Information for patients 18-Weeks Maximum Waiting Time from Referral to Treatment (RTT): What does this mean for you? Your rights under the NHS Constitution You have the right to access NHS services within maximum waiting times, or for the NHS to take all reasonable steps to offer you a range of alternative providers if this is not possible. The waiting times are described in the Handbook to the NHS Constitution. This is applicable for all urgent and routine elective referrals received at the hospital for consultant-led care. Patients referred for cancer treatments are also subject to a 62-day cancer pathway target. Are any services exempt from the 18-week wait? The following services are exempt from 18-weeks: Maternity services Non-consultant led mental health services Emergency care Your 18-weeks starts from: Your waiting time starts when the hospital becomes aware of your referral. This is either when the hospital receives a written referral from your GP or when you activate your referral if you are using the National e-referral Service. Your waiting time stops when: Your waiting time stops when the treatment, which your clinician or other qualified care professional thinks is the best way of treating or managing your condition, is started. This might be the first in a series of treatments or one treatment. Your waiting time also stops if the clinician makes the decision that you do not need hospital treatment for the condition for which you have been referred. If you are discharged back to your GP or a community-based therapy service then you do not need hospital treatment and your waiting time stops. Your waiting time also stops if: you decline the treatment being offered to you; or you do not attend (DNA) your first activity. This may be an outpatient appointment or a procedure that has been arranged for you by the hospital. In this instance your clock will stop, and if it is decided you still need to be seen, a new clock will start. Hospital-cancelled appointments do not stop or restart clock in RTT treatments. For conditions that require treatment but do not involve surgery, your treatment will start (and so your waiting time will stop) when you are given medication, advice, start therapy or are fitted with an appropriate appliance. For conditions that do require surgery, your treatment will start (and so your waiting time will stop) on the day you are admitted for surgery. Sometimes it is clinically more appropriate to actively monitor your condition as opposed to actively treating you. In this case your 18-week clock will stop. If in the future your clinician feels it is appropriate to treat you, then on the day that decision is made a new 18-week clock will be started for you and you can expect to start your treatment within 18 weeks.
Starting a new 18-week clock In certain cases you may start a new 18-week clock. This is normally: following a period of active monitoring (as above), when your clinician feels it is now appropriate to start treating you; if you are having a bi-lateral procedure such as two cataract operations, two hip replacements or two knee replacements. In these cases your original 18-week clock will stop when you are admitted for your first operation and a new clock will be started when your clinician tells you that you are fit and ready for the second operation; if, for whatever reason it is decided that your current treatment plan needs to be changed to something new and substantially different, then you will start a new 18-week clock. The clock will stop when your new treatment is started. What if it s not appropriate to treat you in 18 weeks? In very few cases it would not be in a patient s best interest to start their treatment within 18 weeks. These cases are known as clinical exceptions. If we do not feel that it is in your best interest to treat you within 18 weeks and if we did it might compromise your care, then we will explain this to you. What happens if you are not well enough to have your operation? Sometimes patients are not well enough to have their operation. If this is just a temporary illness such as a cold or flu then your admission may be delayed but your 18-week clock will continue and we will try to admit you as soon as possible when you are well. Sometimes during the course of investigations or at pre-operative assessment, other illnesses or conditions may be discovered. In some cases, for example the discovery of a previously undiagnosed heart condition, it may be unsafe to proceed with your operation because of the risks this might involve. If there is no immediate prospect of carrying out your operation until you are fit enough for surgery, your 18-week clock will be stopped. When you are fit enough to have surgery, which may be quite some time ahead, you will start a new 18-week clock. Offering you an admission date If you do require surgery, we will give you two reasonable offers for your admission date. By reasonable we mean that the first offer date must be at least three weeks ahead of the date when the offer is made. If you turn down the two reasonable offers and choose a later date (for your own personal reasons) then you are pausing your waiting time clock. This means we may be unable to treat you within 18 weeks. In such cases you are deemed to have chosen to wait longer than 18 weeks. By choosing to wait longer than 18 weeks you give up your right to treatment by an alternative provider. Our clinicians have agreed that any patient who chooses to delay their operation for more than three months may be potentially putting themselves at harm or compromising the outcome of their treatment. If you choose to delay your operation for more than three months, your notes will be reviewed to see if this is clinically appropriate and our consultant may contact you to discuss this. Helping us treat you within 18 weeks In order to treat you and other patients within 18 weeks we have agreed with our clinicians and patient representatives the following rules as to how we will interact with you. All of these are in line with the national rules on measuring 18 week waiting times. If you do not attend your first outpatient appointment without giving us notice If the clinician to whom you have been referred does not consider that it would compromise your care, you will be discharged back to your GP. You will have to make contact with your GP who, if appropriate, will refer you again to us. Your 18- week clock will start from zero again when you are re-referred and we receive your referral. If the clinician considers it is important that we re-book your appointment then your clock will start on the day that we agree your new appointment date. Note that this is not the date of your new appointment.
