Health Services: Waiting Lists
(asked on 10th December 2025) - View Source
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if he will take steps to ensure that NHS trusts do not manage referral pipelines, triage processes, or administrative allocation methods in ways that reduce the apparent size of the elective waiting list without reducing the actual waiting time experienced by patients.
For referral to treatment (RTT) pathways that start within an interface service, which is any form of intermediary clinical triage, assessment, and/or treatment between primary and secondary care, a patient's clock start will begin at the point the general practice referral is made and not the date that the referral is received by the secondary care provider. Further information can be found in the RTT consultant-led waiting times: rules suite guidance document, which is available at the following link:
The complete time elapsed between referral and treatment will be recorded on the published consultant led RTT waiting time data, at the following link:
https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-data-2025-26/
Advice and Guidance (A&G) is where a general practitioner requests advice from a specialist digitally, prior to or instead of a referral, and it has helped divert over 655,000 referrals between April and August 2025. The NHS Electronic Referral System, the platform used for most A&Gs, can allow the specialist to "convert" a request into a referral. An RTT waiting time clock would not commence unless the request is converted to a referral. Where a referral to the waiting list is not required, we expect patients to receive care sooner, in a more convenient setting, having benefitted from specialist advice to inform their care management plan.
The Medium-Term Planning Framework, published in October 2025, outlines plans to move toward delivering care through a ‘Single Point of Access’. This describes a model where all appropriate referrals and requests, other than those for urgent suspected cancer, are directed through a single ‘front door’ to support triage to the most appropriate next step or outcome for the patient. This will help ensure a more consistent approach to triage which provides quicker access to patients.
There are no plans for an independent audit of pre-listing referral management processes and reporting of delays across National Health Service trusts.