Frequently asked questions about elective surgery lists

What is an elective surgery list?
What are urgency categories?
Accessing elective surgery
Getting on an elective surgery list and calculating the time to treatment
What the times on this website tell you
Where does the information come from?
Why are treatment times for some procedures quicker for non-urgent patients than for semi-urgent patients?
What to do if you wish to be referred to a particular hospital
What hospitals are included in this web site?
Information for Casey and Northern Hospital patients
What Surgical Specialties and Procedures are included on this site?
Questions you may wish to ask your general practitioner (GP) if he or she suggests you should go and see a specialist
Questions you may wish to ask your specialist about choice of treatment
What to do if your condition deteriorates
What to do if you think you no longer need or want surgery
Public or private does it make a difference?
Are you ready for care?
Hospital initiated postponements
Is there anything else I can do to get my surgery done?
Am I eligible for the Elective Surgery Access Service (ESAS)?
How can I access ESAS?
Your Privacy
Patient Representatives

What is an elective surgery list?

Each health service has its own elective surgery lists categorising patients by procedure and surgeon. They generally record:

• when the patient was placed on the list
• the required treatment or procedure
• the patient's contact details.

People who need emergency treatment will not be placed on an elective surgery list. Elective surgery is surgery, which in the opinion of the treating physician, can be delayed for more than 24 hours.

Elective surgery lists are not simple queues of patients listed on a 'first come first serve' basis. In public hospitals, access to elective surgery is determined by clinical urgency and resource availability. Sometimes the urgency of patients on the list may change, for example, if their condition deteriorates or becomes unstable. In these cases, urgent treatment may be required and priority will be given to these patients. For this reason, your position on an elective surgery list is not an exact indicator of the time it will take for you to have your surgery.

What are urgency categories?

A medical practitioner will give you an urgency category at the time your name is placed on a public hospital elective surgery list. Clinical urgency categories allow hospitals and clinicians to schedule surgery to ensure that patients with the greatest need are treated first.

Three urgency categories are used throughout Australia:

Clinical urgency categories	National standards - desirable treatment times
1 Urgent Has the potential to deteriorate quickly to the point it may become an emergency	Admission within 30 days
2 Semi-urgent Causes some pain, dysfunction or disability Unlikely to deteriorate quickly Unlikely to become an emergency	Admission within 90 days
3 Non-urgent Causes minimal or no pain, dysfunction or disability Unlikely to deteriorate quickly Unlikely to become an emergency	Admission some time in the future There is no national standard but 365 days is used as a guid

Accessing elective surgery

The most important question for people listed for elective surgery is, "When is it likely I will have my surgery?"

The time taken to have your surgery will be affected by:

• Your urgency category relative to other patients
• Your urgency within that category. This will be determined by a medical practitioner who will consider both your needs as well as the needs of others who require similar surgery
• The availability of appropriately trained medical, nursing and support staff for the procedure you require
• Changing demand for hospital services, particularly unplanned emergencies and increased admissions that occur over the winter months

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Getting on an elective surgery list and calculating the time to treatment

If you require elective surgery, and will be having it in a public hospital, this is what will happen:

Your local doctor (GP) will make a referral to:

The oupatient department of a public hospital or A medical practitioner who can admit patients to public hospitals

Once you are seen, a request for admission is made

You will be placed on the elective surgery list for the procedure you need

The time taken for you to have your elective surgery is the number of days from when your name is placed on the hospital’s elective surgery list to the day when you are admitted for treatment. The times to treatment on this website do not include the time taken between a referral by a GP and medical assessment by a specialist or public hospital outpatient department. The specialist or outpatient department can advise you on how long this will take.

What the times on this website tell you

This website will provide you with the time taken for patients to have similar surgery over the 12 month period. The time is the point at which half of all patients treated over the period - (the median) their surgery.

