Treatment waiting times

In March 2010, the NHS Constitution was updated to include a new right for patients to start treatment within a maximum of 18 weeks of a GP referral. In 2012, it became a statutory requirement that at least 92% of people should have a referral to treatment (RTT) time of less than 18 weeks, and since June 2015 this has been the sole measure of treatment waiting time performance.

What's happening to the proportion of people being treated within 18 weeks?

The proportion of people being treated within 18 weeks was consistently high following the introduction of the various referral to treatment (RTT) waiting time targets. The targets were that 90% of admitted patients and 95% of non-admitted patients should be treated within 18 weeks of referral. For 'incomplete pathways', where patients have been referred but treatment has not yet started, the target was set at 92%. In August 2014, a 'managed breach' of admitted and non-admitted targets was introduced which allowed hospitals to miss these targets without consequence. This managed breach lasted until December 2015 and corresponds to the dip in performance we observe at that time. After this breach it was decided in June 2015 to permanently abolish the admitted and non-admitted targets and that the incomplete target would become the sole measure of treatment waiting time performance.

The 92% target for incomplete pathways was breached for the first time in December 2015. As of September 2017, performance had fallen further with only 89.1% of people spending less than 18 weeks on the waiting list for treatment.

Updated November 2017.

How many people are waiting for treatment?

As the proportion of people still waiting for treatment (incomplete pathway) has become the sole measure of treatment waiting times, it is important to look at trends in the number of people who are on the waiting list for treatment. In mid-2007, the treatment waiting list contained over 4 million people, but this was reduced drastically to fewer than 2.5 million by winter 2009. Since then, we see clear seasonal trends with the list growing over the summer months and shrinking in the winter. Beyond these seasonal changes there has been an overall upwards trend in the number of people on the waiting list. Since April 2015, there have been more than 3 million people waiting for treatment each month. As of September 2017, there were 3.8 million people waiting for treatment.

Updated November 2017.

What's happening to people waiting the longest for treatment (over 52 weeks)?

The number of patients still waiting for treatment over 52 weeks after referral (incomplete pathway) was at a high of 21,098 patients in April 2010, but fell dramatically between September 2011 and December 2012. Since then, the absolute number of patients has remained comparatively low, reaching a low of 214 patients in November 2013. However, over the past two years the number of people waiting over 52 weeks has gradually increased from 362 patients in September 2013 to 1,778 patients in September 2017. The proportion of patients with an incomplete pathway waiting over 52 weeks for treatment has followed a similar trajectory and has been below 0.1% since October 2012.

Updated November 2017.

How have referral to treatment times changed in the short term?

The median referral to treatment (RTT) waiting times for all pathways show small fluctuations from month to month. There were increases in median RTT waiting times for all pathways between September 2014 and September 2017; waits for incomplete pathways increased by 1 week, waits for admitted pathways increased by 0.7 weeks and wait for non-admitted pathways increased by 0.4 weeks over the same time period.

Updated November 2017.

About this data

Once there has been a decision from a consultant that a patient needs treatment and they have been referred to a hospital, they are on the waiting list and the clock starts on their referral to treatment (RTT) waiting time. Their treatment pathway, or time on the waiting list, can end in one of two ways:

- 'Admitted': if a patient is admitted to hospital for treatment, the pathway clock stops once they are admitted either as a day case or inpatient.

- 'Non-admitted': if a patient receives treatment that does not require an admission or is not treated, the clock stops when they receive treatment or when a decision is made that no treatment is needed.

Data for 'incomplete pathways' show patients who have been referred but have not yet started their treatment. These data give an indication of the number of people on the waiting list for treatment each month.

Since October 2015, there has been no provision to report pauses or suspensions in RTT waiting time clocks in monthly RTT returns to NHS England under any circumstances.

For further guidance on RTT waiting times, please see the NHS England website

Comments

You should include estimates for RTT non-reporters, especially for the Incomplete Pathways. NHS England now do so in their annual RTT reports. Including such estimates, shows the waiting list at over 3.2M.

George Donald (not verified)
(changed )

Add new comment