Emergency Surgery Redesign


To provide a reference tool for Local Health Districts when initiating the redesign of emergency surgery practices. 


There are multiple benefits, including:

  • Improved patient outcomes
  • Enhanced patient and surgical team satisfaction
  • Increased trainee supervision in emergency surgery
  • Higher rates of emergency operating-theatre utilisation
  • Reduced patient cancellations
  • Reduction in after-hours costs. 



The Emergency Surgery Guidelines encourage hospitals to plan for the predictable surgical workload for all specialties – and to allocate the necessary operating-theatre time accordingly.

This includes immediate access to operating theatres for the most urgent emergency-surgery patients.

The Guidelines provide principles for the redesign of emergency surgery including:

  • Measuring the generally predictable emergency surgery workload
  • Allocation of operating theatre resources – as matched to the emergency workload
  • Designation of hospitals for either elective or emergency surgery for specific components of each surgery type
  • Consultant Surgeon-led models of emergency surgery care
  • Standard-hours scheduling where clinically appropriate
  • Load balancing of standard-hours operating theatre sessions with emergency-surgery demand
  • Specific implementation in Area Health Services.

While the examples provided within the Guideline are drawn particularly from specialties where emergency caseloads are high (e.g. Orthopaedics, General Surgery, Obstetrics and Gynaecology, Plastic Surgery), the principles are equally applicable to those specialties whose caseloads are significant but less. Examples include Neurosurgery, Vascular Surgery, Oral and Maxillofacial Surgery.  

Further still, this can apply to relatively low caseloads. Examples include Urology, ENT, Cardiothoracic, and Ophthalmology. 


Experienced surgical staff who routinely cope with the challenges of emergency surgery have developed these Emergency Surgery Guidelines. 


NSW Ministry of Health

Key Dates

Pilot Sites

Central Coast Local Health DistrictGosford HospitalGeneral Surgery
Wyong Public HospitalGeneral Surgery
Hunter New England Local Health DistrictThe Maitland HospitalGeneral Surgery
Murrumbidgee Local Health DistrictWagga Wagga Base HospitalGeneral Surgery
Northern NSW Local Health DistrictThe Tweed HospitalGeneral Surgery
South Eastern Sydney Local Health DistrictPrince of Wales HospitalOrthopaedics
Sydney Children's Hospital NetworkSydney Children's HospitalGeneral Surgery
Western NSW Local Health DistrictOrange Health ServiceOrthopaedics

Implementation Sites


Related Initiatives

Further Details


Gavin Meredith
Manager - Surgical Services Taskforce
02 9464 4644

Donald MacLellan
Director, Surgery, Anaesthesia and Critical Care
02 9464 4604

Page Top | Added: 5 November 2013 | Last modified: 30 May 2014

Gavin Meredith
Manager - Surgical Services Taskforce
02 9464 4644