In this edition

Executive Director, System Purchasing BranchMessage from the Executive Director, System Purchasing Branch

Dear colleagues

This is the first Surgery Newsletter for 2017 and it’s important to acknowledge that our operating environment has changed since my message in the December issue. We have two new Ministers; Ministers Hazzard and Davies. In the last few months have been extremely busy as we assist the Ministers and their staff as they get up to speed in their portfolios and we adapt to the way they would like business to be conducted.

It is nearly the start of April and it has been a busy time in all our hospitals. The February Elective Surgery Access Performance (ESAP) results for all categories are at or just below target Year to date:

  • Cat 1 99.8% (99.8% last year)
  • Cat 2 97.8% (97.0% last year)
  • Cat 3 96.7% (95.4% last year)

These results and outcomes do not occur by chance. They arise from the deliberate effort and commitment from many staff across a range of clinical, technical and administrative services to provide the best health care. Your work is appreciated and valued.

The total number of overdue patients across all categories is 19% below the number overdue in February 2016. Weekly monitoring and fortnightly teleconferences also continue across a number of hospitals in relation to their overdue lists. Our on-time elective surgery performance in NSW is the best in the country. We all want to continue on this path of ensuring all our patients receive their elective surgery within the recommended timeframe.

I was pleased to hear that so many of you had the opportunity to attend the Professional Development Day for Surgery Waitlist Managers and Booking Officers at the Harbourview Hotel on 10 March. I am sure that the presentations gave you a lot to think about on what’s happening from a state-wide perspective and how you could improve the surgical journey at your hospital. I also hope it provided you with opportunities for networking and growth.

As we all know health care is a 24 hour a day 7 day a week endeavour and does not take a break. For those that are rostered to work over Easter, I thank you in advance for providing care across our 230 hospitals and other health services. Thank you for your ongoing commitment and dedication to providing first class health care to the community we serve.

Kind regards
Elizabeth Wood

Professional development day for Surgery Waitlist managers and Booking officers

The Ministry of Health recently held its inaugural Professional Development Day on 10 March 2017. This event was tailored to encourage excellence and inspire opportunities for networking and growth. It covered everything from performance and elective surgery data collection, presentations from other Local Health Districts, an update on what’s happening from a state-wide perspective and a session on conflict resolution and negotiation skills using real Booking Office scenarios.

The evaluation report found that participants were happy to learn about redesign projects happening in other Local Health Districts and were grateful for the networking opportunity. 51% of participants rated the event as very good and 33% rated it as excellent.

A huge thank you to the guest speakers - Grant Isedale and Tania Kasjan, South Western Sydney Local Health District, James Brinton Illawarra Shoalhaven Local Health District, Carmen Hoffman and Brian Julien Western Sydney Local Health District for sharing on the wonderful work occurring in their Districts.

How many patients were on the waiting list for elective surgery?

Compared with the same quarter last year:

187 more people were ready for surgery and on the elective surgery waiting list at the end of the quarter (73,430 in total; up 0.3%). Of these:

  • 1,657 people (2.3%) were waiting for urgent surger
  • 11,910 (16.2%) were waiting for semi-urgent surgery
  • 59,863 (81.5%) were waiting for non-urgent surgery

National Bowl Cancer Screening Program

The National Bowel Cancer Screening Program (the ‘Program’) invites people aged 50 -74 years to screen for bowel cancer at home. Cancer Institute NSW has the responsibility for the Program in NSW, including provision of the Participant Follow Up Function service, known as PFUF.

The PFUF service complements program reminder letters and care coordination to encourage participants along the screening pathway following a positive faecal occult blood test (FOBT). This includes follow up with their GP and any diagnostic investigations (usually colonoscopy) which PFUF officers update in the Program register.

PFUF officers routinely contact Local Dealth Districts and providers to clarify information related to the FOBT and colonoscopy. Participants provide written consent for the sharing of this information at the time of submitting FOBT samples and completing the participant consent form.

