The below is intended as a high level summary of the 2026 AHDC webinar 'Australian Health Facility Guidelines Update', held 25 June 2026. For the most current information, please always refer the the AusHFG website: https://healthfacilityguidelines.com.au/

Written by Anna Fox, AHDC Committee Member and Senior Associate, Grieve Gillet Architects

Part 1: 2025-6 AusHFG Review

Fiona Wilkinson, Director, Economics and Health Facility Advisory Capital and Commercial Advisory, Health Infrastructure NSW provided a background to the recent AusHFG Review and outlined the key findings. 

In April 2025, the South Australian Government requested an independent review of the AusHFG to determine:

• Whether guideline development processes are robust and evidence based

• Whether AusHFG implementation supports value for money

• Whether specific AusHFG requirements are driving cost escalation

• Whether AusHFG driven requirements add measurable value to health systems and outcomes

The AusHFG review was largely driven by systems pressures, cost of construction and escalation of construction costs. It was acknowledged that these construction and escalation costs were not limited to the health sector, but apparent across all areas of Government, including  housing. Increasing costs in public healthcare delivery were also highlighted, specifically an increase from $56B  in 2014 to $87B in 2024. Fiona highlighted that all of the recommendations from the previous review of AusHFG in 2021 had been applied and considered in this review.

The Review Process: 

The review specifically focussed on its scope, governance and application. Commissioned to independent reviewers in June 2025, involving an independent panel across jurisdictions, with mixed representation from infrastructure and interrelationship governance. Nationally, 80 stakeholders, including a mix of operational staff, were interviewed.The following limitations were highlighted:

• Data, including the availability of data

• Ability to analyse that data

• Access to key people to interview (due to key staff changes etc)

Key findings:

• AusHFG is NOT a major cost driver for projects. Significant cost drivers included community expectations, union and college expectations, hospital space requirements and WHS

• Findings identified that the AusHFG were well clinically informed. There was unanimous stakeholder support for the guidelines. AusHFG is a valuable national evidence informed resource and should remain in place as a collaborative asset. It was noted that if AusHFG did not exist there was considerable risk of duplication across jurisdictions in setting up individual guidelines.

• There was minimal net area growth across the AusHFG. Between 2014 - 2024, across 143 standards, there was growth across 16 Standard Components. Net growth in SOAs across this same 10 year period was 29sqm.

• Cost escalation drivers could be linked to how many jurisdictions undertake planning, managing increasing ageing populations and clinical service planning forecasting. Consequently, projections in public health had a strong forward projection, with hospitals being built to reach that capacity. Cost escalations were less evident in the private sector, where the tendency is to build in smaller planning cycles. 

• Hospitals represent key civic spaces which require long-term planning considerations to be embedded in design. WHS legislation including safety and dignity, and evolving models of care were also identified as key drivers in cost escalation. 

• When AusHFG are applied consistently, they are successful. Application of the guidelines showed considerable variation, which was particularly evident in larger jurisdictions with a higher population base. Other findings suggested variance in governance and departures, including whether departures and variations were actually recorded.

Recommendations:

1. Purpose: Reframe AusHFGs as ‘good practice guidelines’ rather than ‘minimum standards’. Exactly what ‘good practice’ means needs further development.

2. Governance: Variations, reporting and sign off (including the contribution of Health Ministers in the sign off process).

3. Application: Guidelines as a lever to inform variations, POE and further development. 

4. Scope: Further discussion is required to inform what is included in the AusHFG and if they should be broader, particularly for non-clinical spaces such as BOH areas, workstations and office accommodation. 

Conclusion

Maintaining flexibility and moving from minimum standard to ‘best practice’ supports better decision discipline  and reduces the opportunity for automatic scope escalation. Targeting the real growth areas such as non clinical spaces, BOH spaces, travel and engineering, and acknowledging the POE are missing link in evidence to inform these growth areas. Efficiency opportunities in governance and application and increased evidence based knowledge around POEs. AusHGs are currently developing a knowledge sharing database to capture information on POEs, variations and departures.  

AusHFG will work with AHIA strategy working group to develop an implementation plan,  prioritising key actions, noting a three year implementation phase.

