What are NHS waiting times?

An NHS waiting time is the gap between the day your GP refers you to a hospital specialist and the day you start treatment. The official term is the Referral-to-Treatment (RTT) wait. The NHS standard is for at least 92% of people on the waiting list to have been waiting less than 18 weeks. The national figure last reached 92% in February 2016.

The most useful single number is the median wait at your specific hospital for your specific specialty. Half of patients wait less, half wait more. Because it counts pathways still open, this is the wait so far of people currently on the list — a new referral will usually wait longer.

RTT stands for Referral-to-Treatment. It is the NHS England measure of how long patients wait between two events:

• Clock start: the day your GP referral is received by the hospital, or the day you self-refer through an NHS service that allows it.
• Clock stop:the day you start your first definitive treatment — which may be surgery, but is more often the start of a non-surgical course (medication management, a procedure plan, watch-and-wait under a consultant's care, or a discharge decision).

NHS England publishes RTT statistics every month covering every NHS hospital trust in England and every Treatment Function Code (TFC). The user-facing list is around 18 specialties (cardiology, T&O, ophthalmology, gynaecology, and so on).

See the official source at NHS England — RTT statistics.

Two different things go by this name. Your own right, in the Handbook to the NHS Constitution, is to “start your consultant-led treatment within a maximum of 18 weeks from referral for non-urgent conditions”, with exceptions (for example if you choose to wait longer).

The 92% figure is a separate legal duty on the NHS bodies that commission care: regulation 45(3) of the NHS Standing Rules Regulations 2012 says they must make arrangements to ensure that, at the end of each month, “not less than 92%” of the people still waiting “have been waiting to commence appropriate treatment for less than 18 weeks”. It is measured on the people still on the list, not on those who have started treatment. There is also a long-wait ambition that patients should not wait more than 52 weeks, and NHS England's elective-recovery plans have worked through interim milestones — first clearing the very longest waits — while rebuilding towards the 18-week standard.

NHS England's RTT time series shows the national figure at or above 92% in most months from January 2012 to February 2016, and below it in every month since. As of the most recent NHS England release, the national pass rate sits well below 92% — the published figure moves month to month.

On HospitalWaits, the per-hospital % within 18 weeks is shown on every trust × specialty page. See the methodology for how we calculate it.

Here are the latest monthly national medians for a few of the most-searched specialties on HospitalWaits, pulled from the latest NHS England RTT release:

Median of trust medians — see methodology for the calculation and its limits. Pct within 18 weeks is patient-weighted.

When you see a single “NHS waiting time” published, ask which average it is. The three common measures behave very differently:

• Median. The middle wait in a list of all patients. Half wait less, half wait more. The most honest single number — a few extremely long waiters do not drag it up. This is the number we lead with.
• Mean (average).Total weeks waited divided by patient count. A handful of 100+ week waiters pulls the mean above the typical patient's experience.
• 92nd-percentile / 18-week %. The headline number the 92% standard is measured on. What percentage of people on the list have been waiting less than 18 weeks so far. Says nothing about the worst-end of the list.
• Longest wait / % over 52 weeks.The worst-end number. The most relevant if you're considering Right to Choose because of a very long current wait.

The waiting list is the count of people currently waiting. NHS England publishes the total list as one of the headline national stats (it has hovered around the 7-million mark for the last few years).

The waiting time is how long each person waits. A small list at a busy trust can mean a longer wait than a big list at a well-resourced one — list size and treatment capacity together determine the wait.

On HospitalWaits, the trust × specialty pages show both: the list size and the median wait. For your decision, the wait is usually what matters; the list size sets the context.

The RTT release covers consultant-led referral-to-treatment. Diagnostic tests — MRI, CT, ultrasound, endoscopy, audiology, sleep studies, and others — are tracked separately in the DM01 monthly release.

DM01 reports waits for 15 diagnostic test categories. Targets are different: NHS England's aim is for 99% of patients to wait less than 6 weeks for a diagnostic test. National performance varies a lot by test.

If you've been told you need a scan, the wait you care about is the DM01 wait at the imaging unit, not the RTT wait at the outpatient clinic.

The headline national median hides large variation. Three reasons your wait may differ:

1. Hospital matters. For the same specialty, one trust might have a 12-week median wait, another 38 weeks. Use HospitalWaits to find your trust's actual number.
2. Procedure within the specialty. Cataract surgery and complex retinal surgery both sit inside ophthalmology — the published median is the specialty median, not the procedure median. See procedure pages for procedure-level views.
3. Clinical priority. Urgent and cancer referrals are seen faster than routine ones. The published wait is the all-patients median; your individual wait depends on your priority code.

What is the NHS 18-week standard?

It has two parts. Your own right, in the Handbook to the NHS Constitution, is to start consultant-led treatment within a maximum of 18 weeks from referral for non-urgent conditions, with exceptions. Separately, regulation 45(3) of the NHS Standing Rules Regulations 2012 requires NHS commissioners to make arrangements to ensure that at the end of each month not less than 92% of people on the waiting list have been waiting less than 18 weeks. NHS England's figures show the national share last reached 92% in February 2016.

What is the difference between the NHS waiting list and the NHS waiting time?

The waiting list is the count of people currently waiting for treatment. The waiting time is how long each person waits. A trust can have a large list with a relatively short typical wait, or a smaller list with a much longer wait. They're related but different numbers.

What does median wait mean?

The median wait is the middle value when every patient's wait is lined up from shortest to longest. Half wait less, half wait more. Median is a more honest single number than mean for waiting-time data because a few very long waiters skew the mean upwards. Because RTT counts pathways that are still open, this is the wait so far of people currently on the list — not how long a new referral will ultimately wait, which is usually longer.

Why is my actual wait different from the published median?

Three reasons. (1) The median is the typical wait for a whole specialty; your specific procedure may sit at the short or long end. (2) Each hospital varies — the national median hides large gaps between trusts. (3) Clinical priority moves you up or down the list. Use HospitalWaits to find the median at your specific hospital, then ask your GP about your priority.

Are NHS diagnostic test waits covered by RTT?

No. RTT covers consultant-led referrals. Diagnostic tests (MRI, CT, ultrasound, endoscopy, audiology, sleep studies, and others) are tracked in a separate monthly release called DM01.

• NHS England — Referral-to-Treatment (RTT) statistics
• NHS England — DM01 diagnostic waits
• NHS Constitution for England
• Handbook to the NHS Constitution — the 18-week right and its exceptions
• NHS Standing Rules Regulations 2012, regulation 45 — the 92% duty
• HospitalWaits methodology