NHS waiting times - 18 weeks referral to treatment
Quarter ending 31 December 2020

About this release

This release by Public Health Scotland reports on completed patient pathways covered by the 18 weeks Referral to Treatment (RTT) Standard (90% of patients being treated within 18 weeks of referral) up to 31 December 2020.

All 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. In addition, NHS Lothian and NHS Grampian have been unable to submit data for the last 6 and 10 months respectively. This should be taken into consideration when interpreting the statistics shown.

Main points

• The number of eligible patients treated under this standard remains significantly lower than pre-COVID-19 levels. However, the number of eligible patients has increased from a low of 22,818 in April to 62,620 in November 2020, reflecting the resumption of many services. A subsequent drop to 57,462 in December is likely to be due in part to the festive period. However, this figure was still 21.9% less than in December 2019.
• Fewer eligible patients were seen in quarter ending 31 December 2020 when compared to the same quarter in 2019. However, this varies across Boards; NHS Dumfries & Galloway report a 23.5% reduction and NHS Ayrshire & Arran report a 51.3% reduction. This reflects variation in available capacity within Boards while operating within the constraints of infection control.
• Of the patient journeys (excluding NHS Grampian and Lothian) which were completed during December 2020, 83.8%, were fully measurable against the 18-week standard. Of these, 73.8% of patients were reported as being treated within 18 weeks of referral, up from 66.8% in September 2020 but lower than 80.2% in December 2019, underlining a gradual improvement in performance since NHS services initially resumed for non-urgent care.

1. The number of eligible journeys reflects the total number of patients seen each month. The percentage reported within 18 weeks is based on proportion of completed waits that are fully measurable.
2. NHS Grampian figures unavailable for March-December 2020, NHS Lothian figures unavailable for July-December 2020.

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 fully measurable completed patient journeys. PHS produces separate publications for diagnostic tests, new outpatient appointments, inpatient and day case treatment, available on the waiting times page of the Data and Intelligence website (external website).

These statistics continue to be affected by the COVID-19 (Coronavirus) pandemic. During the early stage of the outbreak many services were paused or reduced and there were also less referrals to services. From 19 June, Boards started to resume some services as part of the planned remobilisation of services (external website).

Then, as a second wave of COVID-19 cases emerged through the autumn months, a strategic national framework (external website) was introduced by the Scottish Government on 2 November with the aim of supressing the virus to the lowest possible level whilst tackling the 'harms' caused by the pandemic. This included maximising the safe and effective resumption of planned services where possible, whilst balancing the need to ensure sufficient capacity to respond to the resurgence of COVID-19.

Further information

In absence of a detailed report this quarter, please refer to the PHS Data and Intellgience website for background information (external website) on the 18 weeks RTT standard, data collection processes and quality assurance.

The next release of this publication will be 25 May 2021.

NHS Performs

Information from this publication is included in NHS Performs (external website) a website that brings together a range of information on how hospitals and NHS Boards within NHSScotland are performing.