Part 2  - HPU Updates

Marilyn Mandigma, Lead, AusHFG Health Planning Unit, Health Infrastructure NSW provided Health Planning Unit (HPU) updates, noting these updates offer a more evidence-informed approach: 

HPU 340 Adult Acute IPU

• Addition of overarching design principles

• Support for 50 – 60% single bedrooms for acute Medical and Surgical IPUs (based upon literature, expert consultation and recent projects (benchmarking))

• High/Close Observation and Short Stay Unit Guidelines 

• Guidance for structural columns and service risers

• Inclusion of design strategies to assist with patients with extreme behavioural and psychological symptoms of dementia (BPSD)

HPU 360 Intensive Care Unit (ICU)

• Update to the  mix proportion of open bays and enclosed rooms to enable more flexibility in care models

• Optional door to interconnected rooms to support staffing models

• Optional third (foot) pendant (depending upon service requirements - eg to support ECMO)

• Standardised wall panels to support dialysis (including appendix document for further information) 

• Clarification that overnight stay rooms are optional and can be located external to to unit 

• Reduction in recommended bathrooms and ensuites as informed by benchmarking and recent projects 

HPU 280 Oral Health Unit

• Biggest driver for update was alignment with AS5369 (released in 2023), including design, planning and reprocessing requirements. AusHFG recognised there was some challenges in aligning with AS5369, especially in smaller and regional locations.

• Strengthened guidance for off site reprocessing, including scalable reprocessing and storage guidance for on-site and off-site reprocessing

HPU 390 Neonatal Care Unit

• Addition of overarching design principles

• Design and spatial considerations for newborns requiring prolonged non-invasive ventilation

• Design guidance relating to newborn retrieval and transfer services

• Updated recommendations on nitric oxide usage, including risk assessments

HPU 620 Renal Dialysis Unit 

• Strengthened guidance on water treatment plant design 

• Infrastructure Resilience - expanded guidance on drainage, tundish and pipework 

• Infection Prevention and control (IPC)

• Sustainable Wastewater Management - aligned with jurisdictional requirements

• Service Consistency - alignment with other HPU guidance (eg ICU dialysis guidance)

• Expanded Appendices 

• Flexible Patient Care spaces 

Isolation Rooms - Engineering and Design Requirements

• Isolation Room types

• Air changes 

• Guidance on isolatable pods

• Refined airflow design 

• Air leakage control 

For more information and to review the HPUs, go to: https://healthfacilityguidelines.com.au/content/news-updates

Part 3 - Standard Components and Educational Videos

Shalyce Corney, Lead, AusHFG Standard Components, Health Infrastructure NSW provided an update on a range of resources and updates. 

Educational Videos: 

To assist with understanding the AusHFG, three educational videos have been developed and published on the AHIA website: 

• What are AusHFGs?

• How are AusHFGs developed?

• How are AusHFGs applied to projects

Watch them here: https://healthfacilityguidelines.com.au/news/new-ahia-resource-ahiaaushfg-educational-video-series

3D Visualisations

A new AHIA Resource has been created in the form of 3D visualisations of standard component rooms. These 3D views have been developed to assist with consultation, and will continue to be provided for future publications. They are publicly accessible from your web browser, you can find them here: https://healthfacilityguidelines.com.au/standard-components 

Currently Under Review and Providing Feedback

The AusHFG undergoes progressive review of HPUs and Standard components. You can find the list of items currently under review on the website. Everyone is encouraged to provide feedback on AusHFG via the 'Give Feedback' link. 

Find them here:  https://healthfacilityguidelines.com.au/currently-under-review 

Updates to Standard Components

The following standard components have been recently updated, with some of the key changes noted below: 

• Intensive Care

• • 1 Bedroom - Intensive Care

  • Patient Bay - Intensive Care

  • • ICU updated in alignment with HPU updates 

    • Optional door between rooms to support staffing models

    • Renal Dialysis connectivity and plumbing

    • Tandem pendent no longer 'wet' and 'dry'. To extent possible, services provided on both sides 

• Neonatal Care

• • Patient Bay - Neonatal, Intensive Care/High Dependency

  • Patient Bay - Neonatal Care, Special care

  • • Zoning within bay 

    • Intensive care/high dependency bay updated to indicate pendant (and raised ceiling to accommodate this) 

• IPU Accommodation

• • 1 Bed - Inpatient Unit

  • A number of Standard Components have been retired  

  • • One Ensuite design (could be inboard or outboard depending upon how you flip it when applied to the floorplan)

    • Outboard bedroom with undulation to facade excluded - as data was indicating this is not how buildings were being built)

AHDC members can watch the full webinar recording (please log-in to view): https://www.aushdc.org.au/Past-Presentations/13647781

As our third AHDC webinar for 2026, this was an excellent overview of the AusHFG review and recent updates to health planning units (HPUs), standard components and upcoming changes. 

Thank you to Fiona, Shalyce and Marilyn for your valuable insights.