The provision of health services within the state is assigned to fifteen local health districts, who operate based on area, and two specialist networks, who operate based on other criteria.

[9] The Secretary reports to the following Ministers, who are responsible for the administration of the laws:[6] The Ministry is the executive department for the public health system within the state of NSW.

[8] Local health districts operate based on geographical region, typically consisting of multiple local government areas, and are responsible for all of the public hospitals and other public health services within their region.

The 2016 local government amalgamations had a minor effect on the boundaries of the South Western Sydney and Sydney local health districts, due to the merger of the cities of Bankstown and Canterbury, however as the legislation defining the boundaries of the districts was not changed, these two districts continue to administer the areas which were formerly councils.

As of October 2024[update], the local health districts and their corresponding local government areas were:[7][8][10] The purpose of the specialty networks (also called 'statutory health corporations') is to provide services to target populations regardless of their area.