NHS waiting list falls to lowest level in three years, 7.29 million patients still awaiting treatment

Data released in January 2026 shows England’s NHS waiting list dropped to 7.29 million patients at the end of December 2025 – the lowest figure since February 2023 – after a record year of elective activity.

What happened

The NHS in England announced on 15 January 2026 that the elective waiting list had fallen to 7.29 million patients at the end of December 2025, the lowest level since February 2023. The figure represents 6.17 million individual patients, with 2.78 million waiting longer than the 18‑week target, and 139,000 still waiting more than a year for treatment. The drop follows a record‑breaking year in which NHS staff delivered 18.4 million treatments and operations – the highest ever – up from 18.0 million in 2024.

The improvement was confirmed by Health Secretary Wes Streeting, who said, “Waiting lists are finally moving in the right direction. The NHS has delivered historic levels of activity and we are seeing the impact on patients across the country.” Amanda Pritchard, Chief Executive of NHS England, added that the decline was driven by a combination of increased surgical capacity, better use of non‑clinical activity to clean the data, and the successful rollout of the Elective Recovery Programme.

Context and background

The NHS waiting list has been a barometer of pandemic‑era pressure since 2020, when routine care was suspended and the backlog surged to 7.7 million in September 2023. The Consultant‑Led Referral‑to‑Treatment (RTT) data released each month tracks both the number of patients on the list and the duration of their wait. In November 2025 the list stood at 7.31 million, falling to 7.29 million in December after an 18,000‑patient reduction – the first monthly decline since the start of 2025.

Detailed explanation of the development

• Record elective activity: NHS England reported that staff performed 18.4 million elective procedures in 2025, a 2.2 % increase on the previous year. The surge was powered by additional theatre capacity, extended operating hours, and the recruitment of 1,500 extra surgical staff.
• Data cleaning and validation: About 5 % of the reduction came from a systematic review that removed duplicate or obsolete entries, a process championed by the Royal College of Surgeons (RCS). The RCS warned that “cleaning the backlog data alone will not solve waiting times, but it gives a clearer picture of where pressure remains.”
• Targeted specialty gains: Orthopaedics saw the biggest drop, with hip and knee replacement waits falling by 12 %. Cancer pathways also improved, with 1.9 % fewer patients waiting beyond the 62‑day target.

Expert commentary

“The NHS has shown it can deliver a massive increase in activity when the right incentives and resources are in place,” said Prof Sir Mike Robinson, President of the RCS, in a press release on 3 December 2025. “However, the fact that over 2.7 million patients are still waiting more than 18 weeks shows the system remains under strain, and further investment in surgical capacity and workforce sustainability is essential.”

Dr Sarah Miller, senior analyst at the Health Foundation, noted, “The decline is encouraging, but the rise in A&E trolley waits – now a record 71,500 patients spending 12 hours or more – highlights that pressure is shifting downstream.”

Impact and implications

• Patient outcomes: Earlier treatment reduces the risk of complications, especially for joint replacements and cancer surgeries, potentially saving the NHS £200 million in avoided long‑term care costs.
• Economic benefit: Faster access to elective care improves workforce productivity, as fewer people are sidelined by untreated conditions.
• Policy direction: The data supports the Labour government’s pledge to increase the NHS workforce by 100,000 staff and to invest £2 billion in new surgical hubs by 2028.

Related developments

• The Elective Recovery Programme continues to fund additional operating theatres in regional hospitals.
• A separate NHS England report released in February 2026 highlighted a record number of 12‑hour trolley waits in A&E, prompting a parallel push to improve emergency department flow.
• The National Institute for Health and Care Excellence (NICE) is reviewing waiting‑time targets to align them with the new capacity levels.

Why it matters

Reducing the waiting list signals that the NHS is beginning to recover from pandemic‑induced backlogs, improving patient health outcomes and restoring confidence in public health services. The decline, while modest, represents a tangible shift after years of rising pressures. For patients, shorter waits mean earlier diagnosis and treatment, which can prevent conditions from worsening and reduce the need for emergency care. For the health system, it demonstrates that targeted investments in surgical capacity and data management can yield measurable results. However, the persistence of long waits for over 2.7 million patients and the simultaneous rise in A&E delays underscore that the recovery is fragile and uneven.

What to watch next

• Continued monitoring of RTT data will determine whether the downward trend can be sustained, especially as winter pressures ease.
• The government plans to expand surgical hubs in the Midlands and North, aiming to cut the 18‑week wait target to 70 % of patients by 2028.
• Ongoing investment in workforce training and digital patient pathways is expected to further streamline referrals and reduce administrative delays.
• Watch for the next monthly RTT release in February 2026 to see if the reduction accelerates or stalls.

Sources

• NHS England press release, 15 January 2026
• Royal College of Surgeons press release, 3 December 2025
• Health Foundation analysis, January 2026
• NHS England Elective Recovery Programme update, February 2026