These minimum standards set out what you, as a patient or an unpaid carer, should expect when you or someone you are supporting are referred for planned (non-urgent) NHS care in England.

These standards have been developed with patients, unpaid carers and patient representatives, alongside clinicians and NHS teams.

The standards act on feedback we have heard and, for the first time, set a benchmark for knowing what is happening and who to turn to.

Planned care means treatment that is not an emergency and is booked ahead of time. You may also hear this called “elective care”.

These standards are part of wider work to improve your experience of NHS care.

This includes improvements in general practice, so it is easier to contact your GP practice by phone, online or in person, and so you know how your request will be handled.

It also includes work to make primary care, community services and hospitals join up better, so you get the right care in the right place.

We are also making improvements to the NHS App in 2026/27 so that you, or someone you care for, have the option to see and manage appointments, get clearer updates, and find information and support while you wait.

We are also working to improve communication earlier in your care, including before your referral has been accepted.

Together, these changes should make your care clearer, more joined up and easier to manage.

The standards apply to care for all adults, children and young people and apply from the moment your referral is received by the hospital or clinic until:

• your treatment starts
• you and your clinician decide no treatment is needed
• or you choose not to go ahead with treatment

The standards set clear expectations for all providers of NHS planned care to deliver, ensuring that every patient’s experience of planned care becomes smoother, clearer and more supportive.

While we know many providers meet many of these standards, this will ensure there is a consistent, experience for patients and unpaid carers across the country.

The standards will be reviewed annually to act on feedback and continue improving the baseline experience.

What the standards mean for you

These standards set out what you should expect during your wait for your care, based on what patients, carers and NHS staff have told us is most important.

They are designed to make patients’ experiences of planned care:

• smoother
• easier to understand
• more supportive

Planned care is, of course, only one part of NHS care. You may also be seeing your GP and using other NHS services. We are working to improve how all parts of this journey fit together.

If you are on an urgent pathway – for example, for suspected cancer – most of these standards will still apply. However, because your care must be delivered more quickly, you may get less notice of appointments or fewer updates while you wait.

The National Cancer Plan includes further steps to improve the safety, effectiveness and experience of cancer care and new standards for these services.

These standards sit alongside your existing patient rights. These include your rights to:

• be treated fairly and without discrimination
• get clear information about your care
• choose your provider for your first planned appointment

Making decisions about your care

Patients and their healthcare team should talk through options and work together to decide what is right. This is called shared decision making.

The Patients Association have produced materials to help patients understand shared decision making and how it can improve care.

If these standards are not met

All providers of planned care are expected to meet these standards.

Patients, family, friends and unpaid carers can all raise issues if your experience does not meet with the standards. You should contact the patient advice and liaison service at your hospital or healthcare setting.

NHS providers’ responsibilities

All providers of NHS care, such as your local hospital, are responsible for making sure you receive clear, consistent and supportive communications throughout your planned care experience.

They should explain what is happening, what to expect next, and who to contact if you have questions or concerns.

Hospitals should use these standards to shape their delivery of planned care, including how appointments are planned, how cancellations are handled, and how waiting lists are kept accurate.

All NHS trusts will be reviewing performance against the standards, reporting progress annually to their boards, and publishing a summary of progress each year, so that patients, carers and the public can see the improvements being made.

The role of patients and unpaid carers

Patients and, where appropriate, parents, unpaid carers or family members, play an important part in care.

You can help by:

• attending appointments
• letting the service know as soon as possible if you need to change an appointment or no longer need it
• giving notice if you can’t attend, so other patients can be seen sooner
• responding to communications from your provider, such as confirming you still need an appointment or providing information relevant to your care
• reading information sent ahead of appointments

If your health changes while waiting, you should

• use NHS 111 (online or by phone) if you need urgent medical help but the issue is not life-threatening
• call 999 or go to your nearest accident and emergency (A&E) department if it is a life-threatening emergency
• contact your GP practice for advice if you have a new or separate non-urgent health concern

Minimum standards for the planned care patient experience

When you are referred (standard 1)

Standard 1: You will know when your referral is accepted

Within 28 days of your referral being made you will receive confirmation of next steps in your care. This will often be shown in the NHS App, but it may also be sent by text, post or other methods.

In many cases, you will get confirmation much sooner than 28 days. The 28-day standard is the latest point by which you should be told what is happening next.

Some referrals take longer to review: for example, where the hospital or clinic needs to check more information before deciding the next steps.

If your referral does not lead to you being placed on a waiting list, the provider will explain why and set out the next steps. If a follow-up is needed, your GP practice may reach out to arrange an appointment.

If you have not received confirmation within 28 days, check the information provided at the time of your referral, including contact details for the hospital or provider you were referred to.

You should first try to contact the provider for an update. If you are unsuccessful or your symptoms change or continue to cause concern, your GP practice can advise on what to do next.

Why this matters

Patients and unpaid carers told us that silence after referral causes anxiety. This standard ensures you are not left unsure whether your referral has been received or processed.

