House of Commons Library briefing paper on NHS maximum waiting time standards.
NHS maximum waiting time standards (654 KB , PDF)
The NHS Constitution for England provides that patients have the right to access certain services commissioned by the NHS within maximum waiting times, or for the NHS to offer suitable alternatives if this is not possible. The waiting times – provided either as patient rights or pledges – are described in the accompanying Handbook to the NHS Constitution for England (last updated October 2019).
Patients currently have a right to the following maximum waiting times:
There are additional pledges on waiting times, including a maximum waiting time of:
The full list of waiting time standards is provided in section 1 of the briefing.
Commissioners are responsible for enforcing waiting time standards through contracts with service providers, mostly NHS Trusts. This is primarily through CCGs commissioning services using the NHS Standard Contract. Concerns have been raised that financial sanctions have been gradually removed from the Standard Contract for waiting time standards, including the 18-week referral to treatment (RTT) and cancer standards.
In April 2019, NHS England introduced a new fine for providers and commissioners to each pay £2,500 per patient that exceeds a 52-week waiting time from referral to treatment.
NHS England is currently undertaking a Clinically-led Review of NHS Access Standards. The interim report was published in March 2019 and sets out initial proposals to changes for waiting times, in mental health services, cancer care, elective care and urgent and emergency care. A brief summary of the proposed changes is provided below,
The NHS is currently trialling the proposals, and will publish a public consultation, due in “early 2020”. Implementation of the new standards is expected in 2020/21.
Covid-19 changes
It was announced in March 2020 that all NHS non-urgent operations in England will be postponed.[1] NHS England and NHS Improvement have said that providers will need to postpone all non-urgent elective operations from 15th April at the latest, for a period of at least three months.[2]
However, Trusts’ performance against waiting time targets will continue to be monitored during this period. A letter from NHS England and NHS Improvement in March 2020 confirmed that monitoring and management of standards such as the four-hour accident and emergency wait and 18-week elective care referral to treatment (RTT) targets will continue.
Fines for breaches of the 52-week RTT target will be suspended from 1 April onwards, and the 28-day faster diagnosis standard for cancer will not be subject to formal performance management.[3]
[1] Department for Health and Social Care (DHSC), Coronavirus Bill Summary of Impacts, 19 March 2020, page 5
[2] NHS England and NHS Improvement, Letter to Chief executives of all NHS trusts and foundation trusts
, CCG Accountable Officers, GP practices and Primary Care Networks, Providers of community health services, 17 March 2020
[3] Health Service Journal, Trusts will still be monitored on A&E targets during covid-19 crisis, 30 March 2020
NHS maximum waiting time standards (654 KB , PDF)
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