* Data is being published on Referral to Treatment (RTT) times for patients whose 18 week clock stopped during March 2008.

* Data for admitted patients (patients whose 18 week clock stopped with an inpatient/ day case admission) has been published each month since June 2007 on an unadjusted basis. See statistical notes.

* Data for admitted patients (patients whose 18 week clock stopped with an inpatient/ day case admission) is published this month for the first time on an adjusted basis. See statistical notes.

* Data for non-admitted patients (patients whose 18 week clock stopped during the month for reasons other than an inpatient/day case admission) and incomplete RTT times for patients whose 18 week clock is still running was published for the first time in November 2007.

* The NHS Improvement Plan, published in July 2004, stated "By 2008, no one will have to wait longer than 18 weeks from GP referral to hospital treatment..." - DH PSA target 13. This data is being used to monitor progress towards this target. For admitted patients, adjusted data is used to assess performance.

* Publication is an important mechanism in order to improve coverage and completeness of the data.

* A data completeness assessment is being published alongside the reported figures in order to aid interpretation of the data. The methodology on data completeness has been further refined prior to this publication. Further details are available here.

Table 1 - RTT data by Strategic Health Authority (commissioner based) - admitted and non-admitted data - March 2008

* Table 1 shows the proportion of patients seen within 18 weeks by Strategic Health Authority for admitted and non-admitted pathways.

* The data is accompanied by a data completeness assessment for each Strategic Health Authority.

* The data completeness assessment compares the number of completed pathways with a known clock start reported in the RTT return against the expected number of pathways.

* In total, 281,000 admitted patients and 738,000 non-admitted patients, for whom English commissioners are responsible, completed their RTT pathway during March 2008.

* The NHS reported both the clock stop and the clock start for 279,000 (99%) of completed admitted pathways and 734,000 (99%) of completed non-admitted pathways.

* Of those pathways with both a known clock stop and a known clock start, 87% of admitted patients (adjusted) and 93% of non-admitted patients completed their referral to treatment pathway within 18 weeks.

* For March, seven provider organisations submitted adjusted data in their unadjusted return.

Table 1a - Admitted data by Strategic Health Authority

(*) - The number of completed admitted pathways with a known referral date (from the RTT return) is compared with the number expected (based on monthly elective admissions data adjusted for admissions that do not end RTT pathways). See data completeness methodology paper published here.

Table 1b - Non-Admitted data by Strategic Health Authority

(**) - The number of completed non-admitted pathways with a known referral date (from the RTT return) is compared with the number of first attendances seen from the quarterly return QAR Q3 2007/08 data (adjusted to include all RTT pathways) minus the expected number of admitted clock stops. See data completeness methodology paper published here.

Table 2 - Referral to Treatment (RTT) Times - by time band (commissioner based) - March 2008

* This table shows the distribution, in time bands, of the completed admitted and non-admitted pathways with a known clock start.

Table 3 - Proportion of patients seen within 18 weeks - by treatment function (commissioner based) - March 2008

* This table shows the RTT data by treatment function (treatment functions in alphabetical order).

Table 4 - Proportion of patients seen within 18 weeks and data completeness - by Primary Care Trust (commissioner based)

Statistical Notes

1. Referral to Treatment (RTT) times

RTT data is collected from English Primary Care Trusts on a responsible population basis (see note on next page) and from NHS Trusts on a provider basis.

The NHS Improvement Plan, published in July 2004, stated "By 2008, no one will have to wait longer than 18 weeks from GP referral to hospital treatment..." - DH PSA target 13. The RTT data measures referral to treatment (RTT) times in weeks, split by treatment function. The length of the RTT period is reported for patients whose 18 week clock stopped during the month.

The Department of Health published the 18 Weeks Rules Suite on 28 November 2007. The documents can be found here.

The rules for the data collection are based on those set out in the rules documents.

The data collection is in three parts:

Part 1a - Completed pathways - admitted
Part 1b - Completed pathways - non-admitted
Part 2 - Incomplete pathways

The return includes all patients whose 18 week clock stopped at any point in the reporting period. A column has been provided to enter data for patients whose length of RTT period is unknown, i.e. patients who have had a clock stop during the month but where the clock start date is not known.

For non-admitted patients, the RTT time is measured on an unadjusted basis - from the date the 18 week clock starts to the date that the 18 week clock stops, as detailed in DSCN 17/2006. For admitted patients, the RTT time is measured on an adjusted basis - from the date the 18 week clock starts to the date that the 18 week clock stops, allowing for legitimate pauses as described in the above 18 Weeks Rules Suite and outlined in the Operating Framework for 2008/09 paragraphs 2.24 to 2.28.

2. Provider and Commissioner based data

There are fundamental differences in coverage between commissioner based and provider based information. Commissioner based returns exclude all patients living outside England and all privately funded patients waiting for treatment in NHS hospitals. However they do include NHS funded patients, living in England, who are waiting for treatment in Scotland, Wales and Northern Ireland, abroad, and at private hospitals; these patients are not included in the corresponding hospital based returns.

Commissioner based returns reflect responsible based populations, which is defined as:

Responsible Population:

* all those patients resident within the PCT boundary; plus
* all patients registered with GPs who are members of the PCT, but are resident in another PCT; minus
* All patients resident in the PCT, but registered with a GP who is a member of another PCT

Additional Information

Full details of RTT data for individual organisations is available at: performance.doh/rtt

dh