Government could fall short on pledge to cut NHS waiting lists, analysis finds

The Government will fall short on it pledge to cut NHS waiting lists if current trends continue, according to new analysis.

Placing so much emphasis on the target risks slowing progress on other important issues, such as access to GPs, the Health Foundation warned.

Experts also heard that NHS trusts found themselves between “a rock and a hard place” last winter due to pressure to meet elective targets and manage urgent emergency care performance.

In January, Prime Minister Sir Keir Starmer pledged to slash NHS waiting lists by setting a target for the health service to carry out 92% of routine operations within 18 weeks by the end of Parliament in 2029.

The new report by the Health Foundation said waiting lists are in “slightly better shape” than when the Labour Government came into power last year.

Data shows the proportion of patients seen within 18 weeks has gone up slightly from 58.8% in July 2024 to 61.3% in July 2025, with the total waiting list falling from 7.6 million to 7.4 million.

Health Foundation analysis found referrals onto the waiting list increased by 1.5% between August last year and July 2025.

At the same time, removals rose by 2.3%.

Removals include people whose treatment is marked as complete, either because they have started or do not need treatment, or if the patient has declined treatment.

This figure also includes so-called “unreported removals”, which occur when someone is taken off the waiting list for a reason other than having received their treatment that month.

If these trends continue, the Health Foundation suggests waiting lists could fall to 4.7 million by July 2029 based on trends seen over the last 12 months, with cases waiting less than 20.3 weeks for treatment – short of the 18-week target.

Dr Francesca Cavallaro, senior analytical manager at the Health Foundation, said: “The Government has clearly made progress in reducing NHS waiting times.

“But on current trends, our analysis shows that the NHS would just fall short of meeting the 18-week standard by the end of the Parliament.”

The report said that if referrals continue to grow at 1.5%, removals would have to increase by 2.5% to achieve 18-week waits by the end of Parliament.

And if referrals grow faster – which the Health Foundation said “seems likely” – removals would have to increase further still.

Dr Cavallaro said there is less information on unreported removals “which makes it a bit harder to understand what’s going on”.

However, she added: “Overall, the fact that removals are growing faster than referrals is good news.

“The scale of the challenge remains significant, and even getting close to meeting the target would be a considerable achievement.

“This will require not just more activity, but smarter use of resources and continued investment in the NHS workforce and infrastructure.

“And there are several factors that could hold back progress, including if future referrals rise faster than expected and the potential impact of further industrial action.”

The report comes after the Department of Health and Social Care (DHSC) said NHS productivity has increased by 2.7% over the past year.

However, Dr Cavallaro said it is “unknown how productivity is going to change over time”.

She also highlights that there has been a lot of “political focus” on the 18-week target, and “that it does risk distracting from other things”.

“In particular, access to GP appointments, which we know from our polling work is the number one priority for the public for the NHS,” she added.

“We’ve heard anecdotally from some trusts that over this past winter, because there was quite a lot of pressure to meet the elective targets, that actually trusts were stuck between a bit of a rock and a hard place, between managing urgent emergency care performance last winter and trying to maintain progress on reducing the elective backlog.”

The latest NHS performance data, published earlier this month, shows the overall waiting list for routine hospital treatment had risen for the second month in a row.

An estimated 7.40 million treatments were waiting to be carried out at the end of July, relating to 6.25 million patients, up from 7.37 million treatments and 6.23 million patients at the end of June.

The Health Foundation stressed is it “too early to draw any firm conclusions” on whether or not the Government will meet the 18-week pledge.

NHS Providers chief executive Daniel Elkeles said the analysis shows “the NHS is on the up” and “making real progress” on the 18-week target.

“It’s encouraging to see how steps to bear down on waiting lists, including more community diagnostic centres and surgical hubs, are shifting the dial for patients,” he added.

“But it’s a huge task, and too soon to say if the target for this parliament will be met.”

Tim Mitchell, president of the Royal College of Surgeons of England, said the research “otherwise confirms what surgeons see every day: the NHS is still struggling to meet demand and, unless surgical capacity expands, the Government will almost certainly fall short of its target”.

A DHSC spokesperson said: “In just one year we’ve delivered over five million extra appointments and cut waiting lists by 220,000, and this week’s productivity figures show our reforms are working.

“We’ve put the NHS on the road to recovery and are pressing the accelerator, with £26 billion extra this year, new surgical hubs, more evening and weekend scans, and modern technology to get millions more patients treated on time.

“Strikes have caused delays to patient appointments. We urge the BMA to work with us, not against us, as we drive down the longest waits from 18 months to 18 weeks and get the NHS back on track.”