Treated in Turn

Within each urgency category, a minimum of 60% of elective surgery patients should be treated in the same order as they are added to the waiting list.

Treating patients out of turn leads to:

  • Some elective surgery patients waiting far longer than the recommended time for their surgery
  • Inequitable access to elective surgery
  • Less predictability in waiting times because some elective surgery patients wait a short amount of time while others wait much longer

Expected benefits

The implementation of the treat in turn model of care creates equitable access to elective surgery and leads to greater predictability in the time that patients wait. Predictable waiting times promotes:

  • Fewer surprised breaches of waiting time targets
  • Reduction in maximum waiting times
  • Achievement of elective surgery targets
  • Better patient experiences because patients know how long to expect to wait for their surgery
  • Standardised urgency categorisation because patients aren’t up-categorised to ensure they have their surgery within an appropriate timeframe


Treat-in-turn is applicable to any waiting list of any size.

Key principles

The fundamental components of treat in turn are:

  • Appropriate urgency categorisation
  • Treat 60% - 80% of patients within each urgency category in waiting time order
  • Remaining 20% - 40% allows sufficient flexibility to accommodate differing patient requirements (as judged by the treating surgeon) and other aspects (such as efficient use of operating theatre time and training of surgical trainees).


  • Minimise queue jumping so that most elective surgery patients are treated in waiting time order
  • Identify the longest waiting elective surgery patients in any given month, of which at least 60% should be treated within that month
  • Standardise booking processes that promote the booking of the longest waiting elective surgery patients each month

Performance indicators

  • The percentage of patients treated in turn
  • The maximum waiting time of elective surgery patients

Also known as

  • First in, first out (FIFO)
  • First on, first off
  • 60:40 rule
Last updated: 27 July 2017