Government funds short-stay surgery expansion amid patient selection concerns

The NSW Government’s $30 million one-off injection to expand High Volume Short Stay surgical services across the state will deliver an estimated 2,300 additional procedures by July 2027. The AMA (NSW) President Dr Fred Betros said the funding was a useful contribution, but not a solution to the state’s persistent elective surgery backlog.

The investment builds on the $200 million committed since 2024 to reduce overdue surgeries and follows the establishment of the state’s first Surgery Hub at Northern Beaches Hospital, which has been active since 1 July and is expected to perform up to 5,000 additional planned (elective) surgeries per year.

The latest expansion also comes as a recent NSW Audit Office report found NSW Health is failing to complete planned surgeries within clinically recommended timeframes, despite record levels of surgical activity and billions of dollars in funding.

More than 230,000 planned surgeries were performed across the state in 2024-25, supported by a $2.3 billion investment. Yet fewer than one-quarter of the state’s local health districts met the key performance indicator of having zero patients waiting longer than clinically recommended for elective surgery. Only four of the state’s 17 local health districts achieved the target, according to the report.

“What matters now is delivery. Selecting the right patient for a short stay pathway is a clinical decision made in consultation with the treating doctor, and appropriate arrangements for post-operative follow-up,” said Dr Betros.

The audit highlighted NSW Health’s continued push to eliminate low-value procedures lacking strong clinical or patient outcome evidence. Hospitals are being funded to divert patients away from surgical care where clinically appropriate, while revised planned surgery access policies now require doctors to provide clinical justification and approval for procedures deemed outside high-value care categories.

While NSW Health expects the model to improve surgical throughput, the audit identified concerns from local health districts about unintended consequences. Districts warned that concentrating high-volume procedures within surgical hubs could reduce procedural exposure for surgeons at non-hub hospitals, potentially degrading surgical experience and capability across the wider network.

The report also noted concerns that some surgical skills developed through elective procedures are transferable to emergency and trauma surgery settings, creating additional complexity for larger trauma centres required to maintain broad specialty coverage.

Expansion of pooled surgery waitlists has also been identified as a key demand-management strategy. Under the model, patients are assigned to the next available treating doctor rather than remaining with the referring clinician. However, the audit found local health districts have struggled to implement pooled waitlists at scale because of ongoing clinical workforce shortages and resistance from surgeons.

“These High Volume Surgical programs are exactly the kind of innovative care we want to see, and I’m looking forward to seeing this model expanded across NSW,” said Minister for Health Ryan Park.

“Additional lists only translate into additional surgery if the workforce is there to staff them. New programs should not be resourced by drawing staff away from existing services, which moves the waiting list rather than shortens it,” added Dr Betros.

Recommendations issued to the Ministry of Health by Auditor-General of NSW Bola Oyetunji are scheduled for implementation by June 2027 and focus heavily on cost containment and increasing surgical efficiency. The recommendations do not include specific KPIs tied to patient outcomes or patient preferences, leaving a significant gap in how the success of the reforms will ultimately be measured.

In reimagining healthcare across the entire patient journey, Health Industry Hub^TM is the only one-stop-hub uniting the diversity of the Pharma, MedTech, Diagnostics & Biotech sectors to inspire meaningful change.

The Health Industry Hub^TM content is copyright protected. Access is available under individual user licenses. Please click here to subscribe and visit T&Cs here.