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Waiting List Letters

NHS waiting list letter explained

📖 6 min readNHS.uk sourcedUpdated April 2026
In plain English

A waiting list letter confirms that the hospital has your referral and you are in the queue. The 'RTT pathway' is the official name for that queue. Your rights depend on how long you've been waiting.

What is an RTT pathway?

RTT stands for Referral to Treatment. It is the official name for the journey from your GP referral to starting treatment. Your 'clock start date' is when the hospital received your referral — not when you got the letter.

The 18-week standard

In England, you have the right to start treatment within 18 weeks of your GP referral under the NHS Constitution. If the hospital cannot see you within this timeframe, you can request to be transferred to an alternative provider at no cost.

Note: Scotland uses an 18-week Treatment Time Guarantee. Wales uses a 26-week standard. Northern Ireland uses a 52-week target.

What to do if your wait is too long

  • Contact your GP and ask them to check the status of your referral
  • Contact the hospital's PALS team if you are in England
  • Ask to be transferred to a provider that can see you sooner — see our guide on how to chase your referral
  • If your symptoms worsen, contact your GP separately — do not wait for your appointment
Related guides
NHS appointment letter explainedWaiting list letter and your rightsRTT rights — what you're entitled to
NHS Decoder is a translation tool, not a medical service. We do not provide clinical advice, diagnoses, or treatment recommendations. For clinical questions, contact your GP or call NHS 111.

NHS.uk sourced · No medical advice given · Free to start

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