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Introduction Objective Materials and Methods Results Discussion The public health response (PHR) to the COVID‐19 pandemic significantly disrupted healthcare services worldwide. Our hospital, a major tertiary centre, is a unique two‐state service across Queensland and New South Wales (NSW).The primary objective is to describe changes in service demand and delivery in our hospital resulting from the COVID‐19 PHR. The secondary objective is to investigate patient perceptions of this impact.We performed a retrospective interrupted time series analysis and a population‐based survey to examine patient perceptions of the impact of the COVID‐19 PHR. The study periods were demarcated by the initiation of the COVID‐19 PHR on 1 March 2020 with the ‘pre’ and ‘during’ COVID‐19 periods defined as the 12 months before and after this date respectively.More patients were seen during the COVID‐19 PHR period. The number or stage of cancer diagnoses was not different (P > 0.05). There was evidence (P = 0.03) of an increase in overall occasions of service and fewer failed attendances (P = 0.005). Fewer surgeries were performed on NSW patients (P = 0.005). The survey response rate was 19.3% (n = 185) with 48% stating that COVID‐19 had negatively affected their emotional wellbeing. More participants from NSW than Queensland identified border closures as the most significant impact of the COVID‐19 PHR.The COVID‐19 PHR resulted in an unexpected increase in unit service demand and delivery. The necessary implementation of telephone appointments, while less preferred by patients, sustained service requirements. Cross‐border tertiary healthcare services should consider the significant impact of border restrictions on patient wellbeing. [ABSTRACT FROM AUTHOR]