title: Surgical services: shaping future directions.
abstract: BACKGROUND
  Advances in surgical techniques and anaesthetic practise have facilitated a significant change in the way surgery is currently delivered. In particular, short stay surgery including ambulatory surgery has become the norm for the majority of surgical conditions. However, the planning of surgical services has not always kept pace with nor capitalised on these clinical advances. Like many major urban centres in Australia, the Greater Sydney region is changing, in terms of population growth and configuration of clinical and operational networks. In conjunction with NSW Department of Health, the ministerially appointed Surgical Services Taskforce was tasked with determining the shape and direction of surgery in Greater Sydney over the next 5 to 10 years.
  
  
  METHODS
  Over 400 clinicians either attended hospitals forums or were contacted by the Surgery Futures project team.
  
  
  RESULTS
  From the consultations, three models of service delivery were strongly advocated. These were the development of high volume short stay surgery centres, the establishment of specialty centres and the expansion of the streaming of planned and emergency surgery.
  
  
  CONCLUSIONS
  These three major recommendations will require a significant reorganisation of surgical services in NSW. However, they are also relevant to surgical services planning elsewhere in Australia. It is imperative that these recommendations are incorporated into long term surgical planning in order to improve the efficiency and sustainability of surgical service delivery.
authors.affiliation: Health Services Performance Improvement Branch, NSW Department of Health, North Sydney, New South Wales, Australia. donald.maclellan@doh.health.nsw.gov.au
authors.forename: Donald G
authors.initials: DG
authors.lastname: MacLellan
authors.forename: Tim
authors.initials: T
authors.lastname: Smyth
authors.forename: Patrick C
authors.initials: PC
authors.lastname: Cregan
authors.forename: Joseph
authors.initials: J
authors.lastname: Lizzio
authors.forename: Hunter
authors.initials: H
authors.lastname: Watt
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration* / Q000639:trends; D017598:Efficiency, Organizational; D013502:General Surgery / Q000458:organization & administration / Q000639:trends; D009517:New South Wales; D013043:Specialties, Surgical / Q000458:organization & administration / Q000639:trends; D013503:Surgery Department, Hospital / Q000458:organization & administration* / Q000639:trends; D013531:Surgicenters / Q000458:organization & administration* / Q000639:trends