While you are on the waiting list and throughout your care (standards 2 to 5)

Standard 2: Communication will be clear and easy to understand. If you, or your unpaid carer, have specific communications needs, you will have the opportunity to tell your provider these

Information about appointments, treatment and next steps will be clear and easy to understand.

Clinical and technical language will only be used where necessary to explain your treatment and care.

Information will be provided in a format that meets your needs, in line with the Accessible Information Standard.

While communication will increasingly be through the NHS App, providers will give you the opportunity to state if you have alternative communication needs and preferences.

If you would like your unpaid carer, family member, friend or someone else you trust to support you, you can tell your provider.

You can say what information can be shared with them, how they should be contacted, and when they should be contacted to help you manage your appointments and care.

Information will only be shared if you agree. Your provider will explain how to give your consent.

Why this matters

Patients and unpaid carers told us that clear communication supports understanding, safety and trust whilst reducing confusion and anxiety.

Standard 3: When your referral is accepted, you will get information to help you while you wait

When your referral is accepted, clear information about next steps will be provided. This will include:

• How to contact the service

You should get contact details for practical or administrative questions, such as appointment times, how to get there, or accessibility.

This contact is usually for practical questions, not for advice about symptoms. If you need advice about symptoms, follow the guidance in the information you are given (for example, contact your GP practice or NHS 111).

You can use the same contact information to tell your provider about any additional needs you have and reasonable adjustments required to attend your appointment, such as large print, braille, audio formats, longer time in the appointment, or access to a British Sign Language (BSL) interpreter.

You can explain any other communication needs and set out how you prefer to be contacted.

• Who to contact if the condition you have been referred for changes or worsens and how to act

You will be told clearly what to do if you are concerned about your health including how to recognise when you may need to seek urgent or emergency care, and when it may be more appropriate to contact your GP practice.

• Support while waiting

You should receive information to help you understand and manage your condition while you wait. This may include self-care advice, guidance on symptoms, or information about wellbeing support.

You should also be given clear and reliable ways to contact your provider.

This could include a phone number, email address or other contact route for practical questions, such as appointment times, travel, accessibility arrangements or reasonable adjustments.

Why this matters

Patients and unpaid carers told us that clear contact points reduce stress and avoid repeated enquiries.

Knowing who to contact and what to do if your health changes helps ensure you get the right care where you need it.

Good communication can improve outcomes and reduce anxiety, particularly where waits are long.

Standard 4: You will get regular updates on your wait

While you are waiting, you will get an update at least every 12 weeks. This will confirm that you are still on the waiting list and explain any steps required.

You may be asked to provide updates about your health to inform joint decisions about the best care for you. If your circumstances change and you no longer need the specialist care you are waiting for, you should let the relevant service know as soon as you can.

Some updates form part of a process called ‘waiting list validation’. This is where hospitals check their waiting lists are up-to-date and that you are still waiting for the right care.

You might get a text message or an update in the NHS App. The message should be clear and reassuring, and should explain if you need to reply and what to do.

Why this matters

Patients and unpaid carers told us that regular reassurance whilst waiting reduces uncertainty.

This standard will also help services maintain accurate waiting lists.

Standard 5: Before your appointments, you will be able to tell your provider of any additional needs and reasonable adjustments you require

You will be asked about any additional needs when your referral is accepted and again before your appointment.

You will receive reasonable adjustments to help you attend appointments.

This could involve, for example, help if you use a wheelchair, help with communication if you do not speak English as a first language, or access to assistive technology such as a hearing loop system.

You will have clear information about who to contact if the adjustments are not in place (see standard 2).

Why this matters

Patients and unpaid carers told us that recognising and supporting additional needs helps ensure everyone can access care fairly and safely.

Making reasonable adjustments reduces barriers, supports dignity and independence, and helps appointments go ahead as planned.

Planning and understanding your appointments (standards 6 to 8)

Standard 6: You will receive clear information about your appointments in good time

You will receive communications at least 21 days in advance of when your appointment is.

This will set out what the appointment is for, where it will take place, and how to prepare.

The 21 days’ notice standard does not apply if an appointment is arranged at short notice (for example, because you need an urgent appointment or have been asked to fill a cancellation slot).

However, you will still be given the same key information about when and where it is, what it is for, and how to prepare.

Where appointments are arranged at short notice, your provider should give you the key information you need as soon as possible, using the most appropriate available channel. This may include the NHS App, text message, phone call or another agreed communication route.

In some cases, care may start with a diagnostic test. When this happens, clear information will be provided about the test and how to prepare.

Why this matters

Patients and unpaid carers told us that clear, timely notice helps people plan ahead, including arranging travel, time off work, and dealing with caring responsibilities. This standard helps you prepare properly for your appointment and reduces the risk of missed appointments.

Standard 7: If your appointment is cancelled, by either you or your provider, a new date will be arranged in good time

Providers should keep cancellations to a minimum and give as much notice as possible if an appointment changes.

Patients should do all they can to attend appointments.

If you are unable to attend your appointment, you should let the service know as soon as possible so another date can be arranged. This may allow another patient to receive care sooner.

