NHS RTT definitions and glossary

A clinically appropriate period of monitoring with no treatment, which stops the clock.

Started by clinician or patient decision. A new clock starts if the patient subsequently needs treatment. Heavy use of active monitoring can materially change reported waiting-list size, so it is worth checking when comparing trusts.

Also known as: watchful waiting

A completed pathway where first definitive treatment was delivered via admission.

Includes day case and inpatient treatment. Reported monthly as completed (clock-stopped) admitted pathways with the wait length at the point of treatment.

The date the waiting-time clock begins on an RTT pathway.

A clock starts on the date a referral for consultant-led care is received by the provider, when a patient re-enters the pathway after active monitoring, or when a decision to treat is made following a substantively new condition or a consultant-to-consultant referral within agreed local rules.

The event that ends the waiting-time clock.

Clock stops occur at first definitive treatment (admitted or non-admitted), on a decision to start active monitoring, when it is decided no treatment is required, when the patient declines treatment, or when the patient DNAs their first appointment and is discharged under agreed rules.

A patient still waiting — the clock is running at the census date.

Incomplete pathways are the live waiting list at month end. This is the basis of the headline 18-week and 52-week-plus standards, and of the backlog figures used across this platform.

Also known as: incompletes, open pathway, waiting list

A patient still waiting who already has a Decision To Admit for treatment.

These patients are waiting for an admitted (usually surgical or day-case) episode. They are a subset of incomplete pathways and are the numerator used in the platform's backlog-clearance calculation.

Also known as: dta, decision to admit

A completed pathway where treatment did not require admission.

Typically outpatient treatment, medication, therapy or a decision that no treatment is required. Combined with admitted pathways, these make up total closed (completed) pathways in a month.

Also known as: not admitted

Care scheduled for a clinical reason at a future date — not part of RTT waiting times.

For example a surveillance endoscopy at a set interval. Planned patients are excluded from RTT incomplete waits; if care is not delivered on time they should be moved onto an active waiting list.

The consultant-led waiting time standard measuring the wait from referral to first definitive treatment.

An RTT pathway starts when a provider receives a referral for consultant-led care (or a self-referral where agreed) and ends at first definitive treatment, or another recognised stopping point such as a decision that treatment is not required, active monitoring, or the patient declining treatment. National reporting is monthly by provider, commissioner and specialty.

Also known as: referral to treatment, rtt

92% of patients should start treatment within 18 weeks of referral.

In this platform the 92% standard is quoted against referral-to-treatment performance: completed admitted pathways where treatment began within 18 weeks of referral. The separate '% of the incomplete waiting list waiting under 18 weeks' describes the shape of the list — how long people still waiting have waited so far — and is benchmarked against the national mean and rank, never against the 92% standard. Never read one as the other.

Also known as: 92%, 18 weeks, referral to treatment standard

Patients waiting more than 52 weeks on an incomplete pathway.

Long waits are the main focus of elective recovery. 52+ weeks is the longest wait band the published RTT collection provides, so RTT Insight cannot break out 65-week or 78-week cohorts. The 52+ band can be broken down by trust, ICB and specialty to identify which providers drive national totals.

Also known as: 52+, long waits

Clearance measured against patients with a decision to admit.

Takes only incomplete pathways with a decision to admit (DTA) and divides by the average monthly ADMITTED completions over the last three months — not all completed pathways, because this list is cleared by admitted activity. Reflects pressure on admitted (usually surgical and day-case) capacity.

Also known as: dta basis, admitted backlog

How long it would take to clear the current waiting list at recent activity levels.

Backlog ÷ average monthly closed pathways (admitted + non-admitted) over the last three months, scoped to the chosen ICB, trusts and specialty. Three bases are available: total waiting list, admitted only, and the true (burdened) waiting list. All three assume no new patients enter the pathway, so they are indicative capacity measures rather than forecasts.

Also known as: clearance, time to clear, burn-down

Completed admitted pathways ÷ all completed pathways, summed over the last 3 months.

r = sum of completed ADMITTED pathways ÷ sum of ALL completed pathways (admitted + non-admitted), with numerator and denominator each summed over the most recent three months so a single month's activity does not distort it. It is NOT completed pathways ÷ referrals. r is computed per trust and used to burden the non-DTA list in the true (burdened) waiting list calculation.

Also known as: conversion rate, r value, admitted share of completions

The wait length at the 50th percentile — only meaningful once you say which pathways it covers.

A median is less distorted by extreme long waits than the mean, so it is the preferred headline for comparing trusts of different sizes. It must always be filtered to one pathway type, otherwise it averages completed and incomplete pathways together and means nothing. RTT Insight reports three: median weeks wait from referral to admission (completed admitted pathways — the basis of the national target); median weeks wait for all incomplete pathways (how long patients still waiting have waited so far); and median weeks wait for patients with a decision to admit (a higher clinical risk cohort waiting for admission). Lower is better in each case.

