An estimated 40,000 people were added to NHS waiting lists in England in August.
According to official data, the number of referral to treatment (RTT) pathways where a patient was waiting to start treatment rose to 7.37 million – up from 7.33 million in July.
Among the 7.37 million, in 113,339 cases the patient was waiting more than 52 weeks, in 10,782 cases they were waiting more than 65 weeks, in 1,637 cases they were waiting more than 78 weeks, and in 222 cases they were waiting more than 104 weeks.
Some patients are on multiple pathways. The number of unique patients is estimated to have remained at around 6.2 million.
In 65.2% of cases the patient had been waiting up to 18 weeks, thus not meeting the 92% standard.
Over the month, 1,717,335 new RTT pathways were started and 292,411 pathways were completed as a result of admitted treatment and 1,138,396 were completed in other ways (non-admitted).
For those pathways where the patient was waiting to start treatment at the end of August 2026, the median waiting time was 12.2 weeks. The 92nd percentile waiting time was 38.8 weeks.
Four years at 7 million
David Hare, chief executive of the Independent Healthcare Providers Network (IHPN), maintained that it is now four years since the NHS waiting list first reached 7 million and while progress has been made in bringing the list down from its peak in 2023, the figures are a reminder of the scale of the challenge still facing the health service.
“Bringing waiting times down remains a top priority for the public who are expecting to see a clear improvement in their access to treatment during this parliament and now is not the time to stop aiming to meet the NHS’ 18 week target by 2029,” Hare said.
“This is a collective challenge, requiring the NHS and independent sector working together to make the best possible use of all the capacity available in order to deliver the care patients need. Independent providers are already playing their part, but they could be doing so much more.
“With progress undoubtedly slowing, now is the time for the government to redouble its efforts to tackle the backlog, including a clear steer for the NHS to shift activity away from providers that are struggling to deliver timely care and towards those that can treat patients safely and quickly – whether NHS or independent providers.”
Reaching out for help
Sarah Taylor, director of corporate healthcare proposition at Healix Health, said while more people are reaching out for help, demand for healthcare services is still growing faster than services can keep up with, and for many the wait for support plays out while they’re still holding down a job, often quietly and without their employer knowing.
“That is why the support employers already provide needs to be easy to reach, particularly when it comes to mental health,” Taylor said.
“Our own claims data shows that 32% of mental health claims now come through digital pathways, up from 27.5% the previous year, which tells us people increasingly want support they can get to quickly and on their own terms.
“For someone struggling while they wait for NHS care, the easier it is to access the help their employer already offers, the sooner they can start getting better.”
Patient uncertainty
Dawn Prescott, head of healthcare proposition at The Exeter, said the figures highlight the progress being made and the ongoing focus needed to reduce NHS waiting times.
“While staff across the health service continue to work tirelessly to tackle the elective care backlog, many patients are still facing waits well beyond the 18-week standard,” Prescott said.
“Long waits can create uncertainty for patients and their families, particularly when symptoms are affecting day-to-day life. At times like this, it is important that people understand the support and treatment options available to them so they can make informed decisions about their care.
“By working together, the NHS and private sector can make better use of available healthcare capacity, helping more patients access treatment sooner and supporting further reductions in waiting times.”
Difficult legacy
Tim Gardner, deputy director of policy at the Health Foundation, said the latest data once again highlights the difficult legacy facing the new government on healthcare.
“Despite the NHS delivering a high level of elective activity, NHS waiting lists still increased to 7.37 million in August, while urgent and emergency care was under sustained pressure in September, with ambulance response times rising amid high numbers of callouts,” Gardner said.
“The extreme heat over the summer hampered efforts to improve performance and our latest projections suggest it will be increasingly hard for the NHS to meet its headline 18 week standard for routine hospital care. The NHS now has only a very short window to get elective recovery back on track before colder winter weather and seasonal illnesses start to intensify pressures on urgent and emergency care again.
“With a Budget and a new 10-year plan for the government coming in the Autumn, ministers need to confront difficult choices. A decision is needed on whether to continue chasing the headline pledge on waiting lists or to set a more realistic goal and broaden the focus to other key aspects of care that matter to patients and the public, including waiting times in A&E, access to general practice and improving maternity care.”
Set clear expectations
Sarah Woolnough, chief executive of The King’s Fund, said the figures show why the government will soon have to make its expectations for the NHS clear. NHS waiting lists have continued to rise, with more than 120,000 added since the start of this year through to August.
“The King’s Fund has warned before that the previous administration’s approach of using ‘sprint funding’ to cut waiting lists at speed towards the end of the year was more akin to a sugar rush than the type of sustained recovery patients need,” Woolnough said.
“We can’t expect NHS staff to keep working harder to bring down waiting lists based on these injections of short-term funding. More fundamental action is needed to address the underlying causes of rising demand and create a more sustainable health service for patients.
“A change in administration is an opportunity for the government to make good on its commitment to focus on preventing ill-health, rather than simply treating people when they fall sick. This approach could help improve health outcomes for the public, boost economic productivity and reduce the burden on taxpayers. Tackling issues like obesity, young people’s mental health and long-waiting lists for children would be a good start for reducing the chance of people joining waiting lists for care in the first place.
“The challenge this government faces is marrying this greater focus on prevention with what was promised in the 2024 Labour manifesto, where its main priorities centred on waiting times and increasing access to care. The government will have to break its silence soon on how it plans to deliver these existing waiting time pledges, if indeed it believes it still can, and its commitment to deliver long-term improvements in the health of the nation.”
Stalled progress
Brett Hill, head of health and protection at Broadstone, said the figures make clear that progress in reducing the NHS treatment backlog has stalled, with the size of the waiting list essentially unchanged from where it stood a year ago.
“If we factor in the growing backlog of people waiting for diagnostic tests it becomes all too clear that more funding alone is not delivering the progress the government promised, as systemic NHS capacity constraints are colliding with the twin realities of an aging population and record levels of obesity,” Hill said. “With the headline NHS target now looking set to be missed, the UK economy cannot afford for health to be an afterthought in the Budget.
“The longer people wait for a diagnosis or treatment, the greater the risk that health issues develop into serious or chronic conditions, forcing many to take time off work or leave the workforce altogether. That is a direct hit to productivity and the public finances.
“The UK’s traditional healthcare model is clearly no longer fit for purpose, and a new partnership between the public and private sector is desperately needed.
“The findings of the Keep Britain Working Review were a welcome first step, but the Budget is the moment to back it up with concrete incentives for employers to commit to long-term investment in workforce health, such as tax relief on employer-funded health benefits and wellbeing support services.
“In the meantime, employers looking to manage their people-asset risks effectively are already deploying preventative healthcare and early intervention strategies. Expanding access to PMI or introducing health cash plans, regular health screenings and private GP services can all help catch problems early and speed up recovery before conditions become chronic or result in prolonged sickness absence. We expect businesses to keep expanding access to private healthcare through innovative health and wellbeing schemes to tackle this growing health crisis.”