NHS Scotland waiting times guidance - November 2023: equality impact assessment

Background

The NHS Scotland Waiting Times Guidance: November 2023, updated from 2012, supports delivery of the following national standards:

• 18 weeks Referral to Treatment for 90% of patients.
• 12 weeks for new outpatient appointments for 95% of patients.
• 6 weeks for the 8 key diagnostic tests and investigations.
• The 12 week Treatment Time Guarantee (TTG) as set out in the Patient Rights (Scotland) Act 2011.

The guidance should be read in conjunction with:

• The Patient Rights (Scotland) Act (2011)
• The Patient Rights (Treatment Time Guarantee) (Scotland) Regulations (2012)
• The Patient Rights (Treatment Time Guarantee)(Scotland)(No 2) Directions (2022)
• NHSScotland: national access policy - gov.scot (2023)

The 2023 guidance is intended for NHS Scotland staff responsible for recording and managing waiting time standards and aims to benefit patients and their families, Health Boards, National Treatment Centres (including NHS Golden Jubilee) and clinicians /clinical teams.

The fundamental principle behind the guidance is to ensure that patients who are waiting for appointments, diagnostic tests and treatment are managed fairly and consistently across NHS Scotland. The revised guidance applies universally to all Health Boards, all patients waiting for inpatient/day case treatment, a diagnostic tests or a new outpatient appointment, with the intention of upholding the founding principles of the NHS of fair and equal access. It also aligns with the Scottish Government’s commitment in the Operational Improvement Plan to deliver sustained improvements and reductions in waiting times through service redesign and enhanced regional and national collaboration.

The guidance embeds Realistic Medicine principles, promotes informed choices and reduces unnecessary appointments through digital tools: Active Clinical Referral Triage (ACRT) and Patient Initiated Review (PIR). It also requires Health Boards to adopt a three-stage waiting list validation process as business as usual. These changes aim to support patients to make informed decisions about their care, alleviate pressures on Health Boards, reduce unnecessary appointments, and ensure patients have access to the right treatment at the right time.