Waiting times

A waiting time is the time it takes for a patient to receive treatment after being referred to hospital.

The length of time a patient will wait depends on:

  • the nature of their condition
  • the complexity of the condition
  • how easy the condition is to diagnose

Further information about waiting times in Scotland.

A&E (Accident and Emergency) waiting times

The Scottish Government has set a target that 95% of people attending A&E (Accident and Emergency) should be seen, admitted, discharged or transferred within 4 hours. Unfortunately due to the current pressures on services it may take longer for you to be seen.

Phone 111 if it's not an emergency but you think you need A&E. This may give you access to:

  • a virtual consultation with an A&E consultant
  • an appointment for the healthcare you need

Waiting times standards

Waiting time standards set out the amount of time a patient will wait at each stage from referral to treatment.

The current waiting times standards for acute hospital care (including hip, knee or cataract removal surgery) are:

  • 6 weeks for the 8 key diagnostic tests and investigations
  • 12 weeks for new outpatient appointments
  • 12 week treatment time guarantee
  • 18 weeks for an outpatient appointment, diagnostic tests (if required) and treatment (if appropriate)

The Scottish Government provides further guidance around the Waiting Times Standard.

Examples

The type of diagnosis you receive can affect your expected waiting times with the NHS. For example, your diagnosis can be simple or complex.

Simple diagnosis

Most patients will have conditions that are simple to diagnose. Most need only one diagnostic test, if any at all.

The waiting time for these patients should be short. A patient will be treated within the 18 weeks Referral To Treatment Standard.

90% of patients should be seen and treated within this standard.

Example of a simple diagnosis

The following example shows how a simple diagnosis can lead to a short waiting time:

  1. After visiting your GP with symptoms, they think it's necessary to refer you to hospital.
  2. Your referral is received and you agree to attend an outpatient appointment 4 weeks later.
  3. At your appointment, a diagnosis is given and you agree to inpatient or day case treatment.
  4. You start treatment 6 weeks later.

In this example your waiting time had been 10 weeks, well within the 18 weeks standard.

Complex diagnosis

In some instances, it might not be possible to keep within the 18 weeks standard. Some patients require many tests before a diagnosis can be made.

The waiting time for these patients will be much longer and could be more than the initial 18 weeks.

The legal Treatment Time Guarantee will still apply and will start when treatment is agreed.

Example of a complex diagnosis

The following example shows how a more complex diagnosis can lead to a much longer waiting time:

  1. After visiting your GP with symptoms, they feel it's necessary to refer you to hospital.
  2. Your referral is received and you agree to attend an outpatient appointment 6 weeks later.
  3. At your appointment, it's decided you have to have 4 different diagnostic tests to determine your illness and appropriate treatment.
  4. It takes 12 weeks to do all 4 tests.
  5. After the test results are confirmed and a diagnosis made, you agree to inpatient or day case treatment.
  6. You start treatment 8 weeks later.

In this example your waiting time has been 26 weeks. This falls outside of the 18 weeks standard but within the legal guarantee.

Not included in the 18 weeks Referral to Treatment Standards

Some treatments and services are not covered by the 18 week Referral to Treatment Standard. This includes:

  • fertility treatment
  • obstetrics services (the care of pregnant mothers and their babies before and after the birth)
  • organ and tissue transplantation
  • direct referrals to Allied Health Professionals (AHPs)
  • dental treatment provided by undergraduate dental students
  • direct access referrals to diagnostic services
  • mental health services

Treatment Time Guarantee

The Patient Rights (Scotland) Act 2011 sets out a 12 week legal guarantee for inpatient and day case treatment.

After a diagnosis is made and treatment is agreed, each health board must ensure that patients receive inpatient and day case treatment within 12 weeks. This is called the legal Treatment Time Guarantee.

The impact of the coronavirus pandemic on NHS Scotland has led to a backlog of care. This means some patients are waiting longer than the 12 week period the NHS aims for through the Treatment Time Guarantee.

Ambitious new targets have been set out for NHS Scotland to address the impact of the pandemic on long waiting times for planned care.

Treatment Time Guarantee Regulations

The Scottish Government have produced regulations for the guarantee outlining:

  • which patients are eligible for the guarantee
  • which treatments and services are not covered
  • how the guarantee is calculated

Read the Treatment Time Guarantee Regulations

Treatment Time Guarantee Directions

The Scottish Government have also produced directions for the guarantee outlining:

  • the arrangements for monitoring and recording the guarantee
  • the required communications with patients

Read the Treatment Time Guarantee Directions

Other waiting time standards

There are more Scottish Government waiting time standards for other areas of care, like cancer.

Further information about waiting times standards.

