How to prepare for escalating climate hazards: new resources for health sector

The health sector has been provided with a detailed manual, templates, dashboard and regional data to inform climate risk assessment and adaptation planning.

The suite of documents, published yesterday by the Australian Centre for Disease Control, provide step-by-step guidance for organisations to identify, assess and manage climate-related risks to service delivery, infrastructure and population health.

They address issues such as maintaining continuity of service and supply chains, embedding consideration of climate risks into workforce planning, and upskilling staff to deal with surges in demand due to extreme weather events.

The resources include a series of reports with regional climate health hazard data – for NSW and the ACT; the Northern Territory; Queensland; South Australia; Lutruwita/Tasmania; Victoria; and Western Australia.

Concerns were recently reported at Croakey about delays in the release of these documents, with experts warning that this was undermining the sector’s capacity to prepare for extreme weather events set to be turbo-charged by El Niño conditions.

The documents do not envisage a future where the temperature increase is limited to 1.5 degrees. They use a ‘middle of the road’ scenario that sees temperatures rising by about 2.7°C by the end of the century, as well as a ‘reasonable worst-case’ scenario that assumes both emissions and temperatures continue to rise to the end of the century due to delayed climate action, resulting in temperature increases of about 3.6°C by 2100.

The manual, ‘Guidance on climate risk assessment and adaptation planning for Australian health system organisations’, says climate hazards – such as heat and humidity, bushfire smoke, drought, flooding and rainfall, storms and cyclones – can affect infrastructure, workforce, supply chains and other assets.

At the same time, these hazards also affect population health, as outlined in the table below, placing increasing pressure on health services.

“When climate hazards affect vulnerable populations, the resulting health impacts drive up demand for care, often when health systems are already under strain,” says the manual.

“For example, a heatwave may lead to increased hospital presentations while also challenging the hospital’s cooling systems and staff wellbeing and capacity. Similarly, a flood may displace communities and contaminate water supplies, while also disrupting transport routes and access to healthcare facilities.”

The toll upon the health workforce is also highlighted: “Staff availability and wellbeing can also be compromised, particularly during emergencies when healthcare workers may be personally affected or experience burnout.”

Examples of adaptation

The manual says that by understanding how hazard, exposure and vulnerability interact, organisations can develop strategies to protect communities, strengthen system resilience, and ensure continuity of care in a changing climate.

It gives as examples:

A Primary Health Network could undertake a climate risk assessment as part of its Needs Assessment, to inform future strategic planning and commissioning decisions.
An ambulance service could identify potential risks of service continuity, such as extreme weather events affecting response times or access to patients.
A health infrastructure agency could evaluate the resilience of built assets to hazards such as flooding, bushfires, and extreme heat. This could inform capital works planning, and ensure compliance with building codes and climate adaptation standards.

The manual says adaptation can take many forms, including staff training to manage heat-related illness, patient education on preventive health measures, or community outreach during extreme weather events.

It can also involve governance and planning actions such as embedding climate risk assessment and management into strategic, investment and operational decisions.

Adaptation can also involve engineering and infrastructure actions, such as installing solar power with battery backup to reduce reliance on grid electricity, upgrading heating, ventilation and cooling systems to manage heat stress, and flood-proofing critical infrastructure.

The manual puts forward options for health organisations to consider under leadership and governance, such as integrating climate risk and resilience into board agendas and organisational strategies and plans.

Other options include designating executive accountability for climate risk and resilience, and publishing a climate risk policy or position statement.

Organisations could also develop networks and communication channels on climate risk and resilience with other health services and local organisations.

Under population health, organisations could identify and map vulnerable populations and develop plans in collaboration with these groups to provide targeted support during climate-related emergencies.

The manual also suggests raising community awareness of the health impacts of climate change and what people can do to protect themselves and their communities.

However, it does not explicitly mention the importance of phasing out fossil fuels although it says “effective adaptation requires credible mitigation strategies to address the root causes of climate risks and impacts”.

Strengthening community mental health programs to manage climate-related mental ill-health is another option put forward.

