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National Elective Surgery Targets

What is NEST?

The National Elective Surgery Targets (NEST) are a component of the National Partnership Agreement and aim to ensure that elective surgical patients are treated within their recommended clinical priority time frame.

Achieving the NEST targets is the responsibility of all staff involved in the surgical patient journey. This includes from the time the patient submits their recommendation for admission form until the time they leave hospital and return home.

The objective of the National Elective Surgery Target is to progressively increase the number of elective surgeries performed so that 100% of patients receive their elective surgery within the clinically recommended time by 2016. Two complementary strategies are required in order to reach the NEST :

Part 1:  A stepped improvement in the number of patients treated within the clinically recommended time; and

Part 2: A progressive reduction in the number of patients who are overdue for surgery, particularly patients who have waited the longest beyond the clinically recommended time.

Strategies to Achieve NEST in NSW


  • Booking Office and Admission Process
    • Treat in turn
    • Escalation systems
    • Waiting List Management
    • Day of Surgery Admission
  • Pre Admission
    • All patients screened for attendance at Pre Admission Clinic
    • Better prepared patients (less cancellations)
  • Operating Theatre Efficiency
    • First case on time start
    • Better Operating Theatre utilisation
  • Models of Care and Discharge Processes
    • High Volume Short Stay Units
    • Specialist Centres
    • Emergency surgery
  • Surgery Redesign Training 




NEST Workshop – Monday 4 February 2013

The NSW Ministry of Health hosted this one day workshop aimed at staff from Booking Office, Pre admission, Operating Theatres and Surgical wards (Extended Day Only and High Volume Short Stay Surgery). Approximately 95 people from NSW Metropolitan and Regional and Rural hospitals attended.

The presentations included:

Presentation Speaker Organisation
Overview of National Partnership Agreement (NPA) on Improving Public Hospital Services and the National Surgery Access Target (pdf 1.1 MB) Sally Howard NSW Ministry of Health
Measuring NEST: Understanding NEST Calculations (pdf 837KB) Allan Went NSW Ministry of Health
Redesign and NEST (pdf 963KB) Donald MacLellan Agency for Clinical Innovation
Hospital Patient Flow and NEST (pdf 813KB) Damien Miners NSW Ministry of Health
Patient Flow Portal (PFP) Waiting List Snapshot (pdf 248KB) Melinda Pascoe NSW Ministry of Health
Booking Processes Used to Assist in Achieving NEST (pdf 2.7MB) Debra Pickrell Concord Repatriation General Hospital
Admission and Pre-assessment Process for Patients Scheduled for Elective Surgery (pdf 795KB) Debra Smith Auburn Hospital
Implementing an Acute Surgical Unit and its affect on NEST targets at Wagga Wagga Health Service (pdf 1.5MB) Megan King Wagga Wagga Hospital

Program Contacts

Melinda Pascoe
A/Principal Policy Advisor – Surgery
NSW Ministry of Health
Phone: 02 9391 9557