Example:

A time of three weeks for a particular procedure means that, in the past 12 months, half of all the patients receiving surgery for that procedure were treated in three weeks or less.

The website cannot tell you precisely when you will be treated.

Only times for Category 2 patients and Category 3 patients are shown. Category 1 (or urgent) patients are all treated within the clinically agreed 30 days. Information on times for Category 1 patients has therefore not been included.

Where does the information come from?

The data on this website is from those hospitals that perform a significant amount of elective surgery and report their data to the Department of Human Services. Smaller hospitals that perform fewer procedures are not included. Information about the likely times for treatment should be sought directly from these hospitals or from your treating medical practitioner.

Why are treatment times for some procedures quicker for non-urgent patients than for semi-urgent patients?

Sometimes, the indicative treatment times for non-urgent patients may be quicker than for semi-urgent patients. Treatment times are affected by patients’ availability , any other co-existing medical conditions and the level of demand for the services of individual specialists. For example, surgeons with specialist skills may attract more referrals, which can lead to longer treatment times. Patients may prefer to be treated by a particular specialist, particularly if that specialist has treated them previously. Treatment times can also vary widely when few procedures are performed.

What to do if you wish to be referred to a particular hospital

If you wish to be referred to a particular hospital, you can discuss this with your local doctor (GP). Your GP may make the referral as requested or may offer other options to meet your needs. If you are already on a waiting list at a hospital, your waiting list episode can be transferred to another hospital that you have chosen.

What hospitals provide information about time to treatment for this web site?

Time to treatment information is provided by the following metropolitan and regional hospitals:

The Alfred Angliss Hospital Austin Hospital Ballarat Health Services Barwon Health Bendigo Health Box Hill Hospital Casey Hospital Dandenong Hospital Frankston Hospital Goulburn Valley Health (Shepparton) Latrobe Regional Hospital Maroondah Hospital Mercy Hospital for Women

Mercy Werribee Hospital Monash Medical Centre Northeast Health (Wangaratta) Northern Hospital Royal Children’s Hospital Royal Melbourne Hospital Royal Victorian Eye & Ear Hospital Royal Women’s Hospital Sandringham and District Memorial Hospital St Vincent’s Hospital Sunshine Hospital West Gippsland Healthcare Group (Warragul) Western Hospital Williamstown Hospital

Information for Casey Hospital patients
At times hospitals undertake specific campaigns to treat patients who have not had their surgery within the clinically desirable time. When a hospital targets the treatment of these patients, the times to treatment may appear abnormally high. In particular, Casey Hospital, which opened in October 2004, is specifically targeting patients from other hospitals who have not had their surgery within the clinically desirable time. That is why the times appear to be high.

If you are referred to Casey Hospital for treatment, you may wish to speak to your GP about the likely time to access surgery at this hospital.

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What surgical specialties and procedures are included on this website?

Most elective surgery in Victoria is categorised under ten specialities. The times for treatment for these ten specialties and their most common procedures are available on this website.

Ear, Nose and Throat (ENT) Surgery

• Septoplasty - surgical treatment of the wall between the nostrils
• Myringotomy - a surgical incision of the eardrum
• Tonsillectomy - surgical removal of the tonsils and/or adenoids
• All other ENT surgery

 

General Surgery - includes abdominal, breast, endocrine, vein, trauma and minimally invasive surgery.

• Cholecystectomy - removal of gall bladder
• Inguinal hernia repair - repair of hernia in the groin
• Surgical repair of other hernias
• Circumcision - removal of the foreskin of the penis
• Vasectomy - male sterilisation
• Procedures for the treatment of haemorrhoids
• All other general surgery

Orthopaedic Surgery - surgery of the bones, joints, tendons and muscles

• Hip replacement surgery
• Knee replacement surgery
• Arthroscopy of the knee
• Surgical removal of bunions and other toe deformities
• Shoulder and elbow procedures
• Removal of internal fixation device
• All other orthopaedic surgery

