Deriving 18-week Referral to Treatment Period Status
Initial Activity Start Subsequent Activity
Is the care activity
Yes the first care activity on the Patient
Pathway? Was the status at the end
Was a new decision to
of the previous care
treat made (for the original Yes
Is the patient to be referred
to another Provider? Was the status at the
Is the Source of Referral Status 10 No end of the previous
In scope of 18 weeks? No care activity 92?
Has the patient now been Yes
(see Updated Clock Rules
on 18 weeks website) referred following No
diagnostic tests by the
GP? Was the status at the
Is the service end of the previous
Prior to an RTTP care activity 30 or 90?
No Status 98 Yes
(e.g. Direct Access
No diagnostics)? No
Is the service in the No
Scope of 18 weeks? (see Is the care activity a
Yes Status 92
Updated Clock Rules on Future care activity
Was the status at the end
18 weeks website)
of the previous care
activity 31, 32, 91 or 35?
Status 90 Yes
Status 12 Status 10 No
Is the care activity a
No Was a new decision to Future care activity?
Is this the first care activity Is the patient to be referred
Yes treat made (for the original
Yes on a new pathway to another Provider? Yes
following a consultant
referral for a separate
This flowchart has Is the care activity a No
been produced by NHS
condition? Status 91
Yes Future care activity
Connecting for Health Status 21 Status 20
in consultation with the
Department of Health. No
For queries relating to Is the care activity a Continue active
this flowchart please Future care activity? Monitoring?
contact the NHS Data Yes Is the intent to start Is the intent to start
Model and Dictionary treatment treatment
Service helpdesk. at this care activity?*see at this care activity?*see
No No No
Email: note 3 Yes note 3
Tel: 01392 206 248. Yes Was the patient
Decision to start
Yes discharged with no Yes
Note 1: Active Monitoring?
This scenario assumes that Decision to start further action?
Patient Initiated? Yes
a follow up care activity is Active Monitoring?
made with the same
Yes Status 98
consultant (or with a different
consultant in the same provider No
for the same condition, where No
responsibility for the patient Status 31 Status 32
transfers between the two
consultants, and the same
RTTP continues). Did the patient receive Did the patient receive
Yes Status 30 Yes
Where another condition is First definitive treatment? First definitive treatment?
identified in addition to the
original, and the patient is
referred to another consultant No No
in the same provider for the
new condition, while
continuing to be treated for Did the patient decline Did the patient decline
the original condition under Yes Status 35 Yes
the same RTTP, then the
First definitive treatment? First definitive treatment?
outcome status of this care
activity is still 10 – but a
separate RTTP commences No No
for the new condition, and the
initial status of first the care
activity on the new RTTP is Did the patient die Did the patient die
12 – consultant referral – Yes Status 36 Yes
the first care activity at the before treatment? before treatment?
start of a new RTT period
following a decision to refer
directly to the consultant for No No
a separate condition.
Was the patient
Was the patient transferred to
Note 2: transferred to another Yes Status 21 Yes
Follow up DNA’s (whether by another healthcare provider?
a child or an adult) do not healthcare provider?
change the previous status
of the missed appointment.
The same status carries No No
through to subsequent
appointments if given, If the
patient is discharged without Was the decision made Was the decision made
further contact, the status Yes Status 34 Yes
not to treat? not to treat?
should be 34. Yes
It is permissible to assign No No
status 30 to a future
appointment where it is
Did the patient DNA?
known that the intention is to Did the patient DNA? Yes Is the patient a child? No Status 33
start first definitive treatment
Was the patient *see note 2
at this attendance.
discharged with Yes
No no further action? No
Key: Was a follow up care activity made Yes Was a follow up care activity
(same provider)? made (same provider)?*see
*see note 1 No Yes note 1
First activity in a Referral to
Treatment Period where the No Yes Status 12 No
first treatment that is intended
to manage a patients disease, Was the patient referred for Was the patient referred for
condition or injury will be a
diagnostic tests before deciding diagnostic tests before deciding
whether to make a further care Is this the first care activity whether to book a further care
Yes on a new pathway Yes
activity? Is this the first care activity activity?
following a consultant Yes
following active monitoring
Subsequent activity during a No referral for a separate No
Referral To Treatment Period
Was the patient placed on an Yes Was the patient placed on an
Activity that ends the
Elective Waiting List? No Elective Waiting List?
Referral To Treatment Period
Status 10 Status 11 Status 20
Activity that is not part of a
Referral To Treatment Period Was the patient admitted directly Was the patient admitted directly
following this care activity? following this care activity?
Activity where the Referral
To Treatment Period Status
is not yet known
No Status 99 No