NBH Level 5 Capability: What It Means and What’s at Risk

Why Northern Beaches Hospital’s Level 5 Capability Matters and What’s at Risk

Northern Beaches Hospital was not built as a simple local hospital.
It operates at Level 5 clinical service standards under NSW Health’s framework, which means it is designed to deliver a broad range of complex, high-acuity care for both the Northern Beaches and the wider Northern Sydney region.

What Does a Level 5 Hospital Mean?

Under NSW Health’s clinical services framework, hospitals are classified by “levels” based on the scope and complexity of services they can safely provide.

A Level 5 hospital is expected to:

• Manage a broad range of inpatient, emergency and specialist services

• Treat higher-acuity and more complex conditions

• Support advanced surgical care and specialist teams

• Function as a regional referral hospital for the surrounding areas

Northern Beaches Hospital currently delivers care at this level, including:

• High-acuity emergency care

• Complex inpatient services

• Specialist medical and surgical teams

• Advanced surgical capability

It is also important to understand that some of the private services currently delivered at Northern Beaches Hospital would be regarded as Level 6, equivalent services under the NSW clinical services framework.

These include:

• Neurosurgery

• Complex spinal surgery

• Cardiothoracic surgery

• Complex general and cancer surgery

• Complex obstetric and gynaecological care

While Northern Beaches Hospital is not formally designated as a public Level 6 hospital like Royal North Shore Hospital, the presence of these highly specialised private services means it outperforms many other Level 5 hospitals in terms of capability and access to complex care.

In practical terms, Northern Beaches Hospital is currently operating as a “Level 5 plus” hospital.
This level of care does not happen by accident. It depends on capacity, workforce stability, operating theatres, specialist availability and how services are organised and funded.

Why Capability Matters More Than Ownership

There is a growing assumption that once a hospital is publicly owned, all services automatically continue in the same way.

That assumption is incorrect.
Hospitals may remain public, but their capability can change depending on how services are structured, staffed and resourced. Two hospitals can both be “public” and deliver very different levels of care.
This is why clarity about hospital capability, not just ownership, matters.

The Role of Private Services in a Level 5 Hospital

At Northern Beaches Hospital, public and private services currently operate together on the same site. This co-located model supports:

• Access to specialist teams

• Efficient use of operating theatres

• Workforce retention

• Flexibility during periods of high demand

Private services are not separate from the hospital’s overall function. They contribute to the scale and stability required to maintain Level 5 capability and the additional specialist services that place the hospital above a standard Level 5 facility.

What Has Not Been Clearly Explained

Here is the part that has not been clearly explained to the community.
If private services are removed from Northern Beaches Hospital, or if their future remains uncertain:

• Patients do not disappear

• Demand does not drop

• Emergencies do not stop

If those services are moved elsewhere, the impact is felt locally.

Wait times and waitlists increase.

Patients are required to travel further for care.

Pressure increases on families, particularly older residents and people with complex or chronic conditions.

Over time, workforce uncertainty can also shift capacity away from the hospital, making it harder to sustain the level of care the community expects.

Why This Matters Beyond the Northern Beaches
Northern Beaches Hospital does not serve only local residents. As a Level 5 facility, currently operating as a Level 5-plus hospital, it plays a role in the broader Northern Sydney health network.
Any reduction in its capability affects not just one community, but the balance of care across the region.
The Core Issue: Clarity and Certainty
This conversation is not about public versus private care.

It is about ensuring that:

• The hospital can continue operating at Level 5 capability

• Services are not quietly reduced during the transition

• Access to complex care remains local where possible

Without a clear, confirmed plan for how services will continue, there is a real risk that Northern Beaches Hospital could function at a lower level of capability than it does today.
That would be a loss for patients, families and the wider health system.
Northern Beaches Hospital is a critical part of our healthcare network.

Its capability matters.
NBH is under threat. Let’s protect it.