Consultant-led Referral to Treatment Waiting Times Rules and Guidance

Return to main RTT page

RTT Rules Suite

RTT Rules Suite – published by the Department of Health and Social Care

The October 2022 Referral to Treatment consultant-led waiting times Rules Suite is the current version of this document.

On 1 October 2015, the National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) (No.2) Regulations 2015 came into effect, removing the provision for a patient pause. The October 2022 Rules Suite reflects this change.

The NHS will wish to maintain a local record of delays resulting from patient choice – to aid good waiting list management and to ensure patients are treated in order of clinical priority. However, it will not affect a patient’s RTT ‘clock’.

Recording and reporting guidance

RTT measurement and COVID-19 (PDF, 94K)
Recording and Reporting RTT guidance (PDF, 624K)
Recording and reporting RTT guidance FAQs (PDF, 280K)

This version of the Recording and Reporting guidance and FAQs document was updated on 20 October 2023 to reflect the changes to the Referral to treatment consultant-led waiting times: rules suite designed to help hospitals with the management of patients who decline offered treatment dates.

The Recording and Reporting guidance was updated in March 2021 to reflect changes to the monthly aggregate data return from April 2021 onwards.

The FAQs document was updated on 6 May 2016 to clarify the guidance relating to RTT recording and reporting for gender identity services, bariatric surgery and specialised services.

The FAQs document was updated on 10 August 2017 to add a FAQ (Q7) to clarify the guidance relating to recording RTT clock starts for referrals that are booked having been on the NHS e-Referral Service Appointment Slot Issues (ASI) worklist.

This guidance was published on 1 October 2015 and has been replaced by the guidance above.

Recording and reporting RTT guidance (PDF, 703K) ~ FOR REFERENCE ONLY

The Information Standard relating to the monthly aggregate data return from April 2021 is available on NHS Digital’s website.

Other Information

Guide to waiting times for patients

Consultation on Referral to Treatment waiting times collection timetable

Between January and March 2014, NHS England consulted on a proposed change to the timetable for the monthly collection and publication of consultant-led RTT waiting times data, in particular on options to publish data a week earlier.

The consultation highlighted a number of risks with reducing the time available for Trusts to collate and validate RTT pathways. As a result, a decision was instead taken to reduce the commissioner sign-off period from ten to five working days. This brings the RTT collection in line with other provider/commissioner collections, such as the Monthly Activity Return. This change will apply for April 2014 data onwards.

The documents below provide a detailed account of the responses to the consultation.

RTT timetable consultation – outcome
Annex B – summary of responses

Data Completeness Methodology Papers

Prior to April 2011 a data completeness score for each organisation was calculated and published alongside the Consultant-led RTT data. The data completeness measure was important in the infancy of the RTT collection as it provided an estimate of data coverage for each organisation and was used to highlight organisations submitting unusual numbers of RTT periods. The calculation of a central data completeness measure was removed in April 2011. The methodology papers can be found below for reference.

RTT Completeness Methodology (Nov 08) – Final (DOC, 67K)
Further Refinements to the Indicators of Completeness of Referral to Treatment date (May 2008) (DOC, 65K)
Refinements to the Indicators of Completeness of Referral to Treatment date (March 2008) (DOC, 564K)
Indicators of Completeness of Referral to Treatment date (November 2007) (DOC, 195K)
RTT Methodology Paper (June 2007) (DOC, 98K)