Started to badly need surgery first (6)
I believe the answer is:
opened
'started' is the definition.
(opening is a kind of starting)
'badly need surgery first' is the wordplay.
'badly' indicates an anagram.
'surgery' becomes 'op' (short for operation).
'first' says to put letters next to each other.
'need' anagrammed gives 'ened'.
'ened' after 'op' is 'OPENED'.
'to' acts as a link.
(Other definitions for opened that I've seen before include "Made available" , "Removed the cover" , "Lifted the lid, say" , "starting the game" , "Unlocked, made accessible" .)