Sarah-Jane Waller, Neil Merrett
Introduction
In 2025, NSW Health presented its early experience implementing BADS benchmarks, demonstrating how international best practice could be translated into large‐scale reform. Initiated following attendance at the 2024 conference, the work rapidly evolved from a targeted improvement initiative into a core pillar of
NSW Health’s statewide surgical strategy, responding to persistent access pressures, inpatient bed constraints, and rising demand for planned surgery.
Methods
NSW Health adopted a data‐driven approach to normalize same‐day surgery across hospitals. High‐volume, low‐complexity procedures were identified using statewide activity, length‐of‐stay, and readmission data to ensure clinical safety and scalability. Clinician‐led engagement supported local implementation, while
performance measures were embedded into dashboards. Critically, same‐day surgery metrics were formally integrated into Service Level Agreements (SLA), shifting day surgery from discretionary practice to a system‐level expectation with executive accountability.
Results
Since 2025, a further 14 procedures have been identified for inclusion in SLAs for FY26/27. In FY24/25, the reform delivered 15,000 bed days against a 14,000 target, equating to approximately AUD $16.1 million in system savings and materially improving access to elective surgery. Performance is now reviewed at Chief
Executive level and recognised in an Auditor‐General report as an effective access strategy. International collaboration has strengthened, with engagement between the NSW Health Deputy Secretary and the BADS President.
Conclusion
Our experience demonstrates that embedding BADS principles into governance and performance frameworks deliver sustained, system‐wide reform in surgical access and is transferable to other large health systems.
Authors
Sarah-Jane Waller, NSW Health, Australia
Prof. Neil Merrett, NSW Health Australia, Western Sydney University Australia,
University NSW Australia