For patients across England, NHS waiting lists remain a pressing issue, with over 7.6 million people currently awaiting treatment. Recent data indicate that the NHS shows signs of improvements, but the road to recovery will be long and bumpy.
Small steps forward
By September 2024, NHS referral-to-treatment (RTT) waiting lists had shrunk by 195,000 patient pathways year-on-year, with much of the reduction reflecting genuine progress. This marks a significant uptick compared to the August year-on-year reduction of 103,000. A smaller portion of the reduction, around 50,000, resulted from counting adjustments earlier this year, when community services and a major mental health trust were removed from the dataset. However, this is only a fraction of the backlog that remains, as the number of treatments does not yet exceed the growing number of referrals.
This follows modest progress in late 2023, when waiting list figures showed a slight decline in the number of outstanding treatments. By December 2023, an estimated 7.6 million treatments were waiting to be carried out—down from 7.61 million a month earlier. Despite this small improvement, then-Prime Minister Rishi Sunak admitted he would not meet his pledge to reduce waiting lists, a significant blow to his government’s credibility
A long road ahead
Labour’s Keir Starmer has since inherited a politically charged promise to restore the statutory 18-week waiting time standard by the end of this Parliament in 2029. However, prioritising the NHS is not a new challenge for a UK government. Successive administrations, from Tony Blair’s New Labour to Sunak’s Conservative government, have identified NHS recovery as a key objective, often with mixed results.
The early 2000s saw a dramatic backlog clearance under New Labour, supported by a doubling of the NHS budget in real terms. Today, Starmer’s government faces similar expectations without the financial flexibility of previous years. Achieving the promised reductions will require shrinking waiting lists by approximately 1 million patient pathways per year—an ambitious goal given the constraints of the current fiscal climate.
What it means for patients
For patients, the improvements will be welcome but uneven. While some experience shorter waits for care, many still face significant delays, particularly in routine procedures and diagnostics, with patients waiting a year and a half to see a gynaecologist. The NHS continues to scale up activity levels, but the sheer demand—exacerbated by demographic changes and years of systemic pressures—means the waiting list remains far above pre-pandemic levels. In 2019, the waiting list stood at 4.6 million, compared to today’s 7.6 million
Looking forward
The Labour government’s pledge to return to the 18-week standard reflects a familiar political commitment to improving NHS services. However, the challenges of staffing shortages, operational inefficiencies, and increasing demand mean that this task will require sustained focus and creative solutions. Success will not only depend on investment but also on tackling long-standing systemic issues that have hindered progress under successive governments.
