Practice Development

How to Build a Day Surgery Centre in Australia

 

Building a Day Surgery Centre in Australia – Planning, Design, Accreditation & Costs

Day surgery centres are reshaping private healthcare in Australia. Patients are increasingly choosing same-day procedures for convenience, safety, and affordability. At the same time, surgeons and practice owners see the value in having more control over patient care, surgical lists, and the overall experience. When surgical lists are scarce, every surgeon needs to find the best place to operate on patients.
However, building and operating a day surgery centre is a big project.  The regulatory hurdles are challenging. The setup and operating costs are high. It requires navigating strict compliance, securing financing, and managing a team of architects, builders, consultants, and regulatory authorities.
This article explains how to build a day surgery centre in Australia — from concept to completion — with practical insights, real examples, and key resources.


1. Define Your Vision and Business Case

Every successful project starts with a clear vision.
Ask yourself:

  • Why do you want to build a day surgery centre?
  • Who will use it — your own patients, or multiple specialists?
  • What specialties and services will it offer?

Common reasons surgeons want to build day surgery centres:

  • More Control – independence from hospital scheduling and politics.
  • Improved Efficiency – reduced waiting times and optimised operating lists.
  • Better Patient Experience – improved comfort, privacy, and convenience for their premium patients.
  • Financial return – a revenue stream and long-term asset value.

Key business case considerations:

  • Range of Specialties – Plastic surgery, ophthalmology, IVF, dental, dermatology, pain management, orthopaedics.
  • Equipment needs – onsite labs, ophthalmology microscopes, surgical instruments, onsite sterilisation (CSSD).
  • Financial modelling – separate your fixed operational costs (CEO, DON, accreditation, reception, insurance, rent) from variable costs (nurses, techs, consumables, maintenance).
  • Theatre Utilisation and $ Yield – this is the hardest to estimate and manage. Depending on the location, each theatre needs 200+ days of use at $14k to $20k total theatre fees per day (paid by private patients or insurance patients)
  • An estimate of Space requirements and costs for a day surgery centre (fitout only – Not the building/shell):
    • 500 sqm with one theatre – approx. $3m
    • 750 sqm with two theatres – approx. $4.5m
    • Each operating theatre is a minimum of 60 sqm depending on requirements

2. Understand Licensing and Accreditation Requirements

Day hospitals are heavily regulated in Australia to ensure patient safety.

Building classification

  • Class 5 –Office use, unsuitable for surgical facilities
  • Class 9a – Hospitals with overnight stays
  • Class 9b – Day procedures (the most common classification for day hospitals)

Staged approval process

  • Concept approval
  • Approval in principle
  • Approval to construct
  • Approval to occupy

Accreditation categories

  • Category A – procedures under general anaesthetic
  • Category B – procedures under local anaesthetic and sedation

Agencies and Authorities

  • Day Hospitals Association (DHA)
  • State regulatory bodies (e.g. in WA – LARU – Licensing, Accreditation, Regulatory Unit)
  • Accreditation agencies such as Global Mark, ACSC, and CPG
  • NHSQS and AAAASF (USA based Quad A SF)

Tip: Engage accreditation consultants early — many projects fail or are delayed because infection control, documentation, or design compliance is overlooked during the planning stage.


3. Assemble the Right Project Team

A day surgery build is way too complex to manage alone. You’ll need a multi-disciplinary team:

  • Healthcare architects and designers – to ensure layout complies with regulations.
  • Medical builders – experienced with sterile spaces, CSSD, gases, and theatre design.
  • Engineers – for air conditioning (HEPA filtration), medical gases, UPS/genset power backup.
  • Quantity surveyors – to keep budgets on track and prevent scope creep.
  • Accreditation consultants – to guide policies, procedures, and infection control.
  • Operational experts – CEOs or Directors of Nursing with previous day hospital experience.

Warning: Using general builders or architects without healthcare experience often leads to costly redesigns, operational or accreditation failures.


4. Design and Construction Considerations

Design is where compliance, function, and patient experience intersect.

