About the Clinical Services Framework

The hospital service definitions provide an overview of the minimum requirements / capabilities needed to deliver a safe and quality service at a particular level ranging from one (1) to six (6). Level 1 reflects the least complex level of service delivery and Level 6 reflects the most complex level of service delivery.

Many of the hospital service definitions are cumulative i.e., the delivery of a higher level of service for a particular specialty includes the capability of the service provided at the levels below. This is represented by the wording ‘As for Level’ within the definitions. For example, the description for a Level 5 service may commence with ‘As for Level 4 plus’.

The structure/layout of the hospital service definitions in the Clinical Services Framework 2025-2035 (CSF 2025) have been updated to better reflect contemporary approaches to describing service capabilities. Definitions from the Clinical Services Framework 2014-2024 have been reworked into the new format and all definitions will be reviewed/updated over time to ensure they are based on best available evidence. Definition (capability) content is included under the following three headings/categories:

Service Description

Provides a brief overview of the service including:

• Type of service provided.
• Type of patient (e.g. complexity).
• Providers and subspecialties where relevant.

Service requirements

Provides additional detail and service-specific requirements including:

• Nature of the service provided (e.g. particular interventions or treatment pathways, which could involve virtual care) and specialty skills of the service.
• Providers (e.g. specific expertise of the team/s).
• Inter-service and/or inter-level relationships (e.g. service networking, referral pathways, transfer arrangements and interaction with other services, multidisciplinary teams and specialists).
• Infrastructure and equipment requirements suitable for the needs of the service (e.g. intensive care services) and patients (e.g. paediatric or geriatric patients).
• Clinical support services requirements, if identified.

Workforce Requirements

Workforce requirements describe the minimum medical, nursing, allied health and other workforce relevant to each level of service. The CSF does not prescribe staffing ratios, absolute skill-mix, or clerical and/or administration workforce requirements for a team providing a service, as these are best determined locally.

The hospital service definitions are used to describe the level of service provided for a particular specialty at each hospital as represented by the role delineations entries shown in the HSP Hospital Services Matrices.

Role delineation is a process which determines the clinical capability of a health facility to provide services of a defined clinical complexity. It is based on an assessment of the service provided, infrastructure, equipment and other service requirements, support services, as well as the range and expertise of medical, nursing and other healthcare personnel in a given clinical discipline to provide a service.

As each service definition level indicates the minimum requirements / capabilities it is possible that a hospital can provide more services than described. For example, a hospital may meet all the requirements for a Level 3 service and meet some requirements for a Level 4 service. In this instance the service will reflect a Level 3.

HSP hospital services matrices provide a strategic map of health care services across the WA Health System and provides a framework upon which more detailed and localised planning can be undertaken to ensure the needs of the relevant catchment population are met.

The matrices show the key clinical and clinical support services (both inpatient and non-admitted / outpatient) provided at each hospital site.

The CSF 2025 matrices show: 

• Current role delineations.
• Endorsed 2024-25 role delineations.
• Endorsed 2029-30 role delineations.
• Endorsed 2034-35 role delineations.

The current role delineations reflect the actual level of service delivery reported by HSPs based on a self-assessment process undertaken in 2023-24. They were used to inform changes to previously endorsed 2024-25 role delineations and assist with determining future role delineations for 2029-30 and 2034-35. 

Decisions regarding future role delineations were also informed by:

• Current and projected activity.
• Known government infrastructure commitments.
• Outcomes and recommendations from system-wide Specialty Reviews.
• Strategic policy decisions.
• Elements of the 10-point checklist.

Final role delineations are endorsed by the Clinical Services Framework Executive Steering Committee (CSF ESC) and the Director General.  

The CSF ESC is responsible for:

• Overseeing the ongoing review and development of the CSF.
• Ensuring systemwide specialty issues are comprehensively considered and that recommendations / decisions made will guide clinical planning in terms of what and where clinical services are organised and provided across the State.
• Providing guidance to the Director General on strategic clinical policy decisions that have clinical planning or service delivery implications.
• Reviewing and approving clinical planning input into major health infrastructure projects.
• Promoting systemwide foundation principles and embedding processes to support decision making that consider all aspects of integrated planning and modelling, funding and all aspects of commissioning.
• Seeking input and advice from the Health Executive Committee on key proposals and making recommendations to the Director General.