Hip replacement · England
Where am I on the NHS hip replacement pathway?
Most NHS hip replacement pathways in England follow a similar administrative sequence — referral, specialist assessment, sometimes tests, a decision to treat, then waiting for surgery. Pathways vary, so the most reliable way to know your stage is to ask the hospital.
The usual stages
Not everyone goes through every stage, and the order can differ:
- Referral by your GP or another clinician (the referral-to-treatment clock usually starts when it is received)
- First appointment with the orthopaedic service
- Tests, if needed
- Decision to treat and being added to the waiting list
- Pre-operative assessment
- Being offered a date, and admission
Clues to your current stage
Letters are the best evidence: a referral acknowledgement, a clinic letter, or a letter saying you have been added to a waiting list. If you have none, ask the hospital.
Why the stage matters
Different questions apply at different stages. Before a decision to treat, questions are about appointments and referrals. After it, they are about booking, updates and, if waits are long, alternatives.
What usually happens to the waiting-time clock at each stage
For non-urgent consultant-led care, the referral-to-treatment clock usually starts when the hospital receives your referral and keeps running through the first appointment, any tests and being listed, until your first treatment starts. Diagnostic tests have their own published figures, but on a consultant-led pathway they normally sit inside the same RTT clock.
The clock can stop earlier in some situations set out in the RTT rules — for example if a decision is made not to treat, or to monitor rather than treat for now (sometimes called active monitoring). If you are unsure whether your clock is still running, ask the hospital.
What different letters usually indicate
Wording varies between hospitals, but as a rough guide:
- A referral acknowledgement or appointment booking — your referral has been received
- A clinic letter after seeing the orthopaedic team, usually copied to your GP — you have been assessed; it may say whether surgery was agreed
- A letter saying you have been added to the waiting list — a decision to treat has been recorded
- An invitation to pre-operative assessment — you are listed and being prepared for surgery
A simple way to ask
You can phone or write to the hospital's waiting-list team with: “Please can you confirm my current pathway stage, the date my referral-to-treatment clock started, and whether I am on the inpatient waiting list for hip replacement?”
If letters seem to contradict each other, or you have none, that question is the quickest way to get a clear answer.
What knowing your stage cannot tell you
Knowing your stage helps you ask the right questions, but it does not let anyone predict your operation date. Published waiting figures combine people at every stage. Published NHS waiting figures are reported for the whole Trauma and Orthopaedics specialty, which covers many conditions and operations. They are not a hip-replacement-specific wait and cannot predict your own operation date.
What this means for you
- Gather your letters.
- Ask the hospital to confirm your stage and clock start date.
- Use the guide that matches your stage.
This guide gives administrative information for patients in England. It is not medical advice and cannot predict your operation date.
Frequently asked questions
Short answers first. Tap a question to read more.
Can you tell me my stage from my symptoms?
No. We cannot interpret clinical information. Your stage is an administrative fact the hospital can confirm.
What is active monitoring?
It is a recorded decision to monitor your condition rather than treat it for now. Under the RTT rules it can stop the waiting-time clock. If you think this applies to you, ask the hospital to confirm it and explain what would start a new clock.
See where you stand in 60 seconds
Use our free 18-week calculator to check whether your wait may have passed the NHS Referral to Treatment standard.
Sources & references3
Reviewed against publicly available NHS England RTT guidance and the NHS Constitution.
Editorial transparency
How this guide was put together
- Reviewed against the latest publicly available NHS England RTT statistics and guidance.
- Written and edited by the NHSWaitHelper editorial team.
- Cross-checked against the NHS Constitution and operational guidance.
- Independent — no paid hospital rankings, no hidden sponsorship.
NHSWaitHelper is an independent information platform and is not affiliated with the NHS. We do not provide medical or legal advice. Always speak to your GP, clinician, or a regulated adviser about your individual circumstances.