Key design elements

  • Patient flow – simple, private pathways from admission to theatre to recovery.
  • Staff flow – efficient circulation that separates clean and dirty zones.
  • Sterilisation (CSSD) – central sterile supply department with proper clean/dirty separation.

Services and infrastructure

  • HVAC with HEPA filtration for theatres
  • Backup power (UPS or generator)
  • Medical gases, suction, and oxygen supply
  • Acoustic treatment and soundproofing for privacy – often overlooked
  • Emergency plans – Ambulance bay and wide trolley access / lift access for multistorey sites
  • Industrial plant rooms with delivery access
  • Plenty of Secure storage and space for your Team & Deliveries (Often overlooked)

Recovery facilities

  • Recovery beds and chairs must align with expected patient volume and regulations.
  • An Overnight facility requires higher nurse-to-patient ratios (e.g., minimum two nurses for two shifts overnight).

Site access

  • Ample Car parking and drop-off points are essential.
  • Consider zoning requirements for medical facilities – located in industrial or residential areas?

5. Fitout and Patient Experience

The fitout phase turns a sterile hospital environment into a welcoming, patient-friendly space.

  • Consult rooms – must be appealing and soundproofed for privacy.
  • Waiting areas – bright, comfortable, with modern check-in systems.
  • Brand alignment – design should reflect your practice’s reputation and positioning.
  • Patient journey – focus on comfort, reassurance, and efficiency.
  • Patient Safety fittings – require a lot of cabling and connecting, Consider modular construction units.

A well-designed fitout not only supports accreditation but also builds patient trust.


6. Operational Readiness and Staffing

Before your centre can open, you’ll need:

  • Accreditation documents – infection control, policies, OHS compliance.
  • Staffing plan:
    • CEO
    • Director of Nursing (DON)
    • Reception and admin staff
    • Theatre nurses and anaesthetic technicians
  • Operating lists – allocate surgical days and block times.
  • Clinical governance – reporting systems, incident management, quality assurance.

Strong leadership and well-trained staff are just as important as physical infrastructure.


7. Financial and Commercial Planning

Building costs are only one part of the equation. Long-term financial sustainability depends on careful planning.

Health fund contracts

  • Secure your agreements with Tier 1, 2, or 3 funds to ensure patients receive rebates. (New funding models are coming)

Costs to manage

  • Insurance and indemnity cover
  • Consumables and sterilisation supplies
  • Occupancy and utility costs
  • Accreditation renewals

Revenue modelling

  • Most day surgery centres plan on 40 solid operating weeks per year to allow for downtime, holidays and closures.
  • Your Surgery Centre Revenue depends on funding models, surgeon lists, patient volumes, and specialties offered.

8. Learn from Case Studies

Successful day surgery centres across Australia show different models:

  • Smaller Boutique centres – surgeon-owned, focused on premium patient experience  – 1 or 2 theatres
  • Multi-theatre centres – larger scale, with multiple specialties and economies of scale – 3 or more theatres
  • Regional facilities – important for patient access outside capital cities

Each example requires early planning, experienced consultants, and strict compliance management for best results


9. Common Pitfalls to Avoid

  • No approval possible due to current regulations
  • Long delays in approval due to incomplete compliance documentation
  • Budget blowouts from poor cost management
  • Acoustic failures leading to loss of patient confidentiality
  • Inadequate car parking or ambulance access
  • Overlooking infection control flows in early design

Lesson: Investing in specialist expertise early is cheaper than fixing compliance issues later.


Should You Build a Day Surgery Centre?

Building a day surgery centre in Australia is a rewarding but complex undertaking. It requires vision, capital, and careful execution across design, compliance, staffing, and financial planning.
By assembling the right team and focusing on both compliance and patient experience, you can create a facility that delivers world-class care and long-term independence for surgeons and practice owners.
For many surgeons performing procedures that are low-yield or poorly funded in a private hospital (e.g. dentists and plastic surgeons doing post weight loss skin removal), building your own facility is essential to keep performing procedures.
Other surgeon specialities that perform a high-volume of day cases that pay well are also motivated to build and control their own facility.
Cosmetic Doctors (previously called Cosmetic Surgeons) who are unable to get accreditation in larger private hospitals also buy or operate their own Day Surgery Centres.

