessible Communications Policy
• Build workforce capability for safe, person-centred communication

From principles to practice

Co-design has been at the heart of the ePCP journey. Healthcare staff, academics and consumers worked together to design the platform around real-world needs including plain language editing, health literacy and accessibility checklists, and consumer engagement guides. The result is a platform that ensures consumer voices, frontline experience and research evidence guide every step.

Equity

The ePCP tailors health information making it culturally safe, inclusive and accessible for everyone including Aboriginal and Torres Strait Isander peoples, those from culturally and linguistically diverse backgrounds, people with disability, and the neurodiverse. More than 1,500+ NSW Health staff have been introduced to the platform through statewide roadshows, with six organisations gearing up for rollout, marking a new benchmark in clear, equitable communication.

Impact and reach

Social posts highlighting the importance of clear health communication are driving engagement. Hub Bytes has proven especially effective, delivering concise, easy-to-digest research summaries that help busy healthcare professionals quickly build awareness and apply knowledge.

The I Am Visible LinkedIn campaign, highlighting equitable communication for people with disability, has been one of our most engaging initiatives, with 23,740 impressions and a 7.5 percent engagement rate, exceeding industry benchmarks. With a peer-reviewed publication underway, the ePCP is positioned as a system-wide safeguard for safety, equity, and quality, making clear, reliable communication fundamental to healthcare across NSW.

Driving research into action

With equity at the core of every project, we are building a system where every person in NSW, regardless of language, culture or background, can access clear, safe, and reliable health information. At the heart of our work, researchers, health professionals, and stakeholders work together as equal partners to ensure evidence moves seamlessly into practice. By engaging academics, executives, clinicians, managers, consumers and the community from the outset, we align research priorities with the practical demands of the health system. This collaborative model accelerates the adoption of proven health literacy strategies into health communication, service delivery and models of care, ensuring tangible benefits for people and communities across NSW Health.

The University of Sydney’s Health Literacy Lab is our key academic partner, providing world-class expertise and internationally recognised leadership in health literacy research, teaching and mentoring.

Together we are building system capability across NSW Health, developing a pipeline of innovative projects.

ePCP

The electronic Patient Communication Portal (ePCP) will transform patient safety and equity by standardising how health information is created and delivered. Piloted and evaluated in Northern NSW Local Health District, the scale-up is guided by implementation science frameworks to ensure adaptability and sustainability across diverse contexts.

Parenting+

Embedding health literacy into child and family education programs will equip new parents with practical skills to navigate health and social systems. The model directly supports equity and early intervention priorities, and is being adapted with multilingual and culturally tailored approaches.

Critical health literacy

Researching how culturally and linguistically diverse communities search for, evaluate and apply online health information in their decisions and behaviours will strengthen NSW Health’s response to digital misinformation by informing culturally relevant and adaptable strategies that build digital health literacy.

Health literacy ambassador research

Health literacy ambassador research will create a clear, evidence-based framework with practical steps to embed health literacy into everyday roles. Ambassadors will act as peer leaders, building capability and driving cultural change, supported by strong leadership and governance. The outcome will be a statewide model for a health-literate workforce.

Seeding innovation

The Statewide Health Literacy Hub’s inaugural 2025 pilot research grants are driving equity-focused health literacy solutions. Three competitive projects were awarded $10,000 each:

1. Nepean Blue Mountains Local Health District is piloting a virtual reality tool to reduce vaping in at-risk adolescents
2. A network of local health districts with The University of Sydney is mapping post-heart attack care pathways for culturally and linguistically diverse communities; and
3. South Western Sydney Local Health District with Macquarie University is co-designing a model where bilingual community educators develop and deliver culturally appropriate communication to their communities.

Partnering for better outcomes

The Statewide Health Literacy Hub is a NSW Health initiative, hosted by Western Sydney Local Health District in partnership with the University of Sydney.

Our partnerships go beyond collaboration. They are engines of trust, credibility, and impact. By uniting consumers, strategic leaders, researchers, and community organisations, the Statewide Health Literacy Hub is leveraging these alliances to implement health literacy into policy, practice, and system transformation across NSW Health.

