What were the objectives?

NHS England released £250m in the summer of 2014 to reduce the number of patients waiting longer than 18 weeks after Referral to Treatment (RTT), with a view to improving patient experience and achieving the national RTT admitted standard.
They appointed South, Central and West CSU in November 2014 to deliver a programme that would increase referrals to the Independent Sector (IS), to increase utilisation of the additional capacity NHS England had contracted from 13 IS providers across 125 sites.

The programme was to target all elective activity including surgeries, diagnostics and outpatients, initially focused on patients waiting 12-16 weeks at NHS Trusts significantly behind target, but later extended to 85 NHS Trusts and to patients waiting more than 18 weeks.


What did we deliver?

  • We mobilised a Programme Management Office within a week of award, with a Programme Director, Programme Manager, Deputy Programme Manager, and five Project Managers.
  • We gained the necessary commitment from the Trusts to refer activity to IS providers, with each of them signing a Memorandum of Understanding.
  • We worked collaboratively with local Trusts to document the process from patient identification to treatment.
  • We rapidly set up systems to collate core data to track the progress and outcomes of the programme, gaining agreement from the Trusts to provide weekly submissions.
  • We set up and ran a patient contact centre to manage conversations with individuals about transferring, manage the process, and track patients through the system.
  • We provided weekly analysis and insight on IS transfer activity and finances (based on validated data) to the programme Steering Group.
  • We liaised with NHS Trusts to validate and drive activity and remove any hurdles to progress.

How did we add value to the customer?

We supported a significant improvement in national RTT statistics by managing a total of 34,838 patients through to completion of their treatment, 14% of whom had been waiting longer than 18 weeks.
To optimise programme performance, we suggested replicating the ‘Referral Management Centre’ we operate in the South West. This unit achieves a transfer success rate of up to 70% by directing patients to alternative treatment centres with spare capacity at the point of referral. At that stage, patients have not met their treating clinician nor discussed their treatment outcomes, and as a result they can be more willing to transfer. We successfully piloted this approach for NHS England across six CCGs: Oxfordshire, Bristol, Coastal West Sussex, Brighton and Hove, Thanet, and Canterbury and Coastal.

As well as operating the Referral Management Centre, we set up a public awareness campaign, working with CCGs, GP practices and members of the public to understand how we can empower patients to make a choice.

Customer Feedback

“The ability of the CSU and its partners to mobilise rapidly and their responsiveness to client needs meant that they provided invaluable support in the delivery of a complex and politically sensitive project.” Amy Caldwell-Nichols, Monitor

Read or download the case study – 'Helping NHS England achieve Referral to Treatment targets'