Requirements for a Day Surgery Centre

Here is a list of some of the design & construction (D&C) elements required for a day surgery centre class 5 – L.A./SEDATION CAT B

  • Hydraulic – water filter hws
  • Aircon – hepa filtration
  • Electricals – UPS or genset backup
  • Soundproofing acoustics
  • Ambulance bay access
  • Resuscitation equipment
  • Wide access for trolleys & beds
  • Gases
  • Storage
  • Acoustics – especially in consulting suites
  • Locks and Secure Access
  • Internal Communications systems
  • CSSD – sterilisation
  • Clean / dirty flow
  • Plant room
  • Testing
  • Parking
  • Alarms
  • Range of Permits
  • Recovery beds and chairs
  • Catering / refreshments
  • Staff & Surgeon changing areas / showers
  • Operations and Committees
  • Staffing
  • Guidelines
  • Infection control
  • Accreditation – NHSQS

Surgery Specialties for a Day Surgery Centre

Offering a range of procedures in a multi-specialty day surgery centre has worked well for many hospitals

  • Plastic Surgery
  • Pain / Spine Surgery
  • Ophthalmology– Eye Surgeons need special equipment
  • Fertility – IVF
  • Gynecology
  • Dentistry & OMFS –  especially for Dental Implants and Wisdom Teeth
  • Gastroenterology – for scopes
  • Orthopedics – hand, foot and lately – hip and knee surgery
  • Vascular & Phlebology
  • Vasectomy
  • Dermatologists – X not recommended
  • Cosmetic Surgeon – X not recommended
  • Podiatric Surgery – X not recommended

Day Surgery Centres for Plastic Surgery

Day Surgeries run by Plastic Surgeons in Australia

Here are some well-run Day Surgery Centres – See DHA list of members

  • Dr Darryl Perkins – Aesthetic Day Surgery – Sydney  NSW
  • Dr Grame Southwick – MIPS Vic
  • Dr Reema Hadi – Swan Clinic NSW
  • Dr Scott Ingram – Renaissance Clinic Qld
  • Dr Gavin Chan – Melbourne Vic

Day Surgery Centres managed by Groups in Australia

UK Day Surgery Centres run by Plastic Surgeons

Many plastic surgeons in UK have also built their own facilities when private hospital access was limited.
www.capsco.co.uk is the Consortium of Aesthetic Plastic Surgery Clinic Owners
Some well-run Day Surgery Centres in UK

  • Dr Naveen Cavale – London UK
  • Dr Fulvio Ursa Baiada – London UK
  • Dr Reza Nassab – Manchester UK
  • Dr Hassan Shaaban ASET Clinic – Liverpool UK
  • Dr Hassan Souied –  London UK
  • Tom & Guy Mayou – Cadogan Clinic UK
  • and many more

NZ Day Surgery Centres run by Plastic Surgeons

Many plastic surgeons in New Zealand had to build their own facilities when private hospital access was limited.

  • Remuera Surgical Auckland NZ –
  • Tristram Centre Hamilton NZ
  • NZIPS Auckland NZ
  • Shakespeare Day Surgery NZ
  • Whangarei Day Surgery NZ

USA Day Surgery Centres (ASCs) run by Plastic Surgeons

  • Most cosmetic plastic surgeons in private practice in the USA build and operate their own clinic O.R. facilities. They use Surgical Techniques (like Pec Blocks) and drugs (like Exparel – unavailable in Australia) for multi-day patient pain relief. They also use ERAS (Enhanced Recovery After Surgery) Protocols for rapid recovery after major surgery.

Popular Day Surgery Procedures in Australia

  • Hernias
  • Eye Surgery and Blepharoplasty
  • Hip & New Replacement
  • Gall Bladder
  • Vasectomy
  • Abdominoplasty / Breast Surgery
  • Aesthetic / Cosmetic Surgery
  • Dental Implants
  • Wisdom Teeth Removal

LIST of Resources & Contacts for Building a Day Surgery Centre in Australia

Here are some useful contacts

Medical Builders & Designers for Day Surgery Centre & Clinic Fit Outs

Day Surgery Hospital Consultants and Accreditation Experts

Architects, Engineers, and Quantity Surveyors

  • Hame Chorley
  • Norman Disney Young
  • Startech
  • Parrot (Quantity Surveyors)

Regulatory and Licensing Bodies

  • LARU – Licensing, Accreditation, Regulatory Unit
  • State Health Departments
  • VicHealth Consultants

Engineers

  • Norman Disney Young
  • Startech – Laru preferred

FAQs for Day Surgery Centres in Australia.


