The new Hawke's Bay District Health Board (DHB) met for the first time yesterday, kicking off a five-year revamp of how the region's health service works.
The DHB officially adopted Transform and Sustain, a health strategy for the next five years.
While Hawke's Bay's population was relatively static, it was becoming increasingly likely to need health services while government funding was unlikely to match that.
"If you keep doing what you've always done you'll get what you've always got," DHB chief executive Dr Kevin Snee said.
The strategy was a living document "to craft and continue to develop" and incorporated all health providers in Hawke's Bay - "a whole system document", he said.