Nicky Smith

The Clinical Service Delivery Directorate (CSDD) is responsible for the strategic leadership, coordination and operational oversight of key clinical service streams across the health district to ensure the delivery of integrated, person-centred, safe and high-quality care.

The Directorate brings together a broad range of services including Integrated Mental Health, Alcohol and Other Drugs (AOD), Allied Health, Integrated Virtual Care, Palliative Care Services, Prevention and Response to Violence, Abuse and Neglect (PARVAN), and Integrated Community Services encompassing Integrated Primary Care, Aged Care, and Disability Services.

Key functions of the CSDD include:

• strategic oversight and coordination of district-wide clinical service delivery across community-based, virtual and specialised services
• leadership of integrated models of care that support improved access, continuity of care and multidisciplinary collaboration
• planning, development and implementation of innovative service models that respond to the changing health needs of communities
• ensuring services are aligned with local, state and national health priorities, policies and clinical standards
• fostering collaboration between hospital, community, primary care and partner organisations to support integrated care pathways
• supporting workforce capability, service improvement and quality initiatives across the directorate
• providing expert advice to the Chief Executive and senior executive on clinical service priorities, performance and service development opportunities.

The CSDD is focused on strengthening integrated and accessible care across the continuum, supporting prevention, early intervention and community-based care to improve health outcomes and wellbeing for individuals, families and communities.

Nicky brings more than 25 years of experience as a senior health executive across clinical, operational and executive leadership roles in New Zealand and the United Kingdom. Originally trained as a nurse and midwife, she has built a distinguished career spanning government, public health and social services, with a strong track record of leading large-scale reform, cultural renewal and system improvement in complex environments.

Throughout her career, Nicky has led large, multidisciplinary teams and national portfolios, delivering measurable improvements in performance, culture and service quality. She has extensive experience working at senior levels of government, translating policy intent into practical outcomes through collaboration, co-design and disciplined execution. Her leadership has consistently focused on restoring organisational performance, strengthening accountability and embedding sustainable operating models.

Nicky has overseen significant health and social service portfolios, including acute and specialist services, maternity care, workforce reform and regulatory assurance. She has successfully secured and managed substantial public funding, led system-wide reform programs and introduced digital and quality assurance platforms to improve transparency, compliance and service delivery. Her work has contributed to improved access, equity and outcomes for diverse communities, with a particular focus on culturally safe practice and workforce capability. Earlier in her career, Nicky held senior regional leadership roles across community-based and preventive health services, where she combined clinical expertise, community engagement and innovation to expand access to care and improve service responsiveness. These roles strengthened her ability to lead across the continuum of care, balancing clinical quality, operational performance and fiscal responsibility.

Nicky’s leadership style is collaborative, pragmatic and grounded in change management and culturally safe practice. She is known for bringing clarity and accountability to complex systems, building cohesive teams and creating environments where people feel confident, engaged and supported through change.

She holds a Master of Health Care Ethics and Law, postgraduate qualifications in Strategic Management and Change Management Practice, and a Certificate in Regulatory Compliance, alongside extensive professional development in leadership, mentoring and cultural capability.

District Director Clinical Service Delivery
Email: nicky.smith@health.nsw.gov.au

Executive Assistant
Phone: 0477 861 975
Email: MNCLHD-DCSD-EA@health.nsw.gov.au