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18 weeks Referral to Treatment Standard

Under the 18 weeks Referral to Treatment Standard, a least 90% of patients should receive all of the following within 18 weeks of being referred:

an outpatient appointment

diagnostic test (if required)


Outpatient appointments

Under the 18 weeks standard, health boards should ensure that patients are seen at an outpatient appointment within 12 weeks of receiving a referral.

Diagnostic tests and investigations

Diagnostic tests and investigations are used to identify a patient's condition, disease or injury.

The eight key diagnostic tests and investigations are:

upper endoscopy

lower endoscopy (excluding colonoscopy)



computer tomography (CT)

magnetic resonance imaging (MRI)

barium studies

non-obstetrics ultrasound.

Under the 18 weeks standard, health boards must ensure that the result of any test or investigation is available within six weeks of receiving the request.


Diagnosis is a key factor in determining how long you will wait for treatment.

The easier a condition is to diagnose, the less time is spent on investigation and the quicker treatment can begin.

See examples of how diagnosis can affect waiting times


After a diagnosis is determined and treatment agreed, each health board must ensure that patients receive inpatient and day case treatment within 12 weeks. This is called the legal Treatment Time Guarantee.

Find out more about the legal Treatment Time Guarantee

Not included in the 18 weeks Referral to Treatment Standard

The following treatments and services are not covered by this standard:

fertility treatment

obstetrics services (the care of pregnant mothers and their babies before and after the birth)

organ and tissue transplantation

some back treatments including injections and surgery

surgery to correct curvature of the spine

direct referrals to Allied Health Professionals (AHPs)

dental treatment provided by undergraduate dental students

direct access referrals to diagnostic services

mental health services.

Referrals to hospital and other services