1. 18 Weeks Referral To Treatment Waiting Times Standard
Joyce Wardrope
Health Information Consultant

2. RTT - Whole Journey
From date referral received to date of commencement of definitive treatment
Inclusive of:
OP attendance + DC/IP procedure

3. Current ‘Stage of Treatment’ MeasuresOP
Diagnostics
IP/DC
12 WEEKS
4 WEEKS
9 WEEKS

4. Current ‘Stage of Treatment’ Measures for Cancers
Urgent Suspicion of Cancer (USC) referral
62 days from date referral received to commencement of treatment
Routine referral
31 days from decision to treat to commencement of treatment
Both are whole journey measurements

5. Existing Stage of Treatment Measures
OP Outcomes for New and Review attendances
Patient seen
DNA - Did Not Attend
CNA - Cannot Attend

6. RTT - Whole Journey Measurement
From date referral received to date of commencement of definitive treatment
Inclusive of:
OP attendance + DC/IP procedure

7. 18 weeks from referral to treatment for
18 week Measure OP
Diagnostics
IP/DC
18 weeks from referral to treatment for
ALL source referrals

8. What we need to measure Starting point – date referral received
End point – date treatment commenced
One journey

9. Here is Edward Bear, coming downstairs now, bump, bump, bump, on the back of his head behind Christopher Robin. It is, as far as he knows, the only way of coming downstairs, but sometimes he feels there really is another way, if only he could stop bumping for a moment and think of it. “A.A. Milne, Winnie the Pooh

10. 18 week RTT where we are now
Principles and Definitions – Jan’09
Under review to include Dental, Fitting of Devices, LTC, 1 Stop services, Aesthetic exclusions etc
‘Frequently Asked Questions’ from T&F Groups
Methodology for Measurement of AP & NAP
Unique Care Pathway Number – from referral
Recording Clinic Outcome Codes July‘09
Minimum Data Set for onward referrals Jan’10

11. 18WRTT Clinic Outcome Recording
8 Clock stops codes
Therapeutic treatment commenced
Medical treatment to be prescribed by GP
Patient fitted with medical device
Patient declined treatment
No treatment required / patient discharged
Patient DNA – no further appointment
Return OP appointment – treatment already started /complete

12. 18WRTT Clinic Outcome Recording
9 Clock still ticking codes
Add to waiting list (including admission today)
Admit today for diagnostic test or test result
Refer for diagnostic test
Refer for treatment to Nurse / AHP
Refer for investigation/ treatment to another clinician same condition & retain responsibility for care
Refer for investigation/ treatment to another clinician same condition & transfer responsibility for care
Return OP appointment - continuing management pre treatment
Patient considering options
Patient DNA – further appointment

13. Benefits Allows whole journey measurement
Provides rich source of clinical information
Management of onward referrals to other specialties e.g. max fax & plastics
Eases clinical management of referrals
How many referrals were seen & treated at 1st OP
How many referrals were transferred to plastics
How many patients DNA’d with no further appt
etc

14. Long Term Benefits
Opportunity to provide evidence of treatments' in an OP setting
Opportunity to collect OP procedures
Detailed evidence for Consultant work plan
Detailed evidence for accreditation

15. Dermatology Challenges
Clinic outcomes can be locally adapted
Agree locally what you want to collect
1 referral with >1 reason for referral
How can we manage these?