Urology - surgery involving the kidneys and bladder

• Prostatectomy - surgical removal of the prostate gland
• Transurethral resection - Surgical removal of abnormal tissue from the bladder
• Cystoscopy - a diagnostic procedure to look inside the urethra and bladder
• All other urology

Ophthalmic Surgery - surgery of the eye

• Repair of cataract
• All other opthalmic surgery

Vascular Surgery - surgery of the veins

• Varicose veins a surgical procedure to remove or occlude varicose veins
• All other vascular surgery

Neurosurgery - surgery of the brain, spinal cord and nervous system

• Release of carpal tunnel - a surgical procedure to relieve pressure on the nerves in the wrist
• All other neurosurgery

Gynaecology - surgery of the female reproductive organs

• Laparoscopy - minimally invasive surgery of the female reproductive organs
• Hysterectomy - surgical removal of the uterus
• Anterior posterior - vaginal repair surgical repair of the wall of the vagina between either the bowel or bladder
• Dilation of cervix, curettage of uterus
• Procedures on fallopian tubes
• All other gynaecology

Plastic Surgery

• Excision of skin lesion or subcutaneous tissue
• All other Plastic Surgery

Cardiothoracic Surgery

• All Cardiothoracic Surgery

You should contact your medical practitioner if your medical speciality or procedure is not listed.

Questions you may wish to ask your general practitioner (GP) if they suggest you should go to see a specialist

• Why do you think I need to see a specialist?
• Why are you choosing this particular specialist or service?
• How much experience does this particular service have in treating my type of health problem?
• How can I make an appointment?
• If I do need to be admitted to hospital, when can I have my elective surgery?
• How necessary and how urgent is this surgery?
• Is there any evidence my condition will change if I cannot access my surgery quickly?
• If the specialist or hospital you have referred me to has lengthy times to access surgery for my procedure, can you refer me to an alternate service?
  

It is often helpful to discuss these matters with your general practitioner so he or she can help you more fully understand your situation

Questions you may wish to ask your specialist about choice of treatment

There are differences in the way certain conditions can be treated. Alternative treatments may carry risks and benefits and they may have different effects on your health and quality of life. When you see your specialist, it is important that you ask him or her to explain all the available treatments, including the option of not proceeding with treatment.

It is likely that most issues will be discussed with you when you visit the specialist or outpatient clinic, however these questions may be helpful for you:

• What are the expected benefits and risks of the treatment options?
• What may happen to me if I do not have the treatment you suggest?
• Will the recommended treatment or test affect my general health and wellbeing?
• How urgent is this treatment or test?
• Can you explain to me exactly what you intend to do?
• What type of anaesthetic (general or local) will I need to have?
• What are the risks associated with the anaesthetic?
• Will I need a blood transfusion?
• Will I need any tests before the operation? If so, what are they?
• Is there anything I should or should not do before surgery?
• Will you or someone else be performing the surgery?
• Do you do many of these operations?
• When can I expect to have my surgery?
• How long will I be in hospital?
• What happens after the operation? How can I expect to feel after the operation?
• What sort of follow up care will I need after I leave hospital?
• How long will I be away from work or unable to perform the routine tasks that I do now?
• How much will it cost? (operation, tests, post-operative visits)
• Is there any evidence my condition may change if I do not have my surgery soon?

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What to do if your condition deteriorates

If you have any concerns about changes in your condition or health that occur while you are on the elective surgery list you should immediately contact your doctor or hospital for advice.

What to do if you think you no longer need or want surgery

You may no longer require surgery for a number of reasons:

• Your condition has resolved itself without surgery
• You no longer feel that you want surgery
• You may have found alternative means of treating your condition
• You may have had your treatment elsewhere

If you no longer want or need surgery, please contact the hospital where you were listed for surgery. The hospital may give you the option to be reassessed to confirm you no longer need the surgery, or provide information on how to manage your condition without surgery.