The waiting times clock

The waiting times clock is a common term used to describe how waiting times work.

The waiting time clock will start and stop depending on where the patient is in the process from referral to treatment. This is to calculate how long a patient has waited.

The waiting time clock can be affected by different things. This includes the type of condition and how it'll be treated.

Sometimes the waiting times clock may also be adjusted because the patient:

  • has given reasonable notice that they cannot attend an appointment
  • is unable to attend or did not attend an appointment
  • refuses a reasonable offer of an appointment
  • is unavailable for treatment
Examples of the waiting times clock

18 Weeks Referral to Treatment

Under 18 Weeks Referral to Treatment, the clock:

  • starts on the date when the referral is received
  • stops on the date when the treatment starts

Treatment Time Guarantee

Under the legal Treatment Time Guarantee, the clock:

  • starts on the date the clinician and patient agreed treatment
  • stops on the date the patient starts to receive the agreed treatment

New outpatient appointments

For new outpatient appointments, the clock:

  • starts on the date the referral is received
  • stops on the date of the new outpatient appointment

Diagnostic tests and investigations

For the 8 key diagnostic tests and investigations, the clock:

  • starts when the request for the test is received within the department
  • stops when the verified report has been received or made available

Help and support with waiting times

To get further information on waiting times, contact your local health board. They can answer questions about specific waiting times and offer further advice.

Rights and responsibilities

You have certain rights and responsibilities when using the NHS in Scotland. These come under the Charter of Patients Rights and Responsibilities.

For waiting times, it's important that these rights and responsibilities be respected. This makes sure that patients receive treatment in the shortest time possible.

Your rights and responsibilities apply to waiting times in the following ways:

  • availability
  • appointments
  • attendance

Availability

Availability refers to how able and willing a patient is to have treatment. Patients may be unavailable for a variety of reasons, both medical and personal.

What you can expect

When deciding if you are available for treatment, health boards must:

  • write to inform you if you've been removed from a waiting list for being indefinitely unavailable for treatment
  • inform you if your unavailability is for a known period and state the period of unavailability
  • make sure you are not added to a waiting list if there is no known end date to your unavailability
  • ensure that your availability is reviewed after 12 weeks and again after a further 12 weeks
  • refer you back to your GP if you remain unavailable after 2 reviews
  • record the start date, review date and reason for the unavailability

What's expected of you

When deciding your availability for treatment, you must tell the health board if you're unavailable for treatment for a known period. You should also provide a start and end date for this period.

Appointments

Appointments are an agreement between a patient and a health board about when the patient will attend hospital.

Patients will receive a reasonable offer of 2 or more appointment dates. This happens for each stage of the referral to treatment process.

What you can expect

When offering you an appointment, health boards must:

  • give you at least 7 days notice of an appointment but, where possible, send notice 14 days before the appointment
  • inform you of the consequences of refusing a reasonable offer
  • send details of your appointment in a format appropriate to your needs
  • tell you how long the appointment will last before you attend
  • ensure that any additional needs are taken into account
  • put support in place when offering an appointment
  • tell you as early as possible if you'll need to travel for treatment

If the board breaches the Treatment Time Guarantee, they must offer you the next appointment available. They must also explain why the guarantee wasn't met.

Health boards will try to offer you an appointment in your local area. However, you may be offered an appointment outside your local health board. This is to make sure you're seen as quickly as possible. You could be seen at another local health board or hospital, or a National Treatment Centre. You'll be told as soon as possible if this applies to you. 

What's expected of you

You must consider all reasonable offers of appointment that are made by the health board. You should also make every effort to agree terms.

If you refuse 2 or more reasonable offers, the health board may refer you back to your GP. They may also reset your waiting time clock to zero if it's reasonable and clinically appropriate to do so.

Attendance

Attendance refers to whether a patient attends their appointment at the agreed time.

Patients might not attend their appointments for many reasons. However, it's important that health boards are made aware of the reasons for not attending in good time.

If you did not attend your appointment and did not give notice, you may be referred back to your GP. They may reset your waiting time clock to zero if it's reasonable and clinically appropriate to do so.

What you can expect

After an appointment has been made, health boards must:

  • inform you of the consequences of cancelling and not attending an agreed appointment
  • seek clinical advice before referring you back to your GP
  • not disadvantage you through the cancellation of appointments due to operational circumstances

What's expected of you

You must give notice if you cannot attend your appointment. If you cancel an appointment for the third time you'll be referred back to your GP. Your waiting time clock will also be reset if it's clinically appropriate to do so.

You must inform the health board if you have a valid reason that prevents you from attending. This includes minor illness.

Last updated:
06 September 2022