What is the 18-week pathway referral (or Referral-to-Treatment, RTT)?
An 18-week pathway referral (Referral-to-Treatment, RTT) is for non-urgent treatment, i.e. from your GP (or other health professional such as physiotherapist) to a hospital consultant.
The maximum waiting time is 18 weeks from the day your hospital (or service) receives the referral – either cyber or by letter. This is a key NHS target that is your legal right in the NHS Constitution (for England). 92% of patients should achieve this target. It was last achieved in February 2016.
It is important to note that it is the minimum time for treatment to start (or a decision that no treatment is needed), not to to be seen.
The actions could include:
- being admitted to hospital for an operation or treatment
- starting treatment that does not require you to stay in hospital, such as taking medicine
- a decision that treatment is not needed.
Clock starts: An 18-week clock starts when your GP (or other health professional) makes a referral to a hospital consultant.
Clock pause: This occurs if you decide to defer treatment until a later date, after being offered two dates.
Clock stops: Examples include:
- when you receive your first treatment;
- when a doctor’s decision is made to start a period of active monitoring;
- when the decision is that you do not need treatment (and you are discharged);
- if you decline offered treatment, or
- if you do not attend (DNA) your first outpatient appointment.
More information can be found here. The latest data in England is here.
Notes:
1. It is also your legal right to choose the hospital or service you’d like to go to
2. If you or your GP want a faster service, further action is required – e.g. ringing a consultant at the hospital to explain that it is not routine and non-urgent, and you need to be seen sooner. Many hospital departments also have either ‘Hot Clinics’ or ‘Day Case Units’, where you can be seen that week, by a senior doctor. You can request this as well
3. The 18-week system should not be used if your GP suspects that you have cancer. If that is the case, the two-week cancer referral system should be used.
Summary
We have described what is an 18-week pathway referral (or Referral-to-Treatment, RTT). We hope it has been helpful.
Note. Sadly, currently (October 2024), there are 7.5 million people waiting for an operation or procedure in the NHS, and most will fail this target. MyHSN is very sorry about this issue. This is not good enough. We will try very hard to do better.
