Identifying and definitional attributes
|Metadata item type:||Glossary Item|
|Synonymous names:||National Elective Surgery Target (NEST) tail|
|Registration status:||Health, Standard 21/11/2013|
Calculating the 'tail' (the 10% of overdue patients who have waited the longest)
The 'tail' is the list of patients who meet the criteria at National Health Reform Agreement—National Partnership Agreement on Improving Public Hospital Services (NPA IPHS), Clause A26(c).
As per the NPA IPHS, the baseline for calculating the 'tail' will be 10% of overdue patients who have waited the longest as at 31 December prior to the reporting year. The 'tail' is 10% plus ties, meaning all patients due on that day get included, not necessarily just 10% of patients. The Commonwealth and jurisdictions should agree on the list of patients in the 'tail' by 28 February of the reporting year. As per the NPA IPHS, the 'tail' will be calculated from unit level data provided by the jurisdictions, enabling the Commonwealth to uniquely identify patients and verify performance in the subsequent year.
The 10% of overdue patients who have waited the longest are the 10% of 'ready for care' patients in each jurisdiction, in each category who have been waiting more than: Category 1 = 30 days; Category 2 = 90 days; Category 3 = 365 days.
For each category:
For further explanation, see the example below:
Explanation of 10% 'tail' calculation across categories
All hospitals reporting to the Elective Surgery Waiting List Reduction Plan. Subject to agreement between the jurisdiction and the Commonwealth, hospitals can come into the scheme that have existing waiting lists that have not previously been reported. If facilities are to be added, they should be added to reporting figures only from 31 December. To be eligible to be in scope, a jurisdiction must submit both removals and census data for each hospital.
Patient on more than one waiting list
This is an issue only in cases where a particular patient is in the 'tail' for more than one waiting list for the same procedure. The jurisdictions have agreed that patients should not appear on more than one waiting list; if this occurs, jurisdictions will identify any such instances.
Changing urgency categories
For the purposes of the NPA IPHS NEST tail: once identified in the 'tail', subsequent changes to urgency category are not relevant and the patient must be treated in the relevant year.
'Not ready for care' patients
'Not ready for care' patients are not counted in the 'tail' calculations, as patients not ready for care will not be on the waiting list when the 'tail' is calculated. If a patient is classified as 'not ready for care' subsequent to inclusion in the 'tail', jurisdictions are advised to manage early.