Our new modelling shows that, at national level, the elective waiting list in England must be halved to around 3.4 million for the NHS to meet its statutory waiting time standard.
In the NHS in England it is a constitutional requirement that 92% of patients awaiting consultant-led elective treatment must be waiting no longer than 18 weeks. This target was last met in 2015 with much fewer referrals per year than we see today. At the end of 2024 just under 60% of the 7.5 million patients waiting achieved the 18-week target.
Beating the backlog is crucial. Long waits result in patient harm and additional healthcare demands, worklessness and economic inactivity, and exacerbated inequalities. Patients from more deprived areas are disproportionately affected, often unable to afford private treatment. The government has pledged to standard by the end of the current Parliament.
The question is not whether the waiting list must be reduced – but by how much, and where to focus additional capacity/resource. Our modelling indicates that approximately one million additional removals per year are needed, equating to an uplift of 5.5% on 2024 activity.
We also identified significant regional and specialty variation in the scale of effort required. Some systems will need to make substantially greater capacity gains than others, highlighting where targeted investment and planning are most needed. This analysis was led by and analysts from The Strategy Unit.