Women should give birth at the same site where intensive care units and surgical wards are, Albury Wodonga Health's clinical services plan has recommended.
The plan identified the "fundamental factor creaking risk for AWH's maternity and neonatal services at Wodonga is the separation from other acute services at the Albury campus".
"The maternity service is also working with equipment purchased to support 1200 annual births, significantly less capacity than current birthing levels.
"Consequently, resources are stretched."
Upgrading to a level five neonate service was identified in the plan.
It was also recommended AWH expand its surgical capacity, develop vascular surgical services and "re-capture metropolitan leakage" particularly in general surgery and plastics surgery.
The number of surgeries conducted at AWH has increased yearly from just over 12,000 in 2015 to 13,600 in 2019.
While anaesthesia, obstetrics and intensive care are available 24/7, "access it not always easy, particularly with resources stretched across two campuses".
AWH chief executive Michael Kalimnios said expanding cardiology services was another priority.
"We do currently have an interventional cardiology service which runs a couple days a week and within business hours; really, what we should be offering here, as a major regional centre, is 24-hour, seven-day-a-week service," he said.
"So if you had a heart attack here, it can be dealt with here.
"We are looking at developing a services plan for extending cardiac services."
Developing specialist services such as a diabetes support centre for adults and children is not only about improving things for patient, but to ensure AWH draws back business from metropolitan hospitals.
"Access to care, close to home, is obviously critical thing," Mr Kalimnios said.
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"So the document really focused on expanding current services and increasing the range and complexity of other services.
"That's identifying what sort of services our community should expect."
Mr Kalimnios also intends for AWH to increase its leadership and research.
"In some ways, we spent the last 10 or 11 years just creating the entity of Albury Wodonga Health," he said.
"We're now really ready to step into that regional leadership role."