Nurse Delegated Emergency Care (NDEC) Project


To provide timely, quality care for patients presenting to EDs in rural and remote areas with low risk, low acuity conditions, and to empower Registered Nurses to manage entire episodes of care through a delegated care model which promotes a more sustainable clinical workload for rural doctors.


  • For patients - access to timely and quality care for less-urgent conditions
  • For nurses - a validated and authorised framework to work within their scope of practice to manage entire episodes of care
  • For doctors - a robust model under which care can be delegated, leading to more sustainable clinical workload and work-life balance
  • For rural health services - a collaborative framework for delivering quality patient care in small rural EDs
  • For rural communities – mitigation of some of the barriers to recruitment and retention of doctors


Nurse Delegated Emergency Care (NDEC) is designed to provide timely, quality care for patients presenting to EDs in rural and remote areas with low risk, low acuity conditions. Under this model the care of these patients is delegated by the facility’s Medical Officer/s to specially trained and credentialed registered nurses. In a defined range of patient care episodes, NDEC-accredited nurses are authorised to undertake assessment, investigation, intervention and discharge, following detailed protocols and guidelines.

NDEC can only be only implemented with express support and cooperation from the facility's Medical Officer/s, HSM/NUM and LHD. Operating the NDEC model is within the scope of practice of a Registered Nurse. To be credentialed to practice NDEC, RNs must fulfil the requirements of the NDEC Education and Accreditation Framework, including satisfactory completion of the education and competency assessment. Qualification or endorsement as an Advanced Practice Nurse or Nurse Practitioner is not required.

Implementation, education, accreditation, patient care, auditing and evaluation resources are included to support sites to implement NDEC.


NDEC is an adaptation of the Emergency Department Model of Care developed at Walcha Multi-purpose Service in Hunter New England LHD.

Detailed information is available here:


Details of who we have worked with to deliver the initiative to the health system:

Medicare Locals

  • Illawarra - Shoalhaven
  • Hunter Rural
  • New England
  • North Coast NSW
  • Southern NSW
  • Western NSW
  • Far West NSW

Other Pillars


Key Dates

Pilot Sites

Implementation Sites

Ivanhoe Health Service – endorsed June 2015
Tibooburra Health Service – endorsed June 2015
White Cliffs Health Service – endorsed June 2015
Narrabri District Health Service – endorsed September 2015
Wee Waa Health Service – endorsed September 2015
Bombala Multi-Purpose Service – endorsed June 2015

Far West Local Health DistrictMenindee Health Service

Endorsed June 2015

Wilcannia Multi-Purpose Service

Endorsed June 2015

Hunter New England Local Health DistrictGlen Innes District Hospital

Endorsed September 2015

Inverell District Hospital

Endorsed June 2015

Tomaree Community Hospital

Endorsed September 2015

Walcha Multi Purpose Service

Endorsed September 2015

Illawarra Shoalhaven Local Health DistrictMilton Ulladulla Hospital

Endorsed August 2013

Mid North Coast Local Health DistrictBellingen River District Hospital

Endorsed August 2013

Northern NSW Local Health DistrictNimbin Multi-Purpose Service

Endorsed August 2013

Southern NSW Local Health DistrictDelegate Multi-Purpose Service

Endorsed June 2015

Pambula District Hospital

Endorsed August 2013

Cooma Hospital and Health Service

Endorsed August 2013

Braidwood Multi Purpose Service

Endorsed September 2015

Western NSW Local Health DistrictCoolah Multi-Purpose Health Service

Endorsed August 2013


A baseline analysis of the first phase of implementation has been completed. The report and Evaluation Plan can be found here.

A further evaluation will be undertaken when there has been sufficient activity through the model.

Related Initiatives

Further Details


Nick Goryl
Special Projects Officer, ECI
02 9464 4675

Donald MacLellan
Director, Surgery, Anaesthesia and Critical Care
02 9464 4604

Page Top | Added: 7 November 2013 | Last modified: 17 August 2016