NHS waiting times - 18 weeks referral to treatment
Quarter ending 31 December 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 31 December 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 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 31 December 2023:

• 274,701 patient pathways were completed under this standard when the patient involved either received the results of a diagnostic test, was seen at an outpatient appointment clinic, or were admitted for treatment as an inpatient or day case. The number of completed patient pathways increased by 3.3% (+8,832) from quarter ending December 2022 but remains 11.8% lower than the same quarter in 2019 (311,310) which was prior to the COVID-19 emergency measures being introduced.
• There was variation in the change in activity at NHS Board level. The largest percentage increases in completed pathways when comparing to quarter ending December 2022 were in NHS Forth Valley (+19%, +2,751), NHS Borders (+9.3%, +616), NHS Greater Glasgow & Clyde (+5.7%, +3,953) and NHS Lothian (+5.7%, +2,061). In contrast, the largest percentage decrease was seen in NHS Orkney (-30.2%, -617) and NHS Western Isles (-8%, -127).
• Despite an overall increase in activity this quarter, there was monthly variation. October saw activity increase by 1,279 (+1.4%) compared to September, this was followed by a larger increase in activity in November when the number of completed waits rose by 7,637 (+8.2%). This was followed by a sharp 20.6% (-20,809) decrease in December, likely due to seasonal impacts of reduced services over the festive period.
• Of all pathways completed, 84.9% (233,315) were fully measurable against the 18-week standard. Almost two thirds (66.5%; 155,252) of these pathways were completed within 18 weeks of referral, a decrease from 68.7% in the previous quarter. This is also lower than the 69.4% (159,131) observed a year previously in the quarter ending December 2022.

An area chart showing the number of pathways eligible for 18 weeks referral to treatment standard, from September 2019 to December 2023. After some small fluctuation at the beginning of the period, we can see a sharp decrease as the effects of the covid-19 pandemic were seen in services. Following that, activity has largely been on an upward trend with some seasonal fluctuation. A line showing the trend of measurable pathways that were completed within 18 weeks is also shown, with a general downward trend. This means that fewer waits are completed within the target time of 18 weeks.

Close

Total number of completed patient pathways and percentage of completed patient pathways against the 18 weeks Referral to Treatment (RTT) standard, NHSScotland, September 2019 to December 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, outpatient appointments, and inpatient and day case treatment. 18 Weeks RTT performance is based on adjusted waits for consultant led treatments and fully measurable completed patient journeys.

Please note that data submitted since the onset of the pandemic may not have undergone 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. NHS Grampian were also unable to submit data for the period February 2020 to June 2022, however they have recommenced from July 2022 onwards. Please note that NHS Fife has resubmitted data for April-October 2023, as clinical genetics data were not previously included due to an oversight. In addition, completed waits for physiotherapy were excluded for these months as they were non-consultant led waits.

Further information

Data about this publication are available from the publication page on 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 May 2024.

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.