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Public or private: does it make a difference?

Public hospitals treat both public and private patients. Public hospitals are required to treat patients according to medical urgency. Private insurance or willingness to pay for your surgery will not reduce the time you wait on a public hospital elective surgery list.

You may be asked to choose whether you would like to use your private insurance at a public hospital. Private insurance allows you to choose your doctor but there are some costs involved. You should contact your hospital if you need further information about the costs of using your private insurance at a public hospital.

Are you ready for surgery?

The elective surgery lists are reviewed regularly to make sure that all patients will be able to accept a booking date for surgery as soon as they are contacted.

You may not be ready for your elective surgery for a number of reasons. You may choose to delay your surgery for work or social reasons or may require additional medical treatment before you can have your surgery.

If you have advised your hospital that you are not ready to have your surgery, you will not be placed at the back of the queue when you are again available for surgery. You must advise the hospital when you are again ready for surgery. If you are unsure of your status on the list, contact your hospital.

Hospitals are required to offer you three appointments for when you can have your surgery. If you are unavailable for all three dates, the hospital can remove you from the elective surgery list. It is therefore strongly advised that you contact the hospital if you are not ready for care.

Hospital initiated postponements

Sometimes hospitals need to postpone elective surgery. This is because demand for emergency services is unpredictable and patients who attend hospitals with life threatening illnesses take priority over patients needing elective surgery.

Hospitals understand that postponement of elective surgery is a significant issue for patients. There are guidelines to make sure that postponements are kept to a minimum and that patients are given support and assistance if their surgery is postponed.

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Is there anything else I can do to get my surgery done?

The Elective Surgery Access Service (ESAS) has been established to help Category 2 and 3 patients who have not had their elective surgery in the clinically desirable time. The service provides these patients the opportunity to transfer to a hospital where they can be treated sooner. Currently, patients who require the following procedures are eligible for this program:

• General surgery

• Ear, nose and throat surgery
• Urological surgery
• Ear, nose and throat surgery
• Hip replacement surgery
• Knee replacement surgery

 

Am I eligible for the Elective Surgery Access Service (ESAS)?

You are eligible to participate in ESAS if you need surgery for one of the procedures listed above, and have not received it within the clinically desirable time.

For example, if you are a Category 2 patient requiring a knee replacement, you may access the service if you have not had your surgery within 90 days from the time you are listed.

You may not access the service if you have been given a booked date to have your surgery or need other elective surgery procedures not offered through ESAS.

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How can I access ESAS?

Each hospital has an Elective Surgery Access Coordinator. This coordinator is a registered nurse who will understand the treatment you require, and whether other hospitals may be able to provide your surgery earlier. You can contact the co-ordinator by calling your hospital or the elective surgery list department of the hospital at which you are listed.

Alternatively you may be contacted by an ESAS coordinator if they feel there is capacity at another hospital to get your surgery done earlier. Participation in the ESAS program is voluntary. You do not have to accept the offer of treatment provided by this service.

If you have contacted your hospital and they have been unable to assist you with timely access to surgery, you may be able to be assisted with surgery at another health service for certain procedures. If you wish to pursue this option, you should contact the Department of Human Services’ Elective Surgery Access Service line on 1300 781 821.

Your Privacy

Health legislation and Department of Human Services policies are designed to protect the confidentiality of health information and to ensure appropriate use and privacy of information that may identify, or have the potential to identify, an individual patient.

The elective surgery web site does not contain any individual patient identifying data.

Further information about the Department of Human Services Privacy Policy

Patient Representatives

Each Victorian public hospital offers the services of a Patient Representative. This person is your contact if you are not happy with the treatment you have received at your hospital. The Patient Representative will work with you to find a resolution to your complaint, or investigate your concern to ensure that the right people know that a problem has occurred.

You can contact the Patient Representative at your hospital through the hospital switchboard.

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