NHS waiting times - 18 weeks referral to treatment
Quarter ending 31 March 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 March 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 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 of waiting times statistics.

Main Points

During the quarter ending 31 March 2023:

• 272,194 patient pathways were completed under the 18-week 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. The number of completed patient pathways increased by 6,725 (+2.4%) from the previous quarter, but remains 5.1% lower than the quarterly average in 2019 (286,959). Of all the pathways completed, 85.6% (232,808) were fully measurable against the 18-week standard.
• Activity increased throughout this quarter, with 86,189 pathways completed in January, followed by a slight rise to 86,493 in February and a larger increase to 99,512 in March (see below chart).
• 67.6% of all measurable patient pathways were completed within 18 weeks of referral, 1.8% lower than in quarter ending December 2022. This is a continuation of the noticeable downward trajectory in performance since quarter ending June 2022. The decrease in performance is partly influenced by NHS Boards’ capacity to gradually see and treat more patients, including those with less urgent clinical needs that have been waiting the longest to be seen. 
• 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 Orkney (+18.7%, 383) and NHS Fife (+11%, 1,807), excluding NHS Golden Jubilee University National Hospital for comparison purposes. In contrast, the largest percentage decreases were seen in NHS Shetland (-11.8%, -141) and NHS Highland (-8.7%, -2,131).

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

Background

These statistics continue to be affected by COVID-19 (Coronavirus) pandemic.

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.

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, however they have recommenced from July 2022 onwards. 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 29 August 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.