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Waiting on the NHS across Britain

14 June 2023

Save Our NHS demonstration, London, March 2023. Photo Workers.

On 8 June, NHS England published the latest figures on hospital waiting lists. They showed that at the end of April, 7.4 million people were queuing to start hospital treatment.

This is a new and unwelcome record, up by 100,000 from the previous record number in March. The Royal College of Nursing pointed out that in 2011 an average of 2.53 million people were on waiting lists. The figure for 2022 was 6.79 million.


The length of waiting time is increasing. About 40 per cent of patients were waiting more than 18 weeks to begin routine hospital treatment: the government’s target figure is 8 per cent. And at the end of April, 371,111 people were waiting for a year, up from 359,798 at the end of March.

The government had pledged that by the start of this April, no one would be waiting longer than 18 months. Yet at that point there were 10,737 people who had been waiting that long; the figure has now risen to 11,477. And 523 people were waiting for more than two years.


Waiting times for cancer treatment have become longer too. The NHS target is that 85 per cent of cancer cases are first treated within two months. But in April only 61 per cent were, a further decline from the figure of 63.5 per cent in March.

Accident and emergency departments had their busiest May on record. Average response time for the most urgent incidents was eight minutes 17 seconds, ten seconds longer than in April, and well above the seven-minute target.


Sunak’s pledge to cut waiting lists seems, so far, to have gone into reverse. This is not surprising: his government still refuses to settle pay disputes in the NHS. It is still delaying producing its long-promised NHS workforce plan. And it has given up on reforming social care, which puts yet more pressure on the NHS.

The Royal College of Nursing pointed out that in England over 1.5 million more people waited for more than four hours in A&E in 2022 than in 2011. In 2011/12, 5.2 per cent of patients attending major hospital A&E spent longer than four hours in the department. By 2019/20 this had risen to 24.7 per cent.

Not met

Detailed data from the Royal College of Emergency Medicine shows that the four hour standard, pledged in the NHS Constitution – that 95 per cent of patients should be admitted, transferred or discharged from emergency departments within four hours – has not been met in England since June 2013.

The twelve hour pledge – that no more than 2 per cent of patients should wait 12 hours or more – has not been met in England since April 2021.

Excess deaths

There are excess deaths associated with crowding and extremely long waiting times: for every 72 patients waiting between eight and twelve hours from their time of arrival in the Emergency Department, there is one patient death.

The devolved administrations are doing no better. Scotland last met the four hour standard in June 2020. Before that, it had not met the standard since July 2017. Since records began, Wales has not met the standard.


In Scotland, during the quarter ending this March, 319,514 waits for a new outpatient appointment were completed, ie when the patient involved was seen at an outpatient clinic. Of these waits just under 63 per cent were completed in 12 weeks or less, down from 65 per cent for the previous quarter. The number of waits over 12 weeks increased from 107,925 to 118,402 during the same period.

At 31 March, there were 479,725 patient waits yet to be completed. The upward trend in this figure has continued since the coronavirus pandemic began to affect planned care in March 2020.

The rate of increase in the number of outpatient waits has slowed in recent quarters. Even so, the total waiting list size is now over 14 per cent higher than at the same date last year and 87 per cent higher than at 31 March 2020 – an extra 220,000 people waiting to be seen.

There were 31,498 waits longer than 52 weeks. But the 6,985 ongoing waits longer than 104 weeks for inpatient or day case treatment has dropped by 322 since 30 September 2022.


In Wales, as of 23 May, around 30,000 people were waiting more than two years after being referred for hospital treatment, a key target missed. By March, no patient in most specialties was expected to wait that long.

But official figures showed 31,406 patient pathways had missed the target. About 576,000 patients are on waiting lists, a rise of 2,000 after a fall in the previous five months.