What is an 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.
Last Reviewed on 9 March 2024