This was the first summary of what staff, patients and the public can expect from the National Health Service, and what rights you have as a patient. It included a promise that nobody should wait more than 18 weeks for consultant-led NHS treatment (from the time the GP refers them for treatment.) Previously, some patients had waited up to 18 months for some kinds of treatment. This target has proved challenging for the NHS, which has not met it since April 2016. An updated NHS Constitution was published on April 1 2013, making changes around patient involvement, feedback, end of life care and integrated care, among other areas.