Q: What size should a day surgery centre be?

The minimum space required for one operating theatre is about 60 sqm, but most day surgery centres require 500–750 sqm or larger to include reception, recovery bays, sterilisation areas (CSSD), staff amenities, and patient waiting areas.

Q: What are the main approvals needed for a day surgery in Australia?

Approvals are staged and usually include: concept approval, approval in principle, approval to construct, and approval to occupy. Each step must meet licensing and accreditation standards set by state health departments and accrediting agencies such as Global Mark or ACSC.

Q: How long does it take to get approval for a day hospital?

Timelines vary, but it can take 12–36 months to move from concept to final occupancy approval. Delays often occur due to incomplete compliance documentation, changes in design scope, or slow responses from licensing authorities.

Q: Do day surgery centres in Australia need to be accredited?

Yes. Accreditation is mandatory and ensures the facility meets national safety and quality standards. NHSQS Accreditation covers infection control, clinical governance, patient safety, and OHS. Common accrediting agencies include CPG, Global Mark, and ACSC.

Q: What building classification is required for a day hospital?

Day surgery centres are typically classified as Class 9b buildings under the National Construction Code. Centres that provide overnight stays or higher-level services may require Class 9a hospital classification.

Q: What is the difference between Category A and Category B procedures in day surgery?

Category B procedures involve local anaesthetic or sedation, while Category A procedures require general anaesthesia. The classification affects the facility’s design, staffing, equipment, and accreditation requirements.

Q: What services can be offered in a day surgery centre?

Common services include selected plastic and cosmetic surgery, ophthalmology, IVF and gynaecology, dermatology, dental implants, ENT procedures, selected orthopaedic surgery, vasectomy, pain management, gastroenterology, and minor orthopaedic surgeries.

Q: What is the role of a Director of Nursing (DON) in a day hospital?

The DON is responsible for clinical governance, staffing, infection control, and compliance. Accreditation requires each centre to have a qualified DON who ensures that patient care and safety meet national standards.

Q: What is CSSD and why is it important in a day surgery centre?

CSSD stands for Central Sterile Services Department. It is the area where surgical instruments are cleaned, sterilised, and prepared for reuse. A compliant CSSD must have separate clean and dirty flows to prevent contamination.

Q: Do day surgery centres need backup power systems?

Yes. Most centres require an uninterruptible power supply (UPS) or generator backup to maintain safety during power outages, especially for anaesthetic equipment, lighting, and medical gases.

Q: What are the staffing requirements for a day hospital?

Typical staffing includes a CEO, Director of Nursing, reception/admin staff, theatre nurses, anaesthetic technicians, and sterilisation staff. Additional nurses are required if the centre supports overnight stays.

Q: Can day surgery centres provide overnight care?

Yes, but overnight facilities must comply with higher accreditation and staffing standards, often shifting the classification toward a hospital (Class 9a). Overnight stays also require more recovery beds and higher nurse-to-patient ratios.

Q: What are common mistakes made when building a day surgery centre?

Common pitfalls include underestimating approval timelines, budget overruns from poor planning, inadequate acoustic design, insufficient car parking, and failing to engage healthcare-specific architects or consultants early in the process.

Q: How do health fund contracts affect a day hospital?

Health fund contracts determine the rebates available to patients. Centres typically negotiate Tier 1, 2, or 3 contracts, which affect patient volume and financial viability. Strong Health Fund contracts make the centre more profitable and more attractive to referring surgeons. Solo Hospitals have less negotiating power than bigger groups.

Q: What role does infection control play in design?

Infection control is central to licensing and accreditation. Design must include strict clean and dirty flows, sterilisation areas, HEPA-filtered air conditioning, and proper hand hygiene facilities. Poor infection control design can delay accreditation or lead to costly rebuilds.