Workforce, supply chains and service delivery

Under workforce and operational matters, options include:

Establish onsite staff accommodation for continuity of service provision during extreme events, taking into account childcare, transport and other essential needs for staff.
Develop flexible rostering and remote work protocols for climate disruptions.
Provide mental health support programs for staff affected by climate-related trauma.
Embed consideration of climate risks into future workforce planning.
Conduct regular extreme weather scenario training exercises for emergency preparedness.
Ensure staff are appropriately trained to manage climate impacts, including upskilling staff to support surges in demand associated with extreme weather events.
Establish contingency plans for staff transport in the event of extreme weather events.
Review and enhance workforce surge capacity during disasters, for example by developing a roster of retired staff who may be willing to return to work during surge events.
Review occupational health exposure standards to promote safe work practices in health service delivery and remote working during extreme weather events including heatwaves.
Review and enhance insurance options to ensure they cover climate-related risks.

Options for addressing supply chains and resources including diversifying suppliers and establish local procurement and backup options for critical goods, and developing contingency plans for food supply disruptions, including partnerships with local providers.

To maintain service delivery and continuity, options include increasing ambulance availability during heatwaves, developing protocols for rapid relocation or evacuation of patients during extreme weather events, and conducting annual reviews of emergency management plans to ensure they remain fit for purpose in a changing climate.

Organisations can also consider implementing backup communications protocols and systems, such as satellite phones and radio networks.

“These examples are intended to serve as a starting point for brainstorming, not a comprehensive or definitive list,” says the manual.

It draws upon Queensland Health’s 2019 Climate Change Adaptation Planning Guidelines, which were identified by stakeholders as a best practice model. It is also informed by World Health Organization guidance on Climate Change and Health Vulnerability and Adaptation Assessment, Australian Government’s Climate Risk and Opportunity Management Program, and Australia’s first National Climate Risk Assessment and National Adaptation Plan.

The manual discusses the importance of developing clear support from an organisation’s leadership, as this helps secure resources, mandate, and cross-organisational participation.

It includes clear advice, featured below, for making the business case to leaders, noting that as risk management and oversight are fundamental responsibilities of boards and executives, leadership should be actively involved to guide strategic choices and support the integration of climate risks into broader organisational planning.

This level of involvement reflects the growing governance expectation that boards and executives identify, assess, and respond to climate risks as part of their core oversight duties, the manual says.

It makes suggestions for establishing project teams and governance structures, and suggests engaging representatives from patient groups, and the local community.

The manual includes clear suggestions and templates.

The manual says organisational objectives for undertaking climate risk assessment might include improving organisational resilience, supporting population health, compliance with policy or funding requirements.

Organisations may also be responding to stakeholder expectations – “to demonstrate leadership and accountability to staff, patients, communities, and partners who are increasingly concerned about climate change”.

“As you develop your risk statements, it is important to look beyond the immediate, direct effects of each hazard and consider indirect impacts, interdependencies and the potential for cascading and compounding risks,” the manual advises.

“For example, a bushfire may damage power infrastructure, leading to outages that disrupt hospital operations and compromise cold-chain storage for medications and vaccines. This can then affect patient care, emergency response, and continuity of service delivery.”

The manual says compounding risks arise when multiple hazards occur simultaneously or sequentially, increasing overall harm. “For instance, a heatwave coinciding with poor air quality from bushfire smoke can significantly increase respiratory-related hospital admissions over and above what would be caused by a heatwave on its own or poor air quality on its own, placing additional strain on health services.”

The manual notes that: “Climate risk assessment and adaptation planning should be understood as an ongoing, iterative process rather than a one-off exercise.”

Examples of risk statements

Questions remain

The documents were produced under the National Health and Climate Strategy. Questions for governments and the health sector now include how to fund these activities, and how to ensure that organisations supporting those communities likely to be hit hardest by climate hazards are resourced and supported to do this work.

Many other questions also arise from these publications, including how they mesh with national health reform agendas, especially commitments to improve service delivery for Aboriginal and Torres Strait Islander people, and to address health inequities for rural and remote communities.

The documents could be useful for many sectors, including social care organisations, aged care, disability services, and other service providers.

Examples of scenarios

The grabs below are sourced from the Climate and Health Hazard Data Dashboard, which provides information about six climate hazards for each health district, across three different time horizons and two climate scenarios.

In Victoria’s Gippsland region, for example, the dashboard says that in one potential scenario, the area inundated during tidal inundation events will increase by over 30,000 hectares by 2085. Selected grabs for regions in other states and territories follow below.