NHS waiting times - 18 weeks referral to treatment
Quarter ending 31 December 2024

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 2024.

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.

Note that a patient may be on more than one pathway for treatment at the same time and so the number of completed journeys reported is not the same as the number of individual patients treated.

As part of our ongoing work to ensure our suite of statistical publications meets user needs, we have decided to pause the 18 weeks RTT national data collection, analysis and publication. This is the last planned publication for now. This is to create capacity to meet demands in other priority areas, including activity relating to 8 key diagnostic tests in the Scottish Government's commitment to treat 150,000 more patients in the 2025/26 financial year. Statistics relating to Stage of Treatment and 8 key diagnostic test waiting times targets in Scotland will continue to be published as normal. If you have any question or concerns, please contact us at phs.waitingtimes@phs.scot.

Main points

During the quarter ending 31 December 2024:

• 278,805 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 was admitted for treatment as an inpatient or day case. The number of completed patient pathways was 1.5% (+4,119) higher than the quarter ending 31 December 2023 but remains 10.4% lower than the same quarter in 2019 (311,310) which was prior to COVID-19 emergency measures being introduced.
• There was variation at NHS board level in the number of completed pathways reported over the last year. When comparing to quarter ending 31 December 2023, the largest percentage increases were in NHS Fife (+16.3%, +2,766), NHS Borders (+13.8%, +1,004), and NHS Orkney (+12.9%, +184). In contrast, the largest decreases were seen in NHS Lothian (-5%, -1,939), NHS Greater Glasgow & Clyde (-3.9%, -2,904), and NHS Shetland (-3.6%, -44).
• Despite an overall decrease in activity this quarter compared to the previous quarter, there was monthly variation. October 2024 saw the highest activity this quarter at 98,604 completed patient journeys, a 3.1% increase (+2,951) from August 2024 which recorded the highest activity in the previous quarter. This was followed by a decrease (-14.8%, -14,581) in December 2024. These decreases can be partly attributed to a reduction in capacity during to the holiday period and care should be taken when interpreting the data.
• Of all pathways completed, 84.6% (235,977) were fully measurable against the 18-week standard. 67% (158,135) of these pathways were completed within 18 weeks of referral, a decrease from 67.6% (162,121) in the previous quarter. However, this is higher than the 66.5% (155,232) observed a year previously in the quarter ending 31 December 2023.

A graph showing the trend of completed patient pathways and percentage of completed patient pathways against the 18 weeks Referral to Treatment (RTT) standard, NHSScotland, September 2019 to December 2024.

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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, September 2019 to December 2024.

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.

An error has been identified where, prior to July 2024, NHS Fife recorded activity for new outpatient clinics under the specialty of General Medicine despite them not offering this service. NHS Fife have resubmitted returns between October 2023 and June 2024 which are present within this publication. As a result, NHS Fife and NHSScotland figures will be different to prior publications.

NHS Grampian were unable to submit data for the period February 2020 to June 2022. As a result, we have displayed NHS Grampian separately across the time period so that data can be appropriately compared.

In January 2025 NHS Borders and NHS Forth valley reported that there is an undercount in historic data for some specialties for waits ongoing over 18 weeks. Resubmissions are not possible at this point in time so care should be taken when interpreting the data.

Further information

Data about this publication are available from the publication page on our website.

For more information, please contact us at phs.waitingtimes@phs.scot.

Open data from this publication are available from the Scottish Health and Social Care Open Data platform.