Consultant-led treatment: right to start within 18 weeks

The rules for ensuring patients’ referral to treatment (RTT) waiting time, for consultant-led treatment, is fair and consistent within an 18-week period.


Referral to treatment consultant-led waiting times rules suite: revised for April 2014

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Patients have a right to start consultant-led treatment within 18 weeks of referral or request an offer of alternative providers that can start their treatment sooner. The NHS must take all reasonable steps to meet patients’ requests.

The maximum waiting times legislation requires commissioners to consider the ‘Referral to treatment consultant-led waiting times rules suite’. The rules suite includes:

  • national waiting time rules
  • definitions for RTT waiting times
  • guidance on applying the national rules locally
  • guidance on reviewing the pathways of patients who have waited longer than 18 weeks before starting their treatment
  • guidance on clinical exceptions to the NHS Constitution right to access services within maximum waiting times

On 1 October 2015, the National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) (No.2) Regulations 2015 came into effect, removing the provision for a patient pause. The October 2015 rules suite reflects this change.

The NHS will want to maintain a local record of delays resulting from patient choice, to aid good waiting list management and to ensure patients are treated in order of clinical priority. However, it will not affect a patient’s RTT ‘clock’, and there is no provision to report pauses or suspensions in RTT waiting time clocks in monthly RTT returns to NHS England under any circumstances.

Monthly referral to treatment data, guidance and practical tools for waiting list management are available from NHS England.

Published 31 January 2012
Last updated 1 October 2015 + show all updates
  1. Updated to reflect that the October 2015 Referral to Treatment consultant-led waiting times Rules Suite is now the current version.

  2. April 2014 rules suite added.

  3. First published.