Q: Can you convert an existing commercial building into a day surgery?

Yes, but it requires extensive compliance upgrades including air conditioning, power supply, fire safety, and medical gases. Many clinics choose to fit out a shell space rather than build a new facility, but compliance costs can still be significant.

Q: What is the average return on investment (ROI) for a day surgery centre?

ROI varies widely based on location, specialties, and surgeon utilisation. Well-run centres with strong health fund contracts and consistent surgeon lists often achieve profitability within 3–5 years.

Q: How does car parking affect day hospital approval?

Adequate car parking is essential for patient safety and convenience, and it is often a requirement of local council approvals. Lack of sufficient parking can delay approvals or create operational bottlenecks.

Q: What makes a day surgery centre attractive to surgeons?

Key factors include location, efficient theatre scheduling, strong health fund contracts, modern facilities, and patient-friendly environments. Surgeons also value centres with consistently reliable staff, convenient parking and governance structures that reduce administrative burden. Surgeons also appreciate good coffee and snacks like hot chips 🙂

Q: Are day surgery centres zoned differently from medical clinics?

Yes. Zoning requirements vary by state but generally mandate approval for healthcare use, ambulance access, waste management systems, and adherence to building codes specific to medical facilities.

Q: Can day hospitals operate on weekends?

Yes. Operating hours are flexible, and many centres use Saturday lists to meet patient demand and increase utilisation. However, staffing and accreditation standards must still be met during weekend operations.

Q: How important is acoustics in a day surgery build?

Very important. Poor acoustic design can lead to privacy breaches in consult rooms and theatres. Accreditation bodies may flag insufficient soundproofing, forcing costly retrofits.

Q: What is the typical project timeline for a day surgery build?

From concept to completion, most projects take 18–30 months. This includes design, approvals, construction, fitout, accreditation, and operational setup. Projects can extend much longer if regulatory approvals are delayed.

Q: How do I choose the right location for a day surgery centre in Australia?

Location choice depends on patient demographics, surgeon accessibility, local competition, and zoning approvals. Proximity to referring doctors and good transport links are crucial. Regional centres may benefit from reduced competition, while city-based centres offer larger patient pools but face stricter planning rules.

Q: Can I lease instead of buy a building for a day hospital?

Yes. Many groups lease shell spaces in medical precincts and fit them out for surgical use. Leasing reduces upfront capital costs but may increase long-term operating expenses. Compliance upgrades such as air conditioning, power, and CSSD facilities still add significantly to fitout costs.

Q: What is the minimum theatre size required by Australian standards?

Australian guidelines generally require big operating theatres compared to outside Australia (typically 60 square metres plus). Additional space is required for scrub areas, anaesthetic bays, and storage. Smaller rooms risk non-compliance with accreditation and functional inefficiencies for staff.

Q: What role does a quantity surveyor play in a day hospital project?

Quantity surveyors manage cost control, tendering, and budgeting. Their role is critical in preventing budget blowouts, especially when medical equipment, infection control upgrades, and compliance testing add unexpected costs.

Q: How do acoustics impact day surgery centres?

Beyond patient privacy in consult rooms, acoustics also affect operating theatres and recovery areas. Noise control reduces stress for patients under sedation and prevents distraction for surgical teams. Accreditation may require specific soundproofing standards to be documented.

Q: Do day hospitals need ambulance bays?

Most day hospitals must provide ambulance-friendly access. Even if most procedures are same-day, regulations require provisions for emergency transfers, resuscitation, and patient safety. Lack of ambulance access can delay licensing approvals.

Q: Can a day surgery centre also host cosmetic injectables and skin treatments?

Yes, many centres integrate a MedSpa or non-surgical wing. These services boost revenue streams, enhance patient loyalty, and allow surgeons to cross-refer patients. However, non-surgical areas must remain separate from sterile surgical areas to comply with infection control.

Q: What is the difference between a day surgery centre and a private hospital?

Day surgery centres are licensed for same-day procedures without overnight stays (usually Class 9b). Private hospitals (Class 9a) allow overnight or multi-day admissions. This difference affects staffing, facility design, emergency backup, and accreditation.

