REFERRAL TO TREATMENT PERIOD START DATE

The start date of a REFERRAL TO TREATMENT PERIOD.

This is a specific type of the attribute ACTIVITY DATE.

A REFERRAL TO TREATMENT PERIOD START DATE will be one of the following:

• Initial Referral:

  • the REFERRAL REQUEST RECEIVED DATE of a SERVICE REQUEST for a particular condition.

  • This will include a PATIENT being re-referred in to a Consultant Led Service or an Interface Service or an NHS Allied Health Professional Service (Referral To Treatment Measurement)  as a new referral including after a Discharge After Patient Did Not Attend. The REFERRAL TO TREATMENT PERIOD STATUS is 'National Code 10 - first activity'

• Following an APPOINTMENT that the PATIENT did not attend:

  • the APPOINTMENT ACCEPTED DATE (or the INVITATION OFFER DATE SENT of the first APPOINTMENT OFFER where the APPOINTMENT OFFER is sent) for the first APPOINTMENT following the PATIENT not attending an APPOINTMENT or elective admission. See REFERRAL TO TREATMENT PERIOD and Discharge After Patient Did Not Attend for guidance on PATIENTS who do not attend

  • The APPOINTMENT DATE of the APPOINTMENT that the PATIENT did not attend should be used where it is not possible to identify the APPOINTMENT ACCEPTED DATE or the INVITATION OFFER DATE SENT. The REFERRAL TO TREATMENT PERIOD STATUS is 'National Code 10 - first activity'

• Following active monitoring:

  • the ACTIVITY DATE of a CARE ACTIVITY when a decision to treat was made following Active Monitoring and the REFERRAL TO TREATMENT PERIOD STATUS is 'National Code 11 - active monitoring end'

  • This will include a decision to start a substantively new or different treatment that does not already form part of that PATIENT's agreed CARE PLAN.

• On identifying a separate condition:

  • the REFERRAL REQUEST RECEIVED DATE of a SERVICE REQUEST when a decision has been made to refer the PATIENT directly to a Consultant Led Service or an NHS Allied Health Professional Service (Referral To Treatment Measurement)  for a separate condition (the REFERRAL TO TREATMENT PERIOD STATUS for the first CARE ACTIVITY with the new CONSULTANT  or  NHS Allied Health Professional Service (Referral To Treatment Measurement)  is 'National Code 12 - consultant or NHS Allied Health Professional Service (Referral To Treatment) referral'). 

Referral To Treatment Consultant Led Waiting Times:

For most PATIENTS, the start of the REFERRAL TO TREATMENT PERIOD begins with a SERVICE REQUEST from a GENERAL MEDICAL PRACTITIONER to a CONSULTANT.

SERVICE REQUESTS to CONSULTANTS who provide care SERVICES in community settings also start REFERRAL TO TREATMENT PERIODS and the REFERRAL REQUEST RECEIVED DATE will be the start of the  REFERRAL TO TREATMENT PERIOD.

A REFERRAL TO TREATMENT PERIOD  may also start from SERVICE REQUESTS to CONSULTANTS from GENERAL DENTAL PRACTITIONERS, General Practitioners with Extended Roles, OPTOMETRISTS and Orthoptists, National  Screening Programmes, Specialist  NURSES, other CARE PROFESSIONALS  where commissioning ORGANISATIONS  have approved these mechanisms locally.

An 18-week clock also starts upon a self referral by a PATIENT to the above services, where these pathways have been agreed locally by commissioners and providers and once the referral is ratified by a CARE PROFESSIONAL.

A REFERRAL TO TREATMENT PERIOD will also start where PATIENTS are transferred to an elective Consultant Led Service through SERVICE REQUESTS  from Emergency Care Departments including Minor injuries units, Walk In Centres and Urgent Treatment Centres.

Allied Health Professional Referral To Treatment Measurement:

Further guidance relating to the Allied Health Professional Referral To Treatment can be found on the Department of Health and Social Care part of the gov.uk website at:  Allied health professional referral to treatment revised guide.

Intermediate Care Measurement:

Further guidance relating to the Intermediate Care  Waiting Time Measurements can be found on the NHS England  website at: Community Services Data Set user guidance.