Referral To Treatment (RTT) or 18 weeks

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Referral to Treatment - 18 Weeks Performance Indicators

The NHS Constitution gives patients the right to access services within maximum waiting times, or for the NHS to take all reasonable steps to offer you a range of suitable alternative providers if this is not possible.

The maximum waiting times are described in the Handbook to the NHS Constitution.

Pennine Acute Hospitals NHS Trust supports the NHS Constitution and undertakes to ensure that its requirements are fulfilled.

What to expect

  • Your GP, dentist or other health professional will refer you to a specialist via the Choose and Book service or a referral letter
  • Your 18 weeks waiting time starts on the day the hospital receives the referral letter or on the day you make the booking for your first appointment, via the choose and book service
  • If you were referred by letter you will be called or asked to call, to make an outpatient appointment and offered a choice of dates. Or we will make a provisional appointment for you which you can choose to rearrange if the date and time are not convenient for you
  • You will attend your first outpatient appointment
  • You may be sent for a diagnostic test
  • You may require a follow-up appointment
  • If you need surgery you may need to attend a pre-admission appointment
  • You may require treatment and a stay in hospital
  • Your 18 weeks waiting time ‘clock’ ticks until you receive your first treatment.

Even if you require all of the above tests and appointments this should take no longer than 18 weeks. Sometimes however, it may not be appropriate for to receive treatment in 18 weeks. This may be because as a patient you:

  • need several tests completed in sequence
  • may not be medically fit enough to receive treatment within 18 weeks
  • choose to wait longer than 18 weeks.

You may also wish to read our Useful Information About Your Forthcoming Outpatient Appointment.

In conjunction with the local GPs, we have agreed an Elective Care Access Policy which sets out how we will deliver these standards.

How you can help us to help you

Top tips

  • Talk to your GP about what to expect
  • If your treatment is routine please make sure you will be available for the next 18 weeks
  • If you are planning a holiday for two or more weeks or have other commitments, you and your GP may decide to delay your referral until you are available
  • Tell us if you change address or your telephone number
  • Complete and return the registration form that will be sent to you prior to your first appointment
  • Keep your appointments and arrive on time
  • Let us know in plenty of time if you are unable to attend an appointment
  • Write your questions down before you attend so that you don’t forget to ask
  • Let us know if you think that you have been waiting too long.

Missed appointments

Nine out of ten patients arrive on time for their appointments. However, even one missed appointment can cause delays for you and other patients, and waste precious NHS resources.

  • If you miss an appointment and don't let us know in advance, then we will refer you back to your GP. They will refer you back to us again if and when appropriate.
  • While we aim to offer you a choice of appointments, if you are unable to agree a date that is within the 18 weeks waiting times then we may refer you to go back to your GP and  ask that you contact us nearer the time you will be available.

What if I haven’t received an appointment date?

If you think you are waiting too long for an appointment, please contact the telephone number on the top of the letter you received.  If you are still not satisfied contact our PALS Office.

You can see how we’re doing by accessing our monthly referral to treatment (RTT) by specialty figures.


The NHS Constitution is also available in other languages.