Clearance measured against every incomplete pathway.

Takes all incomplete pathways at the latest period and divides by the average monthly closed pathways over the last three months. The broadest view of how long the whole list would take to clear.

Also known as: whole waiting list, complete waiting list

The share of completed admitted pathways where treatment began within 18 weeks of referral.

Calculated as admitted completed pathways with a wait under 18 weeks divided by all admitted completed pathways in the period. It measures referral to TREATMENT. The same calculation across all completed pathways (admitted plus non-admitted) is a clock-stop measure rather than a treatment measure, because a non-admitted clock stop can be a decision not to treat.

Also known as: referral to treatment within 18 weeks, RTT 18 weeks, treated in time

DTA patients plus the share of non-DTA patients expected to convert to admission.

Calculated as DTA patients + (estimated conversion rate r × non-DTA patients), then divided by the average monthly ADMITTED completions over the last three months. r is computed per trust as that trust's completed ADMITTED pathways ÷ ALL completed pathways, each summed over the most recent three months, so systems with different admitted/non-admitted mixes are not distorted by a single blended rate. It sits between the admitted-only and total bases and estimates the realistic admitted burden ahead.

Also known as: burned list, burdened list, true waiting list

The grouping of waits into week ranges (e.g. 0–18, 18–52, 52+).

National returns split the waiting list into weekly bands. The dashboard's Wait Category filter groups these into readable ranges so you can compare shape of waiting lists, not just totals.

Also known as: wait bands, weeks banding

Otolaryngology — a high-volume specialty with substantial paediatric activity.

Frequently one of the largest contributors to long waits alongside T&O and Ophthalmology, particularly for day-case procedures.

Also known as: ent, otolaryngology

Residual grouping for non-surgical consultant-led activity outside named specialties.

Covers medical treatment functions not separately reported (for example smaller medical sub-specialties). As with other residual groupings, coding practice varies between trusts, which limits like-for-like comparison.

Also known as: other medical

Residual grouping for consultant-led mental health treatment functions.

Only consultant-led mental health pathways subject to RTT are included; most community and talking-therapy services are reported through separate national collections.

Residual grouping for paediatric treatment functions outside named specialties.

Named paediatric specialties (for example paediatric surgery) report separately; the remainder is aggregated here.

A residual national grouping for surgical activity not covered by a named RTT specialty.

NHS England collects RTT by treatment function. Activity in smaller or unlisted surgical treatment functions is aggregated into 'Other — Surgical services'. It is a catch-all, so its size varies with local coding practice and it should not be read as a single clinical service. Always check named specialties before drawing conclusions from this line.

Also known as: other surgery, other surgical

The largest surgical specialty by waiting list volume in most trusts.

Covers joint replacement, spinal, hand and trauma work. Typically dominates 52+ week cohorts and backlog-clearance pressure.

Also known as: t&o, trauma and orthopaedics, ortho

The national code identifying the specialty a pathway is reported under.

RTT is collected by treatment function rather than by consultant specialty. Differences in how trusts map local services to treatment functions are a common source of apparent variation between providers.

Also known as: tfc

The statutory NHS body responsible for planning and commissioning care in an area.

ICBs replaced CCGs in July 2022. In this platform, ICB is the commissioner-level grouping; selecting an ICB filters the trust list to providers associated with that ICB.

Also known as: icb, ics, integrated care system

Non-NHS providers delivering NHS-funded elective care.

Independent sector activity is reported separately in national collections and can materially affect an ICB's total elective picture even where NHS trust performance is unchanged.

Also known as: isp, independent sector

The organisation delivering the care and submitting the RTT return.

Reporting is at organisation (trust) level, identified by ODS code. Mergers and code changes mean historical comparisons occasionally break; the platform uses the current organisation naming.

Also known as: trust, provider, acute trust

New RTT data is published monthly by NHS England and loaded into the platform.

Figures are provisional at first publication and can be revised. Comparisons across long time series should allow for revisions and for periods where reporting was suspended or incomplete.

Months where a trust did not submit a valid RTT return.

Gaps in a trust's time series usually indicate non-submission (often during system migrations) rather than zero activity. National and ICB totals for those months are understated accordingly.

The month the data relates to, shown as Month-Year in the dashboard.

Underlying data stores periods as YYYYMM (for example 202605). The dashboard and reports display the readable Month-Year form; both refer to the same month-end census.

Also known as: periodstring, yyyymm

The month-end position of the waiting list used for incomplete-pathway measures.

Incomplete measures are a point-in-time census; completed (admitted/non-admitted) measures are activity across the whole month. Mixing the two without care is a common analytical error.