With overdue surgeries significantly reduced and a successful same-day surgery pilot running in eight hospitals, Matthew Daly celebrates ongoing improvements across NSW Health that are providing safe, timely, high quality and sustainable healthcare.
In the 12 months to December 2023, the number of overdue surgeries across NSW Health was reduced by 85% (to a total of 2,140). I'd like to thank and congratulate all health staff and clinicians who have contributed to this phenomenal achievement and continue to support a sustainable NSW public surgical system.
Each year in NSW, more than 320,000 people have emergency or planned surgery in public hospitals. Planned surgery performance was affected by the necessary response to the COVID-19 pandemic, which saw temporary restrictions placed on non-urgent planned surgery at hospitals across the state.
The time-limited Surgical Care Governance Taskforce was established to improve the delivery of surgical services and reduce the number of people waiting longer than clinically recommended for their planned surgery, as quickly and safely as possible. The Taskforce has enhanced statewide collaboration, provided cohesive leadership and identified improvements for surgical services in NSW. This would not have been possible without collaboration with other key groups, including the ACI's longstanding Surgical Care and Anaesthetic and Perioperative Care Networks, as well as tireless efforts from the local health districts (LHDs) and specialty health networks (SHNs).
We know there is still more work to do. The goal is to develop sustainable surgical services across NSW by implementing proven models of care and strategies, and ensuring patients are not waiting longer that clinically recommended for surgery.
Same-day surgery pilot benefits patients and the health system
One of the key strategies is to expand procedures that can be safely performed as same-day surgery. Day surgery brings recognised benefits for patients and the health system, related to:
- patient outcomes and experience
- reduced waiting times
- building resilient surgical services in the context of ongoing high demand for inpatient beds.
We are currently monitoring the number of surgeries performed as same-day for five targeted procedures. The list of targeted procedures will be expanded in 2024 and 2025 to align with evolving evidence.
An innovative same-day and short-stay Rapid Recovery Joint Replacement Program pilot is underway, supporting patients to return home sooner, where clinically appropriate. This program is being piloted across eight facilities within Central Coast, Nepean Blue Mountains, Mid North Coast, South Eastern Sydney, South Western Sydney and Sydney LHDs.
Already, patients have been successfully discharged home within 24 hours of surgery. The feedback from patients and their families has been exceptional and the reduction in the length of stay for these procedures is already evident.
The benefits have been attributed to changes made in the surgical and anaesthetic techniques; improved communication and education facilitated by our healthcare staff, especially in setting expectations; and enhancing the patients' pre-operative and follow-up care.
We are focusing on these results to achieve our goal of sustainable surgical services across NSW.
System sustainability for the future
As a division of NSW Health, System Sustainability and Performance will continue to focus on access to safe, timely, high-quality and sustainable healthcare. We will continue to work with LHDs, SHNs and the ACI to reduce the number of patients waiting longer than clinically recommended for their surgery, and ensure the strategies implemented are able to sustain public surgical services in NSW.
NSW emergency departments (EDs) are also under continuing pressure. In an effort to to improve ED wait times and access to care, and explore innovative solutions to divert pressure from our hospitals, a time-limited ED Taskforce has been established. It will be co-chaired by Dr Trevor Chan, Clinical Director, Emergency Care Institute, ACI and myself, and brings together stakeholders from across NSW Health.
Safe, timely, high quality and sustainable healthcare is fundamental and underpins everything the System Sustainability and Performance Division has delivered, and will deliver into the future.
About Matthew Daly
Matthew is the Deputy Secretary of the NSW Health System Sustainability and Performance Division. Prior to his current role, Matthew was an independent consultant predominantly supporting the health and not-for-profit sectors, and Adjunct Professor at the Faculty of Business, as well as Adjunct Clinical Associate Professor, Faculty of Health Services at the University of Tasmania.