NFZ Overhauls Surgery Rules: Specialized Procedures Moving to Dedicated Wards from October 2026

Starting October 1, 2026, the Polish National Health Fund is restricting general surgery procedures and moving specialized treatments to dedicated wards to enhance patient safety and post-operative care continuity.

New Rules for General Surgery

Patients referred for surgery may end up in a different ward than before. Starting October 1, 2026, certain procedures will disappear from general surgery and will be performed exclusively in specialized wards. The NFZ argues that the changes are designed to increase treatment safety and ensure continuous patient care after surgery. The Fund also wants to increase the valuation of some services, including the treatment of bilateral inguinal hernia.

The National Health Fund has prepared changes to the financing rules for services currently performed in general surgery departments. The draft ordinance by the President of the NFZ has been submitted for public consultation, which will run until August 14, 2026.

Scope of the Specialized Procedures

The new regulations assume that selected services characteristic of other fields of medicine will be funded exclusively in wards with appropriate specialized facilities. This concerns, among others, procedures from the fields of:

As the NFZ points out, general surgery departments can currently settle about 230 groups of services. However, some of these do not correspond to the basic profile of these wards.

Impact on Patient Treatment Locations

Patients will still be able to use the same services financed by the NFZ. However, the location where they are performed will change. Procedures that require specialized facilities or the care of doctors of a specific specialization are to be carried out exclusively in appropriate wards. According to the NFZ, this is intended to improve treatment safety and reduce the risk of complications.

Once the new rules enter into force, general surgery will not be able to bill for selected services, including among others:

This means that a patient requiring, for example, arthroscopy will be directed to an orthopedic ward, and a person needing spine surgery to a facility with the appropriate neurosurgical background.

A Resolution to “Suitcase Procedures”

One of the main reasons for the changes is to limit situations where a specialist comes to the hospital only on a designated date, performs planned surgeries, and then leaves the facility. The problem arises when complications occur after the procedure. The patient then requires further care, but the operating doctor may no longer be available at the hospital.

The NFZ wants the entire treatment process to take place in a place that ensures access to doctors of a given specialization around the clock, properly prepared staff, specialized equipment, full diagnostics, and the possibility of immediate treatment of complications. As the NFZ emphasizes, under the new rules, the patient is to be guaranteed continuity of treatment throughout their hospital stay.

Surgery should be carried out in surgical departments. We put patient safety first, indicated Filip Nowak, president of the NFZ.

A good treatment outcome is not evaluated after a few months. It should be durable for a dozen or several dozen years, emphasized Prof. Jarosław Czubak, national consultant in the field of orthopedics and traumatology of the musculoskeletal system.

Access to Procedures and Valuations

The change in financing rules does not mean a restriction of access to procedures. As the NFZ informs, patients will continue to receive the necessary services, but in wards corresponding to their specialization. The NFZ announces that it will monitor whether specialized departments are prepared to take over patients. In justified cases, it will be possible to adjust contracts and financing.

The reform does not mean only restrictions for general surgery. The NFZ also proposes increasing the financing for some procedures performed within this specialization. The valuation of simultaneous bilateral inguinal hernia treatment is to increase by 40 percent. Thanks to this, the patient will be able to undergo one procedure instead of two separate hospitalizations, which means a shorter treatment process and one recovery.

Implementation Timeline

The changes are scheduled to enter into force on October 1, 2026. The NFZ has set this date so that facilities can complete the treatment of patients already qualified for procedures and prepare new rules for directing patients. Currently, the draft ordinance of the President of the NFZ is being consulted. The final shape of the regulations will be known after the consultations end and the ordinance is issued.