Elective care guidance


Guidance for NHS staff involved the delivery of acute elective care who want to understand how best to manage and deliver referral to treatment (RTT) pathways and standards.

Core guidance

Referral to treatment pathways: a guide to managing efficient elective care PDF, 652.3 KB

The guide walks you through the RTT pathway; from pre-referral advice and outpatients, to diagnostics to patient admissions.

Our guide covers those areas which support the operational delivery of an effective RTT pathway, including demand and capacity planning, elective access policies, performance management and reporting.

It gives advice on the management of the RTT pathway, derived from what we've learned from helping NHS organisations across the country to deliver and sustain short waiting times for treatment

Referral to treatment: sustainability assessment tool XLSM, 241.1 KB

This tool has been developed to help you assess the current level of compliance against best practice referral to treatment systems and processes.

The sustainability assessment tool collates the best practice associated with effectively managing elective care for RTT.

It's separated into sections with best practice statements in each. Each statement links to our ‘what good looks like’ framework which includes references to published best practice resources with more detail on what providers should be aiming to achieve.
Providers can assess themselves against these ensuring they have evidence to assure compliance and clearly show where they can improve. The tool also includes sections to re-score after a period of time to show improvement as the associated improvement programme takes effect.

We advise providers to share or complete assessments with commissioners to allow for transparency and to ensure the whole system understands what can be done to improve services for patients.

Training strategy

Elective care training strategy PDF, 205.8 KB

A framework for providers implementing a contextual elective care training strategy comprising training, awareness, engagement, competency and compliance. It is for senior managers responsible for elective care improvement, performance management and/or operational functions.

Developing and implementing a referral to treatment training strategy PDF, 335.0 KB

This is a brief introduction to why a referral to treatment training strategy is important, what to include, how to measure effectiveness and compliance and critical success factors.

Recovery planning

Recovery planning: information sheet PDF, 178.8 KB

This information sheet uses questions compiled by our Elective Care Intensive Support Team to help providers create effective local recovery plans to meet waiting-time standards. It’s supported by an example recovery plan (see below).

Example of a referral to treatment recovery plan PDF, 194.8 KB

Outlines what to cover under headings including performance and backlog issues, weekly trajectories, risk assessment , systems and processes and support.


Writing an access policy PDF, 256.1 KB

A brief introduction to why an access policy is important, what you should include or exclude, who should be involved, what it should address and when you should review it.

Data quality

Data quality good practice: information sheet PDF, 179.5 KB

Good practice data quality policies and procedures gathered through experience of working with a wide range of acute and community provider organisations.

Contact us

If you have any questions or would like help with the tool, please contact us at NHSI.ElectiveIST@nhs.net.

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    • 3 May '17

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