NHSScotland waiting times guidance: November 2023

1. Introduction

This guidance will support Health Boards to effectively manage their Planned Care waiting lists. This will support delivering healthcare services that will be:

Person-Centred – there will be mutually beneficial partnerships between patients, their families and those delivering healthcare services which respect individual needs and values, and which demonstrate compassion, continuity, clear communication, and shared decision-making.

Safe – there will be no avoidable injury or harm to people from healthcare they receive, and an appropriate, clean, and safe environment will be provided for the delivery of healthcare services at all times.

Effective – the most appropriate treatments, interventions, support, and services will be provided at the right time to everyone, who will benefit at equitable rates, and wasteful or harmful variation will be eradicated.

There have been a number of significant changes affecting Planned Care Waiting Times in recent years, including pandemic backlogs, staff shortages and some of the most difficult winter periods the NHS has ever faced.

We are committed to delivering sustained improvements and year-on-year reductions through service redesign and enhancing regional and national working.

This guidance aims to account for ongoing improvements and changes to the way services are being delivered. Additionally, the principles which are contained within this guidance should be applied to all patients who have been referred for an appointment, diagnostic test, or treatment.

The Patient Rights (Scotland) Act 2011 supports the Scottish Government’s vision for a high-quality NHS that respects the rights of patients, their carers and all the people who deliver NHS services.

The Act preserves in law that, once a patient has been diagnosed as requiring inpatient or day case treatment, a Health Board must take all reasonably practicable steps to ensure that the patient’s treatment starts within 12 weeks of the treatment having been agreed. This is the Treatment Time Guarantee.

The intention of the Treatment Time Guarantee is to ensure timely access to care at the point of treatment. The Treatment Time Guarantee applies to all planned inpatient and day case treatments (with a few exceptions which are set out in The Patient Rights (Treatment Time Guarantee) (Scotland) Regulations 2012 (legislation.gov.uk))

The Treatment Time Guarantee operates within the 18 Weeks Referral-To-Treatment standard, to support timely access to high-quality care at each point of the patient journey. To deliver the 18 Weeks Referral-To-Treatment standard, which states the initial referral and treatment date should aim to be within 18 weeks, all stages of the patient’s pathway need to be as short as possible. This is why there are waiting times standards for each stage of treatment. Consequently, the aim is for the majority of patients to be seen in less than 12 weeks for both outpatients and the Treatment Time Guarantee.