NHS RTT Crisis: How Modern Workforce Solutions Can Bridge the Gap

Four out of ten NHS patients are waiting too long for treatment.

The latest data from NHS England shows only 59.8% of patients starting treatment within the recommended 18 weeks – against a target of 92%. The NHS hasn’t met the 92% target since 2015 – and as of November 2024, nearly 222,000 patients had been waiting over a year for treatment. Behind this statistic sit 7.4 million people living with pain, uncertainty, and conditions that worsen while they wait.

This isn’t just missing a target. It’s a system-wide crisis that demands fresh thinking about how we deliver healthcare.

Understanding the RTT Target Reality

The Referral to Treatment (RTT) standard exists for good reason. When someone needs medical care, 18 weeks from referral to treatment represents the maximum time they should have to wait. This target recognises that delayed treatment can lead to worsened conditions, increased anxiety, and in some cases, preventable complications.

The 92% target means that at least 92 out of every 100 patients should start treatment within this timeframe. Currently, we’re achieving less than 60%. This means that more than 4 out of every 10 patients are waiting longer than they should for care they need.

The human impact behind these statistics is enormous. People are living with pain, uncertainty, and declining health while they wait. Some are taking time off work for appointments that get cancelled. Others are watching their conditions worsen because treatment keeps getting pushed back.

Why We’re Missing the Target So Badly

The gap between 59.8% and 92% stems from interconnected system failures:

Workforce Capacity Crisis

The fundamental issue is simple – you can’t treat patients without the right people in place. One missing team member can cancel entire clinic sessions or operating lists, affecting multiple patients at once.

Emergency Care Stealing Resources

When staffing is tight, emergency cases naturally take priority. Planned procedures get postponed repeatedly, pushing elective patients further down the waiting list.

Administrative Bottlenecks

Pre-operative assessments, procedure booking, and department coordination create multiple failure points. When these systems don’t work efficiently, patients stay stuck in the pipeline even when clinical staff are available.

Limited Physical Capacity

Running additional sessions requires coordination across multiple departments and significant overtime costs, making it difficult to scale up quickly when backlogs grow.

The Cost of Delay

Every week that patients wait beyond the 18-week target has real consequences:

In fact, the number of patients waiting over 52 weeks has surged past 220,000, showing how delay has become the norm, not the exception.

A Modern Approach to an Old Problem

Traditional solutions focus on asking existing staff to work more hours or lengthy permanent recruitment. These approaches aren’t sufficient for the current crisis scale.

The solution lies in flexible, technology-enabled approaches that quickly scale capacity and ensure the right staff are in the right place at the right time.

Modern workforce platforms can connect trusts with qualified professionals ready for additional shifts, creating larger capacity pools without permanent recruitment commitments. AI-powered systems verify credentials and get qualified staff working faster than traditional processes. Trusts can use targeted insourcing projects with their own clinical staff supported by additional personnel, maintaining oversight while dramatically increasing capacity.

How Flexzo AI Addresses the RTT Challenge

Flexzo AI’s platform directly tackles the core issues that prevent trusts from meeting RTT targets:

Rapid Staff Deployment

Our collaborative staff bank connects trusts with over 30,000 pre-approved healthcare professionals. When you need additional capacity for weekend clinics, extended theatre sessions, or temporary service expansion, qualified staff can be deployed quickly rather than waiting months for traditional recruitment processes.

Intelligent Matching

The AI system doesn’t just provide more staff – it provides the right staff. By matching professionals based on specialisation, location, availability, and even real-time travel conditions, trusts get people who can actually contribute effectively to reducing specific waiting lists.

Simplified Compliance Management

Instead of repeating compliance checks for every new assignment, our system manages DBS verification, right-to-work checks, and professional registration validation centrally. Staff can move between trusts seamlessly, and compliance stays up to date automatically.

Cost-Effective Capacity

By eliminating agency fees and intermediaries, trusts can access additional workforce capacity within existing budgets. This means more of the money allocated for waiting list initiatives goes directly to patient care rather than administrative overhead.

Insourcing: Keeping Control While Scaling Up

For many trusts, insourcing represents the sweet spot between maintaining service quality and rapidly increasing capacity. Unlike traditional outsourcing, insourcing allows trusts to:

• Keep clinical governance and oversight within the organisation.
• Use existing facilities and equipment more intensively.
• Maintain continuity of care and patient relationships.
• Reinvest savings back into patient services rather than external profits.

As nearly a quarter of elective operations are now being cancelled last-minute and not rescheduled within 28 days, trusts need ways to scale internal capacity – fast and flexibly.

Flexzo AI’s insourcing platform makes this approach practical by handling the complex logistics of staffing additional sessions. Trusts can focus on patient care while the technology handles workforce coordination, compliance tracking, and schedule management.

Real Impact on Real Targets

The RTT crisis won’t be solved by incremental improvements. It requires step-change thinking about how we deploy healthcare workforce capacity.

The Institute for Fiscal Studies has said the NHS would need to increase planned care by nearly 5% each year to hit the 92% target by 2029 – a tough ask without smarter workforce strategies.

With the right technology platform, a trust struggling to meet RTT targets can:

• Launch additional weekend clinics within weeks rather than months.
• Scale up theatre capacity for specific specialties experiencing the longest waits.
• Maintain service levels even when permanent staff are unavailable.
• Track progress against RTT improvements in real-time.

This isn’t theoretical – it’s happening right now in trusts that have embraced collaborative workforce models.

The Path Forward

The 59.8% RTT performance we’re seeing today doesn’t have to be permanent. The gap between current performance and the 92% target is significant, but it’s not insurmountable with the right tools and approach.

What’s needed is recognition that traditional workforce models alone cannot deliver the capacity required. The future of RTT improvement lies in hybrid approaches that combine permanent staff, collaborative workforce platforms, and smart technology to create more flexible, responsive healthcare systems.

For trusts ready to close the gap on RTT targets, the solution is available now. Modern workforce platforms like Flexzo AI offer immediate access to the additional capacity needed to start making real progress on waiting lists.

The numbers are clear. The solution is here. The question is whether we’re ready to embrace the change needed to deliver the care patients deserve within the timeframes they have a right to expect.

Taking Action

If your trust is struggling with RTT performance and looking for practical solutions to increase treatment capacity, Flexzo AI’s platform offers a proven path forward. Our team understands the complex challenges of modern healthcare workforce management and can demonstrate how collaborative staffing models can help bridge the gap between current performance and target achievement.

Contact us to explore how our AI-powered workforce solutions can help your organisation move closer to meeting RTT targets while maintaining the quality of care your patients deserve.