While the COVID-19 pandemic has shone a light on Victoria's sometimes "flawed" health system, local services have been finding innovative ways to ensure their struggles don't become permanent.

And with some parts of the state falling victim to rising case numbers, some hospitals have needed to shift their focus slightly to combat issues such as staff shortages and busy emergency departments

Bendigo Health director of surgery Graeme Campbell said even before the Code Brown was declared back in January, staff were working just as hard as ever before.

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"Code Brown didn't change too much for us, we were already working considerably harder for probably the 12 to 18 months prior," he said.

But with the rise and fall of COVID-19 cases in the region, Mr Campbell said the health service had been working to treat as many patients in as many areas as they could.

"We've got this juggling act between an emergency department and demand through the front door, making sure the patients in the region are being looked after as well as working through the people on our elective surgery waiting lists," he said.

"You can define elective surgery as anything that can be managed by a waiting list and includes some very urgent procedures and others that aren't, but that doesn't mean they aren't important.

"And we've been working to juggle all of that since 2020."

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But Mr Campbell said staff shortages had caused a large headache for the health service.

"We may be limited by staffing issues because just in surgical services we've got maybe 15 or 20 staff off sick most days, and it's not all COVID either," he said.

He said working through the state government's surgical initiatives had somewhat alleviated some of the strain.

"The plan coming out of the Department of Health late last year was to become part of a 'surgical blitz' to try and work through the increased waiting lists from COVID," Mr Campbell said.

"Before COVID hit, we had a surgical waiting list of around 1300 people.

"When we peaked last year there were 2150 and we're now sitting at 1917, so we've managed to treat about 10 per cent of that and reduce the numbers.

"And we've managed to do that despite the COVID wave. But rather than a blitz, I think persistent effort over a long period of time will help this time around."

Mr Campbell reassured people they had not been forgotten as waiting lists grew.

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"We just know that there are some people that have been waiting a long time for surgery, but they wouldn't be waiting if it wasn't important to them," he said.

"We're trying to do as many as we can while we balance out with the other demands around us."

A recent exercise with a specialised waiting list helped to open staff's eyes to what they were dealing with and what the public was thinking.

"We recently audited our orthopedic waiting list by text messaging and asking for online engagement to see if we could find anyone who no longer required their surgeries and/or if we could re-categorise them," he said.

"The team looked for patients who needed to be up-categorised and needed things more urgently and found a small number of those.

"And we did get considerable feedback from those who were just waiting and they seemed to appreciate the communication we were able to do.

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"There was also a small group of people we were able to put into pre-habilitation, which is something we would like to do a lot more of, so they are ready for when they do go in for their surgery."

But for staff, the ultimate goal is to continue working through those surgical lists as soon as possible.

"We've shown it is possible for us to do, so we hope to continue working to reduce it even more," he said.

"It would be very nice to see it back to a pre-COVID level, and I'm not saying that time was perfect either, but it is hopefully part of the long-term plan."

Mr Campbell said it was a team effort across regional Victoria to get through these waiting lists.

"We're not doing it on our own by any means. We actually divert up to 100 cases a month to other centres such as Castlemaine hospital, St John of God and the day surgery," he said.

"We do that because our priority is ensuring people get their surgery wherever it's most suitable for them.

"Our main message would be that we are continuing to perform elective surgeries and we will do as much of it as we can."

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