When does the RTT clock start?
Your Referral to Treatment (RTT) clock usually starts on the date the hospital receives your GP referral. It does not start when you receive your first letter or when you are first seen — it starts at the point of referral.
In some cases it starts earlier — for example, if you were referred from A&E, the clock may start from your A&E attendance.
When the clock pauses
Your RTT clock can be paused — known as a clock stop — in certain circumstances:
- You declined two or more reasonable appointment offers without good reason
- You failed to attend (DNA) an appointment
- You are on a patient-initiated pause because you are not ready to proceed
Hospitals cannot pause your clock simply because they do not have capacity. If your clock was paused and you did not decline appointments or miss them without good reason, you can challenge this.
When the clock stops
The clock stops when you start treatment, or when a decision is made that treatment is no longer needed. If treatment starts and then needs to continue, a new clock may begin.
How to check your clock start date
Your waiting list letter should include your clock start date. If it does not, contact the hospital's appointments team and ask for it specifically. If you believe your clock was incorrectly paused, contact PALS at the relevant Trust. See our full guide on RTT rights and what you are entitled to.