NHS waiting times - 18 weeks referral to treatment
Quarter ending 30 June 2023

About this release

This release by Public Health Scotland (PHS) reports on completed patient pathways that are fully measurable against the 18 weeks Referral to Treatment (RTT) standard (90% of patients being treated within 18 weeks of referral) up to 30 June 2023. A fully measurable patient pathway refers to patient journeys where it has been possible for the NHS Board treating the patient to link all stages of the patient's journey and measure the time from the initial referral to the start of treatment.

Please note that a patient may be on more than one pathway for treatment and so the number of completed journeys reported is not the same as the number of individual patients treated. In relation to this, the terminology across this and other waiting times publications has been changed to prevent misinterpretation.

Main points

During the quarter ending 30 June 2023:

• 265,170 patient pathways were completed under this standard when the patient involved was either seen at a new outpatient appointment clinic, received the results of a diagnostic test or were admitted for treatment as an inpatient or day case. This was a decrease of 6,947 (-2.6%) from the previous quarter and remains 15.7% lower than the quarterly average during 2019, prior to when the COVID-19 pandemic began to impact services.
• Despite this, the underlying trend over the last two years has been gradually upwards. For instance, when comparing the 12 months to June 2023 to the period July 2021 - June 2022, excluding data for NHS Grampian which was missing for the earlier period, the number of completed pathways increased by 6.4%.
• Activity in April decreased by 22.2% (-22,130) compared to March, likely due partly to reduced capacity on the Easter public holidays; there were 77,381 completed pathways in this month. However, activity rose by 20.9% (16,208) between April and May to 93,589, and the number of completed pathways further increased to 94,200 in June (see below chart).
• Of all the pathways completed, 6% (227,026) were fully measurable against the 18-week standard. Of these, 69.7% of measurable patient pathways were completed within 18 weeks of referral, 2 percentage points higher than in quarter ending March 2023. This is the first quarterly increase in performance seen in NHSScotland (excluding NHS Grampian) since quarter ending June 2022.
• There was variation in the change in activity at NHS Board level. The largest percentage increases in completed pathways, when comparing to the previous quarter, were in NHS Shetland (+12.8%, 129) and NHS Western Isles (+10.2%, 154). In contrast, the largest percentage decreases were seen in NHS Orkney (-39.4%, -956), NHS Dumfries & Galloway (-10.3%, -587), and NHS Lanarkshire (-10.2%, -2,914).

Total number of completed patient pathways and percentage of completed patient pathways against the 18 weeks Referral to Treatment (RTT) standard, NHSScotland, June 2019 to June 2023.

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Total number of completed patient pathways and percentage of completed patient pathways against the 18 weeks Referral to Treatment (RTT) standard, NHSScotland, June 2019 to June 2023

Background

The 18 Weeks RTT standard applies to the entire patient journey from the initial referral to the start of treatment. Achieving the standard depends on waiting times for diagnostic tests, new outpatient appointments, inpatient and day case treatment. 18 Weeks RTT performance is based on adjusted waits for consultant led treatments and includes only fully measurable completed patient journeys. This means that the length of wait accounts for periods where the patient is unavailable (e.g. for medical or patient advised reasons).

All NHS Boards have encountered significant pressure on local information and intelligence resources due to the additional demands arising from the COVID-19 pandemic. As a result, data submitted since the onset of the pandemic may not have been subjected to the usual levels of quality assurance. There are also gaps in the data; NHS Tayside were unable to submit data for the period July 2017 to December 2017 and NHS Grampian were unable to submit data for the period February 2020 to June 2022. This should be taken into consideration when interpreting the statistics shown.

Further information

Information on the 18 weeks RTT standard and the data collected can be found on the waiting times section of our website. Open data from this publication are available from the Scottish Health and Social Care Open Data platform.

The next release of this publication will be 28 November 2023.

NHS Performs

A selection of information from this publication is included in NHS Performs, a website that brings together a range of information on how hospitals and NHS Boards within NHSScotland are performing.