NHS waiting list progress is masking a deeper problem for the health service

The first portrait shows the NHS making steady, if unspectacular, improvements in treating more patients and cutting waiting times. The overall waiting list for routine hospital treatment fell to 7.29 million in December, the lowest in nearly three years. The number of patients waiting over 52 weeks also dropped to the lowest level since August 2020. This was when the suspension of non-urgent routine treatment during the initial outbreak of Covid-19 saw a huge spike in long waits.

These are positive achievements, not least given the five day strikes by resident doctors that took place before Christmas and an early outbreak of seasonal flu. And small steps towards getting hospital waiting lists back under control should, if maintained over time, add up to substantial progress.

The government’s top priority for the NHS is to restore the 18-week standard for how long patients wait from referral to starting treatment. Our projections suggest, based on recent trends, that the health service is set to fall short of delivering on this pledge. Even so, this would still represent major improvements for patients.

The second portrait is far less appealing. January was one of the worst months for urgent and emergency care in recent history, despite a steady fall in the number of patients in hospital with flu.

Over 71,000 patients waited over 12 hours in A&E departments from a clinician deciding they needed to be admitted to hospital to a suitable bed becoming available. These delays were uncommon, even on the eve of the pandemic, but this is the highest number in a single month since current records began in 2010. This came alongside a fall in patients being admitted, discharged or transferred within 4 hours to 72.5 per cent, the lowest since December 2024.

Routinely resorting to so-called ‘corridor care’ to manage pressures on A&E departments puts patients at risk of avoidable harm and takes a major toll on NHS staff. This is not a safe way to run a health service, and what was unthinkable just 10 years ago now risks becoming normalised.

These two portraits illustrate the competing demands facing the NHS. It’s good to see a further reduction in hospital waiting lists, which our polling shows is important to the public – but A&E waiting times are even higher on people’s priorities for the NHS. And far too many patients face unacceptably long waits, as overcrowded emergency departments struggle to care for people in some of the most acutely desperate, vulnerable moments of their lives.

These are symptoms of deeper problems, with no quick or easy solutions. The NHS was exhausted by the pandemic and a decade of underfunding before that. Action is required throughout the entire health system. This includes investing in additional capacity for primary and acute care, implementing new technology and skills to improve service efficiency and productivity, and undertaking long overdue reform and investment in social care.

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Tim Gardner is Assistant Director of Policy at the Health Foundation.

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