If you do not attend an appointment without giving prior notice, the relevant NHS service will seek to understand the reason and will tell you any next steps.

If your appointment is cancelled or needs to be rescheduled, clear information will be given on how to rearrange it.

A replacement appointment date will be given within 28 days, although the appointment itself may take place later.

Why this matters

Patients and unpaid carers told us that late cancellations are disruptive and distressing, particularly when people have arranged time off work, transport, or caring responsibilities.

Fair notice and timely rebooking help minimise disruption and maintain trust in the care process.

Standard 8: You will be told when your care is complete and what happens next

When you and your clinician determine that you are receiving appropriate treatment or that you do not require treatment, this will be understood and communicated, including any arrangements for follow-up appointments.

Where you and your clinician agree you no longer require planned care, this will be clearly communicated.

You will be told if you need follow-up care. This might be:

• a set follow-up appointment that the service books for you, or
• patient initiated follow-up (PIFU), where you contact the service if you need a follow-up. The service should explain how PIFU works and how to get in touch.

Why this matters

Patients and unpaid carers told us that having clear information on the next steps following engagement with the system is important and can help to reduce anxiety by providing clarity to support longer term health beyond individual pathways.

Annex A – Your rights as an NHS patient

This annex summarises some of your key rights when receiving NHS care, and where to find more information or support if you need it.

These rights apply alongside the standards set out in this document.

Your right to choose

In many cases, you have a legal right to choose where you are referred for your first outpatient appointment for planned NHS care.

This right applies when you are referred for a first outpatient appointment in a consultant-led service (for physical or mental health conditions), provided the service is NHS funded and the referral is not urgent or excluded from choice.

You do not have a legal right to choose where your outpatient appointment will take place if you are:

• already receiving care and treatment for the condition for which you’re being referred and this is an onward referral
• using urgent, emergency or crisis services
• in need of emergency or urgent treatment, such as cancer services where you have received an urgent referral for suspected cancer or for breast symptoms (where cancer is not suspected)
• a prisoner, on temporary release from prison, or detained in ‘other prescribed accommodation’ (such as a court, secure children’s home, secure training centre, an immigration removal centre or a young offender’s institution)
• someone who is held in a hospital setting under the Mental Health Act 1983
• a serving member of the armed forces
• using maternity services (maternity is exempt from core ‘right to choose’ legislation, but you should still be offered choices around your maternity provider, place of care, and birth options)

You may be able to choose:

• the hospital or provider you are referred to
• a clinical team led by a named consultant (or, for some mental health services, a named healthcare professional)

Your healthcare professional should explain your options and support you to make a choice that works for you.

Find out more about your choices in the NHS and the NHS Choice Framework.

Your right to clear information

You have the right to be given information about your care in a way you can understand. This includes information about:

• what is happening with your referral or appointment
• what to expect while you are waiting
• who to contact if you have questions or concerns

If you have communication or information needs, the NHS should make reasonable adjustments in line with the Accessible Information Standard.

Waiting time standards

The NHS has national waiting time standards for planned care. These set expectations for how long people should normally wait for treatment once a decision to treat has been made.

Waiting times can vary depending on clinical need and local circumstances, but services are expected to keep patients informed and treat people fairly while they wait.

For most planned, consultant-led NHS care, you have the right to start treatment within 18 weeks of being referred. This is for non-urgent consultant-led treatment for a physical or mental health condition.

If you have already waited, or are told you are likely to wait, longer than this, the NHS should take reasonable steps to offer you a suitable alternative provider that could see you sooner, if one is available.

This does not apply in all situations. For example, it does not apply where it is clinically appropriate for you to wait longer, where you choose to wait longer, or where services are excluded from the 18-week standard.

Different waiting time standards apply for an urgent suspected cancer referral.

If you’re referred for an urgent cancer check, cancer should be confirmed or ruled out within 28 days of the referral. You’ll get a letter from the hospital within a few days of being referred to confirm they’ve received the referral.

You should have an appointment with a specialist or to have tests soon afterwards (often within 2 weeks).

You have the legal right to ask to be seen or treated by a different provider if you’re likely to wait longer than the maximum waiting time specified for your treatment.

The hospital or integrated care board (ICB) will have to investigate and offer you a range of suitable alternative hospitals or clinics that would be able to see you sooner.

Find out more about NHS waiting times and your rights.

Raising concerns or asking for help

If something is not working well, or you are worried about your care, you have the right to raise concerns and ask for support.

In the first instance, you can:

• contact the service or hospital providing your care
• ask for help from the Patient Advice and Liaison Service (PALS), which offers confidential advice, support and information

If required, PALS can assist you with making a formal complaint.

Find your local PALS service.

Making a complaint

If you want to make a formal complaint, you have the right to do so and to have your complaint investigated properly.

Making a complaint should not affect your future care.

Find out how to make an NHS complaint.

The NHS Constitution

The NHS Constitution brings together your rights as a patient and explains what you can expect from the NHS, as well as the responsibilities of patients, the public and staff.

Publication reference: PRN02340_i