Waiting time targets: What they mean for you

BBC Scotland has been examining the treatment of patients within the Scottish government's 18-week guarantee and the knock-on effect into private healthcare spend.

Here is a guide to waiting times guarantees in Scotland, and what they mean for patients.

12-week 'right to treatment'

Legislation passed by the Scottish Parliament last year means that, from the start of this year, you have a legal right to be treated within 12 weeks, unless you're waiting for diagnostic scans or waiting for one of the excluded treatments outlined below.

For the vast majority of patients, this will be from the time you see a specialist at an outpatient clinic until you get the treatment that you both agree is necessary.

If you need a diagnostic test, the clock starts once you get the results. You shouldn't wait too long for those scans though - see below.

18-week 'guarantee'

Since December 2011, no-one should have waited longer than 18 weeks from the point they were referred for treatment until that treatment occurs. This includes all scans and diagnostic tests.

Tests and scans

You should wait no longer than six weeks for eight types of scans and tests.

These are: upper endoscopy, lower endoscopy, colonoscopy, cytoscopy, CT scans, MRI scans, barium studies and ultrasound scans (unrelated to obstetrics).

All other tests and scans should be performed within your total 18-week waiting time guarantee if you've seen a consultant.

However, if you've been referred by a GP and not seen a consultant at all, there is no waiting time guarantee.

Cancer

You should wait no longer than 62 days for treatment if your referral is "urgent".

Once a definite diagnosis of cancer is made (eg following a scan) you should wait no longer than 31 days for treatment. However, this is only the first treatment.

There is no waiting time target for subsequent treatments, such as radiotherapy or chemotherapy following surgery. Scotland's targets differ from England's targets in this respect.

Excluded groups of patients

You will wait longer if you are waiting for fertility treatment or obstetric treatment.

Waiting time guarantees also don't apply to those waiting for organ or tissue donations, or treatment for "injuries, deformities or diseases of the spine" by injection or surgery (eg scoliosis). The exclusion of spinal conditions is under review.

Get-out clauses?

The Scottish government's target is that health boards should treat 90% of patients within these time periods.

The 10% margin is to allow for patients for whom faster treatment would not be appropriate. It is NOT intended to be a 'get-out' clause for over-stretched clinics.

So, if you are waiting longer without good reason, you should start asking questions.

You may not be treated within 12 or 18 weeks if you ask to see a specific consultant.

The health board should tell you if you're guaranteed treatment within 12 weeks and, if not, why not.

All this should be in a format and a language you can understand.

Unavailability

The waiting time "clock" stops if you are unavailable for any reason, but you should specifically agree to a period of "unavailability" being applied to your case and a letter should be sent to you confirming this to be the case.

If you can't make the first appointment offered, you should be offered a second one.

Both should be "reasonable" - in a location you can get to and in a timescale that is possible, but it is considered reasonable to offer you an appointment in another health board area.

If you can't attend the appointment for unavoidable reasons and you ring the clinic in advance, you should be offered another appointment and you shouldn't wait longer than 12 or 18 weeks.

Three strikes and you're out

If you miss your appointment and don't ring in advance then you will be referred back to your GP.

If you still need treatment your GP will need to make a new referral and the whole process starts again.

If the clinic cancels your appointment

You should not be disadvantaged if the hospital/clinic cancels your appointments. You should be offered a new appointment, within the government's waiting time guarantees.

This applies even if the cancellation was due to severe weather.

What to do if you're waiting too long

Firstly, contact the clinic and start asking questions.

Ask why you are waiting longer than the 18 or 12-week guarantee. Demonstrating you are familiar with these guarantees may be enough to get you a faster appointment.

If you don't get satisfactory answers, there are several people to turn to - you can contact the Patients Association for advice, or get in touch with your MSP.

The Citizens Advice Bureau runs an advisory service specifically for patients.

Many health boards have a patients liaison officer who will ask questions on your behalf, but remember that they are ultimately employees of the health board.

BBC Scotland's health correspondent is also happy to investigate individual cases. You can contact her at eleanor.bradford@bbc.co.uk

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