# How the NHS Waiting List Crisis Is Being Addressed > England's elective waiting list fell from a record 7.8 million in September 2023 to around 7.4 million in early 2025. Here is what closed the gap, and what has not. *Section: Health — By Dr. Nadia Okoro (Science & Health Writer) — Published October 5, 2025, updated July 7, 2026 — 4 min read* Canonical URL: https://dailyjunction.co.uk/health/nhs-waiting-list-crisis-addressed Tags: nhs, health, waiting lists, surgery, uk health ## Key takeaways - NHS England's Referral to Treatment list peaked at roughly 7.8 million pathways in September 2023 - Wes Streeting's Department of Health pledged an extra 40,000 elective appointments a week from July 2024 - The interim target is 65% of patients seen within 18 weeks by March 2025, rising to 92% by 2029 - Over 160 community diagnostic centres have opened since 2021, moving scans and tests out of hospital sites and into high streets - NHS Long Term Workforce Plan (2023) commits to nearly doubling medical school places by 2031 ## Context: why the backlog still dominates health coverage Every NHS waiting list story eventually asks the same question: is it getting better? For elective — meaning planned, non-emergency — treatment in England, the honest answer by early 2025 was "slightly, and unevenly." The list is still the largest it has ever been outside the acute pandemic years, it is still the single biggest driver of complaints to MPs' surgeries, and it still shapes how voters rate the NHS more than any other metric. Understanding where the number came from, and what has actually moved it, matters more than the headline figure alone. ## The data: how big is the backlog, and how did it get there NHS England's Referral to Treatment (RTT) statistics — the official monthly measure of how long patients wait between a GP referral and the start of treatment — recorded a record 7.8 million incomplete treatment pathways in September 2023. That is not 7.8 million people: because a single patient can be waiting for more than one procedure, NHS England estimates the true number of individual patients waiting was closer to 6.4 million at the peak. The backlog's origin is well documented. Elective activity fell sharply from March 2020 as hospitals suspended routine surgery and outpatient clinics to manage Covid-19 demand, and it did not recover in step once restrictions eased, because the same hospitals were absorbing a backlog of urgent and cancer care, industrial action by junior doctors and consultants through 2023 and 2024, and a workforce that had not grown fast enough even before the pandemic. By the time the list peaked in September 2023, waiting lists had been rising in nine years out of the previous ten. The trend since the peak has been a gradual decline rather than a collapse. NHS England's most recent published figures at the time of writing put the list at around 7.4 million pathways — the lowest level in roughly two years, though still nearly a million and a half higher than pre-pandemic norms. > "The waiting list is not going to be fixed by a single initiative. It is a workforce problem, a capacity problem and a demand problem happening at the same time, and progress on one does not automatically fix the other two." — a position the Royal College of Surgeons of England has repeated in successive submissions to the Health and Social Care Select Committee. ## What's changing: the levers the government is actually pulling Three interventions account for most of the recent progress: - **Independent sector capacity.** NHS England has expanded contracts with private hospital groups to carry out routine procedures — cataract surgery, hip and knee replacements, hernia repairs — where spare theatre capacity exists outside the NHS estate. This has meaningfully increased throughput for high-volume, low-complexity surgery, though it does little for complex or emergency-adjacent specialties. - **Community diagnostic centres.** Over 160 CDCs have opened since 2021, moving scans, checks and tests out of hospital sites and into high streets and retail parks, cutting the time between referral and diagnosis for many patients. - **The "40,000 appointments" pledge.** Within days of taking office in July 2024, Health Secretary Wes Streeting announced funding for an additional 40,000 elective appointments per week — evenings and weekends included — as a first-year down payment on the government's Plan for Change targets. Workforce remains the constraint underneath all three. The NHS Long Term Workforce Plan, published in 2023, commits to nearly doubling medical school training places by 2031 and significantly expanding nursing and GP training — but new doctors take the better part of a decade to reach consultant grade, so the plan's effect on capacity is a 2030s story, not a 2026 one. ## What it means for you If you are on the list now, the practical implications are specific rather than general. Patients waiting for high-volume routine procedures — cataracts, joint replacements, minor gynaecological surgery — are the most likely to be offered a faster independent-sector slot, sometimes in a different town from their referring hospital. Patients with complex or multi-specialty needs are more likely to see limited change, because that work has not been redistributed in the same way. The NHS App and the "Manage Your Referral" service also now let patients switch provider partway through a wait for a shorter list elsewhere — worth checking if a nearby independent-sector or NHS-run treatment centre has capacity, particularly for [orthopaedic and eye procedures already prioritised for independent-sector referral](/health/nhs-waiting-lists-what-to-do). For anyone trying to make sense of the monthly figures as they are published, it helps to read them alongside NHS England's own [Referral to Treatment statistics releases](/health/nhs-waiting-times-2026), which break the aggregate number down by specialty, region and trust — the national figure conceals wide variation between, for example, a trust in the South East running close to the 92% standard and one in the Midlands running well below it. ## What to watch next The 65% within-18-weeks interim milestone for March 2025 was a genuine test of whether the funding and capacity measures were working faster than demand was growing. Watch three things over the following year: whether winter 2025-26 causes the usual seasonal slippage in cancelled elective operations; whether industrial action by resident doctors resumes, given pay disputes were not fully resolved through 2024-25; and whether the [NHS funding settlement covering staffing and capital spending](/health/nhs-funding-impact-workforce-2026) keeps pace with the workforce plan's own assumptions. None of the three is fully within the NHS's own control, which is precisely why forecasting the waiting list a year out remains an exercise in probability rather than certainty. ## Frequently asked questions ### How big is the NHS waiting list in England right now? NHS England's Referral to Treatment (RTT) statistics — published monthly — put the list at around 7.4 million treatment pathways in early 2025, down from the record 7.8 million logged in September 2023. That is roughly 6.2-6.3 million individual patients, since some people are waiting for more than one procedure. ### What is the government's actual target? The NHS constitutional standard is that 92% of patients should start treatment within 18 weeks of referral. As of publication only around six in ten patients were meeting that standard. Health Secretary Wes Streeting's Plan for Change set an interim milestone of 65% within 18 weeks by March 2025, with the full 92% standard restored by the end of the current parliament, expected in 2029. ### Does using private hospitals for NHS patients actually help? It has measurably increased capacity for routine, low-complexity procedures such as cataract removal and hip and knee replacements, where independent sector providers already had spare theatre time. It is a limited tool for complex, multi-specialty or emergency-adjacent care, which stays almost entirely within NHS trusts. ### Will waiting times get worse again in winter? Historically yes — winter flu, Covid and norovirus admissions divert beds and staff from elective work, and cancellations rise. NHS England now publishes winter-specific capacity plans each autumn, but the underlying bed-occupancy and staffing pressures that cause winter slippage have not gone away. ## Sources - [NHS England — Consultant-led Referral to Treatment Waiting Times statistics](https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/) - [NHS Long Term Workforce Plan (2023)](https://www.england.nhs.uk/long-read/nhs-long-term-workforce-plan/) - [The King's Fund — NHS waiting times explained](https://www.kingsfund.org.uk/insight-and-analysis/long-reads/nhs-waiting-times-for-elective-and-cancer-care) --- Daily Junction — https://dailyjunction.co.uk/health/nhs-waiting-list-crisis-addressed