Q: How do surgeons book operating lists in a day hospital?

Operating lists are typically allocated in advance, often in half-day or full-day blocks. Surgeons may contract for weekly sessions or book ad hoc based on patient load. Efficient scheduling maximises theatre utilisation and financial viability.

Q: What equipment is mandatory in a day surgery centre?

At a minimum, facilities require anaesthetic machines, patient monitoring equipment, sterilisation (CSSD), recovery beds, resuscitation equipment, suction and oxygen supply, and surgical lighting. Specialty equipment depends on the type of procedures performed.

Q: What insurance is required to operate a day surgery centre?

Insurance requirements include professional indemnity, public liability, property insurance, workers’ compensation, and medical malpractice coverage. Insurers may request proof of accreditation before granting cover.

Q: Can multiple surgeons co-own a day hospital?

Yes. Many centres are structured as partnerships or companies owned by multiple specialists. Co-ownership spreads financial risk, secures multiple referral streams, and improves utilisation of theatres. Shareholder agreements and governance frameworks are essential.

Q: How do overnight recovery requirements affect costs?

Adding overnight capacity increases staffing costs significantly. Regulations often require higher nurse-to-patient ratios and extra recovery facilities. This can add hundreds of thousands annually to operating costs, and may change the building classification from 9b to 9a.

Q: Can dental or podiatric procedures be performed in day hospitals?

Yes. Many day hospitals accommodate oral maxillofacial surgeries, dental implants, and podiatry procedures requiring sedation or general anaesthesia. These specialties can diversify revenue streams and improve utilisation.

Q: How do you manage infection control during construction?

Construction must follow infection control principles, including dust barriers, filtered air circulation, and separate clean/dirty zones. Infection control experts often review design and construction plans before approval.

Q: How many recovery chairs or beds does a day hospital need?

The ratio depends on patient load and case mix. A common guideline is at least two recovery spaces per theatre, with more required for longer anaesthetic procedures or multi-speciality centres.

Q: What is the role of the Day Hospitals Australia (DHA)?

The DHA represents private day hospitals across Australia, providing advocacy, compliance support, benchmarking, and networking. Membership can help operators stay updated on regulatory changes and industry standards.

Q: Can a general GP clinic be converted into a day hospital?

In most cases, no. GP clinics rarely meet space, infection control, and compliance requirements. Extensive renovations would be required, including upgrading air conditioning, structural changes, sterilisation areas, and medical gas infrastructure.

Q: Are there tax advantages to building a day surgery centre?

Yes. Centres may qualify for accelerated depreciation on medical equipment, capital works deductions, and GST input credits. Tax strategies should be structured with professional financial advice.

Q: How do patients perceive day surgery compared to hospital procedures?

Studies show patients often prefer day surgery centres for their efficiency, reduced infection risk, shorter stays, and personalised care. Well-designed centres also provide a more comfortable, boutique experience compared to large hospitals.

Q: What financing options exist for building a day hospital?

Common options include private equity, bank financing, joint ventures with other specialists, or partnering with established hospital operators. Lenders often require a detailed feasibility study and signed surgeon commitments before approving funding.

Q: Can I expand a one-theatre day hospital into two theatres later?

Yes, if the original design includes provisions for expansion. This typically means oversizing services (power, HVAC, sterilisation capacity) and allocating shell space that can later be converted into a second theatre.

Q: What is the role of acoustic testing in compliance?

Acoustic testing ensures rooms meet soundproofing standards for confidentiality. Many accrediting agencies request test reports before granting approval to occupy.

Q: How many operating days per year are common for day hospitals?

There are many holidays, maintenance downtime, and accreditation reviews. Financial models should account for these non-operational weeks. If your O.R. can be utilised for 200+ days per year then you are doing well.

Useful Research Resources

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David Staughton B.Sc.(Hons) CSP CCEO Practice Consultant

David Staughton B.Sc.(Hons) CSP CCEO is an Australian practice consultant for Plastic Surgery Practices in Australia & NZ and around the world. He is an expert at improving results with teams, systems and accountability.