Part of the NHS pledge to put patients at the centre of everything they do involves making sure that you are diagnosed and start treatment as soon as possible, at a time that is convenient for you.

The NHS Constitution says you have the right to access certain services commissioned by NHS bodies within maximum waiting times. Where this is not possible and you ask for this, the NHS will take all reasonable steps to offer you a range of suitable alternative providers.

What are maximum waiting times?

You have the legal right to start your NHS consultant-led treatment within a maximum of 18 weeks from referral, unless you choose to wait longer or it is clinically appropriate that you wait longer.

Consultant-led treatment includes treatments where a consultant retains overall clinical responsibility for your treatment. This could include treatments provided by the service or team led by your consultant. The setting of your consultant-led treatment, whether hospital-based or in a community-based clinic, will not affect your right to start treatment within 18 weeks.
If you cannot be seen within the maximum waiting time the organisation that commissions and funds your treatment (CCGs or NHS England) must investigate and offer you a range of suitable alternative hospitals or community clinics that would be able to see or treat you more quickly. Your local CCG or NHS England must take all reasonable steps to meet your request. However, you will need to contact the hospital before alternatives can be investigated for you.

If you are waiting longer than 18 weeks and wish to investigate alternative providers, please contact the Patient Advice and Liaison service and they can help you commence this process.

Patients with urgent conditions such as cancer and heart disease will be able to see a specialist more quickly. For example, you have the right to be seen by a specialist within a maximum of two weeks from GP referral for urgent referrals where cancer is suspected.

Note: Referrals for investigations of breast symptoms where cancer is not initially suspected are not urgent referrals for suspected cancer, therefore, they fall outside the scope of this right.

A detailed list of rights and pledges regarding waiting times can be found on page 27 of the Handbook to the NHS Constitution (PDF, 798kb).

How is your waiting time calculated

If a GP, dentist, optician or other clinician refers you for hospital treatment, the clock starts when you book your first appointment or when your referral letter is received by the hospital. In other words, measurement of the time you wait starts from this point.

When you see a clinician at your chosen hospital or clinic you may:

  • undergo tests, scans or other procedures to help ensure that your treatment is tailored appropriately to your condition
  • have medication or therapy to manage your symptoms until you start treatment
  • be referred to another consultant or department

The clock will stop (your waiting time ends) if no treatment is necessary or when your treatment begins. This could include:

  • being admitted to hospital for an operation or treatment
  • starting treatment, such as taking medication, that doesn’t require you to stay in hospital
  • beginning your fitting of a medical device, such as leg braces
  • agreeing to your condition being monitored for a time to see whether you need further treatment
  • receiving advice from hospital staff to manage your condition

If you want to delay your hospital admission, for example because of a planned holiday, the NHS may temporarily pause the clock.


The right to start treatment within 18 weeks does not apply:

  • if you choose to wait longer
  • if delaying the start of your treatment is in your best clinical interests, for example where stopping smoking or losing weight is likely to improve the outcome of the treatment
  • if it is clinically appropriate for your condition to be actively monitored in secondary care without clinical intervention or diagnostic procedures at that stage
  • if you fail to attend appointments that you had chosen from a set of reasonable options, or
  • if the treatment is no longer necessary

The following services are not covered by the right:

  • mental health services that are not consultant-led
  • maternity services
  • public health services commissioned by local authorities