Engaging the NSW Health system

Executive engagement rose from 79 percent of NSW Health organisations in late 2024 to 89 percent by mid-2025. These relationships informed system-level mapping and maturity assessments, identifying local needs, strengthening existing initiatives, and shaping new ones.

Key NSW Ministry of Health directorates, along with the Cancer Institute NSW, Agency for Clinical Innovation, Health Education and Training Institute, and the Bureau of Health Information, are actively engaged in co-designed projects. They are joined by Sydney, Western NSW, Hunter New England, and Northern NSW local health districts, as well as the NSW Refugee Health Service. Phase two and three organisations are scheduled for scale-up in 2026.

Strategic alignment

Ongoing NSW Health funding, through the Elevating the Human Experience program, keeps health literacy central to the Future Health Strategy. This support enables the Statewide Health Literacy Hub to shape statewide initiatives from the Single Digital Patient Record to organisational frameworks and policy, and contribute to national reforms, including the third edition of the National Safety and Quality Standards in Health Care and the National Health Literacy Strategy.

Research

Our partnership with the Sydney Health Literacy Lab at The University of Sydney brings academic depth and translational expertise, enabling an evidence-based model of co-creation that moves health literacy research quickly into practice across NSW Health.

Academics work alongside NSW Health staff, mentoring and supporting their knowledge and skill development to become active contributors to research, guiding them through study design, implementation, evaluation, and publication.

This approach advances system priorities and builds enduring capacity within the workforce to lead future research translation. We developed alliances with the University of NSW, Macquarie University, Western Sydney University, and Neuroscience Research Australia (NeuRA), through major research collaborations.

Consumers

Consumers have been central from the outset co-chairing sessions, participating in panels, and reframing health literacy for communities.

Ongoing partnerships with consumer councils and advisory groups across local health districts, the Cancer Institute NSW, the Clinical Excellence Commission, and Health Consumers NSW have ensured authentic engagement.

Consumers are active contributors to health literacy initiatives, serving as co-researchers in data collection, analysis, and design, and building a growing pipeline of community leaders in health literacy research.

The road ahead

We have laid strong foundations through innovation, research translation, and collaboration. By strengthening workforce capability, harnessing digital solutions, and co-designing with communities, we are charting a path toward a system that delivers safer, research-informed, and more inclusive person-centred care for all.

Written and verbal communication training modules will launch in the first quarter, followed by culturally adapted communication and digital health literacy modules. These programs will support the statewide rollout of the electronic Patient Communication Portal (ePCP) and align with the Single Digital Patient Record. Since October 2025, six early adopter organisations have begun implementation planning for ePCP with support from local groups within a shared knowledge network (SKN).

Through training, the ePCP, and translational research, we are helping NSW Health deliver the Single Digital Patient Record by embedding health literacy into workforce capability, digital tools, and organisational practice. The new Digital Health Literacy Shared Knowledge Network will support this by giving staff the skills and tools to design and share accessible digital health communication.

Our pilot research grants, workshops, and masterclasses will mentor staff to become health literacy ambassadors, equipped to advocate for and drive improvements across their organisations from the frontline to leadership. This work will inform the design of a statewide model that defines the roles, capabilities, and pathways, building a sustainable network of leaders who can embed health literacy across NSW Health.

The Statewide Health Literacy Hub will continue to make health literacy part of everyday business across NSW Health. This includes integrating health literacy into recruitment, roles, onboarding and capability frameworks. We will influence policy and ensure health literacy is more explicitly recognised in national standards and strategies by having critical input into the third edition of the National Safety and Quality Health Service (NSQHS) Standards under development by the Australian Commission on Safety and Quality in Health Care.

We have contributed to the forthcoming National Health Literacy Strategy, anticipated to land in 2026 following final community consultation. NSW Health will be well-placed to meet national health literacy roadmaps.

By embedding health literacy through training, digital platforms, workforce frameworks, and policy, the Statewide Health Literacy Hub is making clear, safe, person-centred communication standard practice, positioning NSW Health as a leader in this evolving field.