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Your rights in the NHS

Guide to NHS waiting times

Part of the NHS pledge to put patients at the centre of everything they do involves making sure that you are diagnosed and start treatment as soon as possible, at a time that is convenient for you. The NHS Constitution says you have the right to access certain services commissioned by NHS bodies within maximum waiting times. Where this is not possible and you ask for this, the NHS will take all reasonable steps to offer you a range of suitable alternative providers.

This promise is made a legal right by NHS England and Clinical Commissioning Groups (CCGs) in the responsibilities and standing rules regulations 2012 (PDF, 259kb) and as amended by The National Health Service Commissioning Board and CCGs (Responsibilities and Standing Rules) (Amendment) Regulations 2013.

What are maximum waiting times?

You have the legal right to start your non-emergency NHS 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.

Consultant-led treatment includes treatments where a consultant retains overall clinical responsibility for your treatment. This could include treatments provided by the service or team led by your consultant. The setting of your consultant-led treatment, whether hospital-based or in a community-based clinic, will not affect your right to start treatment within 18 weeks. 

Only services commissioned by the NHS are included. Therefore, public health services commissioned by local authorities, such as sexual health services, are not covered by this right.

If you cannot be seen within the maximum waiting time the organisation that commissions and funds your treatment (CCGs or NHS England) 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 commissioner first before alternatives can be investigated for you. Your local CCG or NHS England must take all reasonable steps to meet your request.

Patients with urgent conditions such as cancer and heart disease will be able to see a specialist 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 rights and pledges regarding waiting times can be found on pages 27- 30 of the Handbook to the NHS Constitution (PDF, 797kb).

Comparing waiting times

You can exercise your right to choose the hospital you are referred to 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 using the Services near you option at the top of each page. Enter a postcode and type of procedure or specialty or service into the search field.

Note: Waiting times shown are for the specialty or service that the procedure sits under, as a whole. For example, if you look up hip replacement you will find the average time waited for an inpatient in orthopaedics at that hospital. The length of time that you 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 is your waiting time calculated

If a GP, dentist, optician or other clinician refers you to a consultant for treatment, the clock starts when you book your first appointment through NHS e-Referral Service 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 NHS e-Referral Service means your appointment can be booked while you’re still in the GP’s surgery. But you'll still have the option to book later at a more convenient time if you wish to talk to your family first or compare hospitals before making an appointment. You can book your 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

Exceptions

The right to start treatment within 18 weeks 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 your referral, or you think that your treatment will not start within 18 weeks, you should contact your hospital, clinic or commissioner.

If you are not happy with the organisation’s response, you also have the option of taking the complaint further using the NHS complaints procedure.

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 should 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 the body that commissions and funds your treatment (CCG or NHS England).

Again, if you are not happy with the 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.

Organ donation

The lack of organs suitable for donation in the UK means that patients often wait a long time for a transplant operation. This means you can't be guaranteed an organ transplant within the 18-week waiting time limit. The NHS Blood and Transplant website has information on some transplant waiting times, such as kidney, liver, heart and lung transplants. 

Page last reviewed: 20/04/2015

Next review due: 20/04/2017

The NHS Choice Framework

The Choice Framework explains when you have a legal right to choice about treatment and care in the NHS. The legal right to choice doesn't apply to all healthcare services, however, where you do not have a legal right to choice you should at least be offered some choices, depending on what’s available locally.

GP referrals

Find out how to get a GP referral, including tips on other services you may access through your GP

Having an operation

If your GP has suggested you may need surgery, this guide is for you

Hospital admissions

Find out what happens when you are admitted to hospital, including what forms to fill in or tests to undergo