The Gauteng department of health has revealed interventions designed to reduce surgical backlogs and improve patient access across public hospitals.
The province faces a backlog of about 30,600 patients awaiting procedures. Of this total, 29,969 cases are classified as “legacy” backlogs, while 631 represent current cases awaiting scheduling under routine service flow.
According to the department, the accumulation of cases is the result of sustained system pressures.
“The backlog reflects significant strain over recent times, particularly the accumulation of legacy cases,” it said.
“Key factors include increased referrals to tertiary and central hospitals, infrastructure and equipment constraints, workforce limitations and external disruptions, such as the water supply challenges experienced across parts of the province in 2025 which led to surgical cancellations.”
While recent remedial reforms have improved efficiency, delays persist because hospitals must prioritise emergency and high-acuity cases over elective procedures.
To address the challenges, the department is integrating digital innovation with increased resource allocation:
Treatment time guarantees platform
The department is rolling out a digital dashboard that allows patients to track their status on the waiting list.
The system is intended to strengthen co-ordination between facilities and support more responsive, clinically informed decision-making.
Extension of working hours
Hospitals will extend surgical schedules into weekends and after-hours. To support this, the department is recruiting additional specialised clinicians and improving human resource allocation to ensure theatres remain operational longer.
Enhanced cluster coordination
The department plans to redistribute cases within hospital clusters, moving patients from over-burdened facilities to those with available capacity. This includes strengthening referral pathways and tightening operational oversight to minimise last-minute cancellations.
Data validation and digitisation
Efforts are underway to accelerate the validation of waiting lists to ensure resource allocation is based on accurate, up-to-date information.
“Particular focus is being directed towards tertiary and central hospitals, where demand for specialised procedures remains high, leading to longer waiting times.”
Addressing resource shortages and infrastructure
The department is working to improve the resilience of health facilities by addressing operational risks, including theatre conditions and equipment reliability. Measures are also being put in place to mitigate the impact of external disruptions such as water or power outages.
“Collectively, the interventions are expected to reduce the legacy backlog over time while establishing a more responsive, efficient and sustainable public health system in Gauteng.”
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