Big changes to the Surgery Redesign School

The Surgery Redesign Training Program is being overhauled in 2017 following an in-depth review which included valuable participant feedback. The five day face-to-face program – aimed at developing the foundation skills of project management, change management, process improvement and clinical redesign – will now be broken down into separate one and two-day sessions across the year. This will enable busy clinicians, nurses and managers who might otherwise not be able to take part to attend the training.

Each session can now be taken as a one-off or in succession and are pitched at both introductory and advanced levels to ensure all participants receive training appropriate to their experience and ability to influence. The new one-day-courses have been rebranded as Sprint LABS (Learning and Building for Surgery).

The course is aimed at both individuals and project teams, particularly those with a proposed surgical project which they would like to develop and implement – ideally one which can be completed in three to six months. Participants are exposed to state-based approaches in their specialty, and have the opportunity to hear from clinical leaders and experts, as well as learn from other health staff in the program.

Three individual one-day courses will now be available at introductory and advanced levels – Project Management Planning, Diagnostics, and Planning and Solutions. The 2-day Accelerating Implementation Methodology (AIM) course will continue to be delivered twice a year, giving participants a practical guide to effectively managing change by overcoming personal and cultural barriers. The first Introduction to Project Management Planning one-day course will be held on 12th July 2017.

The courses are delivered by the Centre for Healthcare Redesign in partnership with the Surgical Services Taskforce and the Ministry of Health. If you would like more information about any of the above courses or would like to apply for the course on 12th July please contact Joanna Lamb via email at or ph:02 9464 4641.

Eyes on the future

Cataract surgery is the most common elective surgery in NSW and this forum provides an opportunity for hospital and primary health staff to showcase their own work in a poster competition, network and have the opportunity to discuss current and future challenges in eye health care.

The day will focus on:

  1. sharing what works:
    current innovations in emergency departments, stroke wards and chronic eye condition care with the opportunity to talk to the people behind the initiatives.
  2. providing a voice:
    this is your opportunity to meet with other eye health stakeholders to identify current and future challenges and shape how we can work together to address them.

For further inquiries please contact:
Sarah Jane Waller, Ophthalmology Network Manager
Phone: (02) 9464 4645

Improving theatre performance in Illawarra Shoalhaven Local Health District

The team from Shoalhaven Hospital - Leanne Davey, Nurse Manager Perioperative Services, Raeline Phillips, Registered Nurse Day Surgery & Kerrie O’Leary, Illawarra Shoalhaven Local Health District Clinical Redesign Co-ordinator in partnership with Bradley Scotcher, Deputy Director of Nursing / Project Sponsor & Prof Martin Jones, Clinical Lead / HOD Surgery with Shoalhaven staff on the Pre-Op to Theatre: Ready & on Time project. It involved the redesign of preoperative screening & triage processes, preadmission staff work allocation schedules and improve systems that included preoperative wellness checks and text messaging reminders. Team communication huddles & theatre forecast meetings were introduced to improve first case on time.


By December 2016:

  • To improve first case on time performance by 40%.
  • Reduce monthly day of surgery cancellations to 1.5%.
  • Improve elective surgery patient experience by 20% and improve co-ordination & integration of preoperative care by 30%.


  • Leading cause of day of surgery cancellations were patient related (32%) with patients not adequately prepared for surgery - failed to arrive or their surgery cancelled due to being unwell.
  • Monthly reporting of first case on time at Shoalhaven Hospital on average was 23% which is significantly below the Ministry of Health target of 95%.
  • Starting on time with first elective surgical case improves overall efficiency and a reduction in delays and cancellations.
  • These delays and cancellations not only affect an organisations performance and efficiency but have negative outcomes for both patients and carers who are usually required to take additional time off work, resulting in financial / emotional stress and distrust in the service provider.


  • Preadmission clinic was redesigned with new work schedules to ensure dedicated time for request for admission (RFA) screening process of all patients prior to surgery.
  • New clinical guidelines for preoperative screening and triage processes were developed.
  • Morning team communication was introduced during weekdays that consisted of Surgeon, Anaesthetists & Nursing staff to enhance collaboration amongst clinicians.
  • Theatre Nurse start time was changed to 7am to allow for adequate setup time and reduce risk of delays.
  • Daily forecast meeting was introduced weekdays to review anaesthetic requirement for all patients scheduled first on list, staffing and equipment required.
  • Patient information on bowel preparation and preoperative instructions were revised.
  • Phone calls to patients the day before surgery were made earlier in the day and included a wellness screening.
  • A Policy was developed to assist staff in managing patients with no carer.
  • Text messaging reminders were implemented for all elective surgical patients.