If you do not attend subsequent outpatient appointments without giving us notice Again, your clinician will take a view as to whether discharging you back to the care of your GP will compromise your care or not. If your care would not be compromised, you will be discharged back to your GP. You will have to make contact with your GP who, if appropriate, will refer you again to the hospital. Your 18-week clock will start from zero again when you are re referred and we receive your referral. If you provide us with notice of the cancellation we will offer you another appointment without discharging you back to your GP. If you feel you do not need your appointment, please cancel this with as much notice as you can and inform our Appointment Centre that you wish to be discharged and why. If you choose appointment dates for outpatient appointments or diagnostic tests that make it impossible to start your treatment within 18 weeks from referral In such cases you are deemed to have chosen to wait longer than 18 weeks. By choosing to wait longer than 18 weeks you give up your right to treatment by an alternative provider. Contacting you about your appointments In order to make the best use of our resources we try to make sure that patients are aware of their appointments and in order to do this: we will make two attempts to call you by telephone during office hours and one out of hours to arrange an appointment with you; we will spread these calls over two days and try at different times of day; if we cannot speak to you, we will write to you offering you a fixed appointment with at least three weeks notice; if this fixed appointment is not convenient, we ask you to call us as soon as possible to rearrange a convenient date. What if you feel you have been waiting too long? If you feel that your treatment has not started within 18 weeks since you were referred or that there is a risk that you will not be treated within 18 weeks then please contact us. What we will do We will check how long you have been waiting and what is planned to happen to you next. We will confirm to you if it is or is not possible to treat you within 18 weeks. If it s not possible to treat you within 18 weeks: we can offer you the choice of staying under the care of your current consultant and wait longer than 18 weeks for the start of your treatment (note: this will still be recorded as a failure on our part); we will investigate and offer you a clinically appropriate alternative provider who would be able to treat you sooner. If we cannot offer you an alternative provider who could treat you sooner: If we are unable to offer you an alternative provider who could treat you sooner than us, we will confirm this to you and advise you whom to contact next. This will normally be the Clinical Commissioning Group (CCG) which is responsible for commissioning your healthcare. For certain specialist services this could be NHS England.
Contacting us For general enquires: For changes to a first outpatient appointment please contact the Appointment Centre on 01473 702400 a detailed list of specialties and variations is also shown on this page. For changes to a follow-up outpatient appointment please contact the Follow-up Centre on 01473 703162 a detailed list of specialties and variations is shown on the next page. Please contact your consultant s secretary for advice in the first instance in relation to your treatment dates and for rebooking any procedures or surgery you have been booked for. Other useful contact telephone numbers: Patient Advice &Liaison Service (PALS)... 01473 704781 Outpatient Team Leaders... 01473 704464 Emergency Department... 01473 702033 Departmental First Appointment Teams Antenatal... 01473 703102 Diabetes and Endocrine... 01473 704180 Eye Clinic... 01473 703230 Hand Therapy... 01473 703312 Nutrition and Dietetics... 01473 704001 Oncology... 01473 704925 Orthotics... 01473 703302 Paediatrics... 01473 702181 Physiotherapy and Hand Therapy... 01473 703312 Physiotherapy (Paediatric)... 01473 702185 Physiotherapy (Fynn)... 01473 703522 First Appointment Call Centre Audiology... 01473 702400 Breast Surgery... 01473 702400 Cardiology... 01473 702400 Colorectal Surgery... 01473 702400 ENT... 01473 702400 Gastroenterology... 01473 702400 General Medicine... 01473 702400 General Surgery... 01473 702400 Gynaecology... 01473 702400 Lipid... 01473 702400 Nephrology... 01473 702400 Neurology... 01473 702400 Oral Surgery... 01473 702400 Orthodontics... 01473 702400 Paediatrics... 01473 702400 Pain Management... 01473 702400 Plastic Surgery... 01473 702400 Respiratory... 01473 702400 Rheumatology... 01473 702400 Upper GI Surgery... 01473 702400 Urology and Testicular... 01473 702400 Vascular... 01473 702400 Indexing Team... 01473 702400 Diagnostic Appointment Teams Breast Screening... 01473 703344 Endoscopy... 01473 702653 Neurophysiology... 01473 704005 MRI... 01473 703678 X-ray... 01473 703382 Ultrasound... 01473 703376
Contacting us Follow-up Appointment Centre For FOLLOW-UP appointments only: Antenatal... 01473 703102 Audiology... 01473 703117 Breast Surgery... 01473 703162 Cardiology... 01473 703062 Colorectal Surgery... 01473 703162 Dietetics... 01473 704001 ENT... 01473 703110 Gastroenterology... 01473 703162 General Medicine... 01473 703162 General Surgery... 01473 703162 Gynaecology... 01473 703660 Lipid... 01473 703162 Nephrology... 01473 703162 Neurology... 01473 703162 Oral Surgery... 01473 703200 Orthodontics... 01473 703200 Paediatrics... 01473 702181 Pain Management... 01473 703436 Physiotherapy... 01473 703110 Respiratory... 01473 703162 Rheumatology... 01473 703526 T&O... 01473 702050 Upper GI... 01473 703162 Urology... 01473 703162 Vascular... 01473 703162 Reception-based Services including follow-up booking Antenatal... 01473 703102 Dermatology... 01473 704169 Diabetic Foot Clinic... 01473 704912 ENT... 01473 703110 Gynaecology... 01473 703660 Lung Function... 01473 703250 Maternity... 01473 703108 Oral Surgery... 01473 703200 Orthodontics... 01473 703200 Paediatrics... 01473 702181 Pain Management... 01473 703436 Physiotherapy... 01473 703312 Rheumatology... 01473 703526 T&O... 01473 702050
If you want to know more about your right to be treated within 18 weeks If you want to know more about your rights under the NHS Constitution, please visit the following website: https://www.gov.uk/government/publications/the-nhs-constitution-for-england If you want to know more about the rules governing 18-week waiting times If you want to know more about the rules governing 18-week waiting times, please visit the following website: http://www.england.nhs.uk/statistics/rtt-waiting-times/rtt-guidance/ Produced by: The Ipswich Hospital NHS Trust Heath Road, Ipswich, Suffolk IP4 5PD Hospital switchboard: 01473 712233 www.ipswichhospital.nhs.uk DPS: 00037-16 Issue 1: April 2016 Review date: March 2019 The Ipswich Hospital NHS Trust, 2016. All rights reserved. Not to be reproduced in whole, or in part, without the permission of the copyright owner.