How NHS RTT 18-week performance varies by region
Reviewed by PlainNHS · · Source: NHS England RTT statistics
Summary
Across 12 NHS Trusts in the PlainNHS dataset, the average RTT 18-week performance was 75.3% — significantly below the NHS England operational standard of 92%. Regional variation is meaningful: the top-performing region averaged 77.9%, while the worst averaged 70.2%.
Method
For each NHS Trust profiled by PlainNHS we extracted the latest published RTT 18-week performance figure (NHS England's monthly statistical release). Trusts were grouped by NHS region, and for each region we computed the mean, minimum, and maximum RTT 18-week percentage across constituent Trusts.
These figures update automatically whenever NHS England publishes a new monthly release, so this ranking always reflects the latest available data.
Results — ranking of NHS regions by RTT 18-week performance
| Region | Trusts | Mean RTT 18wk | Min | Max |
|---|---|---|---|---|
| East of England | 1 | 77.9% | 77.9% | 77.9% |
| North East | 1 | 77.2% | 77.2% | 77.2% |
| London | 6 | 76.2% | 67.5% | 89.1% |
| South East | 1 | 75.6% | 75.6% | 75.6% |
| Yorkshire & Humber | 1 | 74% | 74% | 74% |
| Scotland | 1 | 71.4% | 71.4% | 71.4% |
| North West | 1 | 70.2% | 70.2% | 70.2% |
Discussion
The headline finding — an overall 75.3% mean against the 92% operational target — mirrors the national picture reported by NHS England since the pandemic-era elective backlog began to build. The spread between best and worst regions (77.9% vs 70.2%) is unlikely to be explained by case-mix alone; published policy reviews from the Nuffield Trust and the King's Fund identify workforce shortfalls, ageing estate, and elective-recovery investment as the principal regional differentiators.
For patients exercising their NHS Choose & Book entitlement, the data implies that crossing regional boundaries (when clinically permissible) can substantially shorten elective waits. Our comparison tool lets you check whether any specific cross-regional swap improves your projected wait for a specific procedure.
Limitations
This analysis covers only those Trusts profiled by PlainNHS at the time of publication (12 Trusts across 7 regions) — most regions currently have only 1-6 Trusts in our dataset, so a region's average can reflect one Trust's performance rather than a stable regional pattern; treat single-Trust regions as illustrative, not representative. RTT 18-week performance is one of several NHS-England-published operational metrics; we have not attempted to weight by activity volume or to control for elective case-mix. The figures are operational statistics, not patient-outcome measures.
Source attribution
- NHS England, Referral-to-Treatment (RTT) Waiting Times, monthly release.
- NHS England, Elective Care Recovery Programme.
- PlainNHS, PlainNHS methodology.
Important: This page is descriptive statistical analysis. It is not medical advice. Always consult your GP, NHS 111, or the treating NHS Trust for clinical decisions.