The NHS is making sure that you are seen as soon as possible, at a time that is convenient for you. Under the NHS Constitution you have 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, when you ask for this.
The NHS Operating Framework for 2011/12 (PDF, 744kb) makes it clear that patients’ rights to access services within maximum waiting times under the NHS Constitution continue.
What are maximum waiting times?
You have the right to start your consultant-led treatment within a maximum of 18 weeks from referral, unless you choose to wait longer, or it is clinically appropriate that you wait longer. This includes treatments where a consultant retains overall clinical responsibility for the service or team, or for your treatment. This means the consultant will not necessarily be present for each appointment, but will take overall responsibility for your care. The setting of your consultant-led treatment, for example whether hospital-based or in a community-based clinic, will not affect your right to treatment within 18 weeks.
If it is not possible to be seen within the maximum waiting time, the primary care trust (PCT) or strategic health authority (SHA) that commissions your treatment must investigate and offer you a range of suitable alternative hospitals or community clinics that would be able to see or treat you more quickly.
However, you will need to contact the original hospital, clinic or PCT first before alternatives can be investigated for you. Your PCT or SHA must take all reasonable steps to meet your request.
Patients with urgent conditions such as cancer and heart disease, will be able to be seen and receive treatment more quickly. For example, you have the right to be seen by a specialist within a maximum of two weeks from GP referral for urgent referrals where cancer is suspected.
Note: Referrals for investigations of breast symptoms where cancer is not initially suspected are not urgent referrals for suspected cancer, therefore, they fall outside the scope of this right.
A detailed list of maximum waiting times can be found on page 22 of the Handbook to the NHS Constitution, (PDF, 1.6Mb).
Comparing waiting times
You can exercise your right to choose a hospital by comparing hospitals across England on this website.
Waiting times may vary between hospitals. Your decision about which hospital to go to may depend on recommendations made by your GP, the urgency to start treatment, or whether the hospital specialises in a particular treatment.
You can compare waiting times for hospitals other than your local ones to see if the waiting time is shorter elsewhere. You can do this in two ways:
a) Compare hospitals for inpatient treatments such as hip replacements
Find out the average time you can expect to wait from referral to starting treatment at a specific hospital or a number of hospitals. Simply select Hospitals from the Find and choose services field. Enter your postcode and type the name of the procedure, or select from an A-Z list. You’ll see a ‘Simple list’ of hospitals in your area and an indication of average waiting times. If you switch to ‘Detailed comparison’ you can compare up to five hospitals with each other. Expand where it offers more related data for your procedure and you’ll be able to compare the hospitals by waiting times.
b) Compare hospitals by specialty or service (outpatient treatments) such as orthopaedics
Follow the same steps as described above but replace the procedure with specialty or service. Again you can choose to view the results as a ‘Simple list’ or a ‘Detailed comparison’. Both views display ‘average wait to see a specialist’ and ‘average time from GP referral to treatment’ for an outpatient appointment.
Note: Waiting times shown are for the whole of the specialty or service that the procedure is in. For example, if you look up hip replacement you will find the average waiting time for an inpatient in orthopaedics at that hospital. The length of time that you will wait will depend on your specific treatment and clinical needs, and you could be seen quicker or wait longer than this average waiting time.
How does it work
If a GP, dentist, optician or other clinician refers you for hospital treatment, the clock starts when you book your first appointment, or when your referral letter is received by the hospital. In other words, measurement of the time you wait starts from this point.
Booking your hospital appointment through Choose and Book means your appointment can be booked while you’re still in the GP’s surgery, or later at a more convenient time if you would prefer to talk to your family or compare hospitals first before making an appointment. You can book an appointment online or by calling The Appointments Line on 0345 608 8888.
When you see a clinician at your chosen hospital or clinic you may:
- Undergo tests, scans or other procedures to help ensure that your treatment is tailored appropriately to your condition.
- Have medication or therapy to manage your symptoms until you start treatment.
- Be referred to another consultant or department.
The clock will stop (your waiting time ends) if no treatment is necessary or when your treatment begins. This could include:
- Being admitted to hospital for an operation or treatment.
- Starting treatment, such as taking medication, that doesn’t require you to stay in hospital.
- Beginning your fitting of a medical device, such as leg braces.
- Agreeing to your condition being monitored for a time to see whether you need further treatment.
- Receiving advice from hospital staff to manage your condition.
If you want to delay your hospital admission, for example because of a planned holiday, the NHS may temporarily pause the clock.
Exceptions
The right to be seen within maximum waiting times does not apply:
- If you choose to wait longer.
- If delaying the start of your treatment is in your best clinical interests, for example where stopping smoking or losing weight is likely to improve the outcome of the treatment.
- If it is clinically appropriate for your condition to be actively monitored in secondary care without clinical intervention or diagnostic procedures at that stage.
- If you fail to attend appointments that you had chosen from a set of reasonable options, or
- If the treatment is no longer necessary.
The following services are not covered by the right:
What if you have waited longer than 18 weeks?
If you have already waited longer than 18 weeks from the start of your referral, or you think that your treatment will not start within 18 weeks, you should contact the Patient Advice and Liaison Service (PALS) at your local PCT.
If you are not happy with the PCT’s response, you also have the option of taking the complaint further using the NHS complaints procedure.
What if the hospital cancelled your operation?
If your operation is cancelled by the hospital at the last minute (on or after the day of admission, including the day of surgery) for non-clinical reasons, the hospital will have to offer another binding date within a maximum of the next 28 days or fund your treatment at the time and hospital of your choice.
If you have not been offered an appointment within 28 days, you should contact PALS at your local PCT.
If you are not happy with the PCT’s response, you also have the option of taking the complaint further using the NHS complaints procedure.
For operations cancelled before the day of admission, the cancelled operations guarantee does not apply. However, the right to start consultant-led treatment within a maximum of 18 weeks from referral for non-urgent conditions, as stated in the NHS Constitution, continues to apply.