  • First case on time performance increased to an average of 62% in November 2016.
  • Patient related day of surgery cancellations were reduced by 65% between August and October 2016, with median cancellation rate 1% (Target 1.5%).
  • 86% of patients were triaged to appropriate preadmission process (n=22).
  • Number of RFA forms screened within 2 days of receipt increased from 0% in August 2016 to 17% in October 2016(n=22).
  • Number of patients with no documented screening on RFA form reduced from 22% in August 2016 to 0% in October 2016.
  • Improved patient experience with preoperative information from 60% to 90% (n=10).
  • Patients reporting a positive experience with coordination & integration of care increased from 50% to 100% (n=10).
  • Team huddles have identified additional opportunities to improve operating theatre efficiency, as well as patient & staff safety. Staff have reported improvements in teamwork, communication & efficiency.

For any enquiries please contact
Leanne Davey, Nurse Manager / Perioperative Suite, Shoalhaven Hospital
Phone: (02) 4423 9419

Minister update

Throughout January, there have been a number of changes in Cabinet at both the Federal and State Level, several of which impact NSW Health.

At Federal Level, Sussan Ley announced her resignation as the Federal Minister for Health and Aged Care on 13 January, 2017.Greg Hunt is the new Federal Minister for Health. He was previously the Minister for Industry, Innovation and Science, and was awarded the inaugural Best Minister in the World award last year at the World Government Summit hosted by the United Arab Emirates.

The portfolio of Aged Care has passed to Ken Wyatt, who was the previous Assistant Minister for Health and Aged Care, and worked at the Ministry in the role of Aboriginal Health Director for four years. He is the first Indigenous Australian to be appointed to a Federal Cabinet position and was sworn in as the new Federal Minister for Aged Care and Minister for Indigenous Health.

At the State level, 18 January 2017 marked the resignation of NSW Premier Mike Baird, who has been replaced by the previous NSW Treasurer, Gladys Berejiklian.

The new NSW Treasurer taking her place is Dominic Perrottet. NSW Minister for Health Jillian Skinner announced her resignation this month as the Minister for Health. Brad Hazzard, the previous Minister for Family and Community Services, has been appointed as the new Minister for Health and Medical Research.

NSW continues highest elective surgery performance

According to the Bureau of Health Information Report, during the October to December 2016 quarter, a total of 54,812 elective surgical procedures were performed. This was 1,457 (2.7%) more than in the same quarter last year. Of all the elective surgical procedures performed this quarter, 22.5% were categorised as urgent, 32.9% as semi-urgent, and 39.6% as non-urgent. A further 5.0% were categorised as staged.

Orthopaedic surgery and ophthalmological surgery were the specialties with the most patients waiting at the end of the quarter. Together, these specialties made up 49.6% of all patients waiting for elective surgery in NSW public hospitals. Medical (non-specialist) surgery and cardiothoracic surgery had the smallest number of patients waiting.

Surgery Access Line


  • 218 calls received since October 2016
  • Provided 37% of these callers with information
  • Provided 59% of these callers with options
  • 4% of callers made a complaint

Common questions

  • Am I on the waitlist? How much longer will I have to wait?
  • What is the process of having surgery in NSW as a public patient? How much is it?
  • Can I have a breast reduction? Tummy tuck?
  • I’m on a waitlist in one area but I’m moving soon, can I have my surgery in another area without starting again on the list?

Tell us what you think

What did you think of this edition of the Surgery Newsletter?

Do you have some feedback on one of our stories, or do you have a story idea? We would love to hear from you.

Email the editors at:

Ms Melinda Pascoe
Phone: (02) 9391 9557

Ms Chrissie Crawford
Phone: (02) 9391 9394

Current as at: Thursday 29 June 2017
Contact page owner: System Purchasing