The NHS 18-Week Elective Care Target, also known as Referral to Treatment (RTT), is a key NHS standard for planned (non-emergency) care in England.
What it means
The target states that:
At least 92% of patients should start consultant-led elective treatment within 18 weeks of referral.
What counts as the 18 weeks
- Start of the clock: When a GP or another healthcare professional refers a patient for consultant-led treatment.
- End of the clock: When the patient:
- Begins treatment (e.g. surgery, therapy, or another definitive intervention), or
- Is formally told that treatment is not necessary, or
- Declines treatment or is discharged back to primary care.
What services it applies to
- Consultant-led elective services such as:
- Surgery (e.g. orthopaedics, general surgery)
- Outpatient medical specialties
- It does not apply to:
Current context
- The 18-week RTT target was introduced in 2008
- Performance has declined in recent years due to:
- Rising demand
- Workforce and capacity pressures
- COVID-19 backlogs
The 92% standard remains the official target, but it is not currently being met nationally, and recovery plans focus on reducing the longest waits first.
