Treatment Waiting Times Explained – What You Need to Know

Treatment Waiting Times Explained

If you watch the news, read the papers or browse social media – you will likely see a story about the NHS and time targets, but what are ‘waiting times’?

Waiting times

A ‘waiting time’ is the time it takes for a patient to receive treatment after a referral. ‘Waiting times’ consists of a series of standards that all add up to the maximum amount time a patient waits at each stage in the referral and treatment process.

If you are ‘referred’ as a result of a physical or mental health condition you have the legal right to receive treatment or see a specialist within a maximum ‘waiting time’.

Waiting times and services

The right to be seen or receive treatment within ‘waiting times’ only applies to services commissioned by your NHS body (i.e. for those in England, that’s NHS England).

Waiting times do not apply to non-consultant led mental health services, maternity services or any services commissions by local authorities.

Waiting time stages

If you have received a referral, your waiting time starts from the point the hospital or service receives your referral letter – or when you book your 1st appointment via the NHS e-referral service.

Your waiting time ends when your treatment begins or if a clinician decides no treatment is needed or if you decide you do want the treatment offered.

For example:

  • You have been admitted to a hospital for treatment or an operation
  • You have started treatment, such as taking medication
  • You have been given a medical device – such as a leg or arm brace
  • You agree to being monitored for some time, to see if you require treatment
  • You are receiving advice from hospital staff to manage your condition

Maximum waiting times

The maximum waiting times for non-urgent, consultant-led treatments is 18 weeks from when your referral letter is received or when your 1st appointment is booked (via NHS e-Referral Service).

This does not apply if:

  • You choose to wait longer or delay your appointment
  • Delaying your treatment is required – i.e. to lose weight, or so you can stop smoking
  • Your medical condition needs to be monitored
  • You do not attend appointments that you had chosen from a set of reasonable options
  • You no longer require treatment

If you are waiting because of suspected cancer, the maximum waiting time is 2 weeks from the day a hospital or service receives your referral letter, or from when your appointment is booked (i.e. via NHS e-Referral Service).

What happens if my waiting time is longer than the maximum?

If your waiting time is longer than the maximum waiting time allowed you have the right to request to be seen or treated by a different provider (i.e. private provider). The Clinical Commissioning Group (CCG) will investigate and offer you a range of alternatives.

What happens if my operation is cancelled?

If an NHS service or hospital cancels your operation at the last minute (on or after the day of admission) for non-clinical reasons, you should be offered another binding date within 28 days, or you have the right to ask for funding so you can seek your treatment at a hospital of your choice.

If your operation is cancelled, a hospital or service is not obliged to offer you an alternative option within 28 days, but your right to start consultant-led treatment within the maximum waiting time still stands. If you have to wait longer, due to a cancellation – you have the right to request to move to a different provider.

What happens if I have private health insurance?

If you have private health insurance cover – you may be able to receive treatment without waiting. If your policy covers you for the treatment you require, once referred you can opt to use your private medical cover to pay for the cost of your treatment, care or operation.

If you would like to learn more about private health insurance options contact us. Our expert team are on hand to provide you with free, 100% independent advice and PMI quotes.

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