RTT Assurance & Patient Perception

Imagine this ... you’ve been referred to a clinic for a sore throat and a possible lump. At your first appointment, the doctor examines you and says:

“Everything seems fine from today’s tests. I’m happy to discharge you, but just to be sure, I’ll send you for a blood test and an X-ray, which are likely to come back normal. The results will be posted to you.”

What would you expect to happen next? How complete do you feel your care is? And how would you feel to find out or know that in the system, your pathway might already be stopped even though tests are next?

I recently asked ten members of the public these three questions. Here are anonymized quotes from some of the participants.

Voices from the Public - What would you expect to happen next?

Participant 3: “So from my experience ………. I will just be sent home and I will just have to wait for the best. Hope for the best.

Participant 1: “At this point I would expect to get an appointment for the blood test and the x ray and then after those two have happened I would expect them to send me a follow-up. Either a follow-up appointment or a phone call just confirming that everything is normal.

Participant 2: “Well I would expect that the doctor’s going to at least give me a diagnosis of what I could be having.”

Regarding whether care is complete:

Participant 1: At this point I think its complete. Maybe I will have to call my doctor again and chase it …”

Participant 2: I don’t think my care is complete. I am still waiting for treatment! I am waiting for treatment because .. you know - I am waiting for clarity as to what it could be. If everything’s fine.”

Regarding how it feels if the pathway is stopped:

Participant 2: “Not good. No one likes to hear that their pathway could possibly be stopped. I want to be assured that I am getting the right care and the right treatment.

Participant 4: “This could possibly happen because it happened to me previously and its not a good feeling that I feel like they forget about me. Or I feel like I am not important to them.”

Participant 1: “That would annoy me a lot because in my mind it’s not complete, so to find out that it’s been ended so it would mean I would have to phone them up to keep checking and then it just kind of like you expect them as the care providers to do the follow-up not you chasing them. So, yea it would annoy me. If it was ended at this point.”

Participant 3: “…I would be very angry. I will be sad. I will be thinking that I was forgotten and I pay money to NHS for nothing really.”

Why This Matters for NHS Leaders?

Hearing these voices reminds us why RTT assurance exists. The NHS Constitution sets a standard that 92% of patients should wait no longer than 18 weeks from referral to first treatment. Every day, NHS staff take steps to meet that target.

Yet, as of March 2026, there are over 6 million patients still waiting for treatment. Each pathway error — or even the perception of an error — can erode patient confidence, trust, and experience.

The Role of Validation:

Many Trusts employ internal teams to validate patient pathways, and occasionally freelance specialists are called in for intensive RTT audits. Why? Because validation ensures:
1. Pathways aren’t incorrectly stopped
2. Pathways aren’t left open longer than they should be
3. Waiting list reporting is accurate
4. Patient safety and experience are maintained

Even small errors in RTT data can ripple across operational reporting, risk management, and patient confidence.

Leaders - imagine this …

Over just two months, every staff member at your Trust who interacts with RTT — whether on Cerner, Epic, eCMIS, EPR, or PAS — enters every outcome and decision correctly.

The impact on waiting list accuracy, risk reduction, and patient confidence would be significant. Accurate data doesn’t just improve reporting; it safeguards patients and strengthens the reputation of your Trust.

Lessons from My Experience:

I’m Eunice, and I’ve been validating RTT pathways across the NHS since 2014, working with at least 15 Trusts. From my experience; errors can stop pathways incorrectly or leave them open for too long. I think that RTT training often focuses on a limited group, but many staff influence patient pathways every day. I believe that empowering all staff with a job role that relates RTT prevents errors before they happen.

A few Questions …

If you are responsible for RTT in your Trust, consider:

* Who really needs RTT training?
* Are staff confident applying what they’ve learned?
* How is training effectiveness measured?
* Could RTT learning be more engaging or accessible?

Reflecting on these questions can uncover opportunities to improve pathway accuracy, reduce risk and enhance patient safety.

Why Patient Confidence Matters:

Returning to our scenario, one participant reflected:
“I would lose confidence if my pathway is stopped before treatment. But from my experience I still trust the NHS — they are doing their best.”
Robust RTT assurance shows patients that their care is actively managed and safe. It demonstrates that NHS staff are doing their best, even amidst systemic pressures.

Next Steps:

Improving RTT assurance doesn’t require a system overhaul. Some impactful steps include:

- Role-specific RTT training for all staff involved in pathways
- Scenario-based learning to highlight real-world consequences
- And of course regular validation of pathways to prevent errors

These actions strengthen patient safety, trust, and waiting list accuracy, while reducing the risk of patients “getting lost” in the system.

For an overview of the services offered, you can check out The RTT People’s new website, or email The RTT People for more details on how tailored RTT training and support could benefit your staff.