England’s National Health Service (NHS) has finally reported a long-awaited dip in its waiting list numbers, breaking a three-month streak of increases and sparking cautious hope among patients and care providers. Yet, as the country heads into what many experts predict will be one of the most challenging winters for healthcare in recent memory, the modest improvement is tempered by mounting pressures, persistent backlogs, and looming industrial action.
According to official NHS England data released this week, the total number of treatments awaiting scheduling or completion at the end of September 2025 stood at 7.39 million. This figure, while still staggeringly high, is down from 7.41 million the previous month—a decrease of 15,845 appointments. It also marks a reduction of 230,000 from July, and, as Health Secretary Wes Streeting put it, represents "the first time in 15 years that waiting lists have fallen." The number of individual patients affected is 6.24 million, a statistic that remains well above pre-pandemic levels, when waiting lists hovered near 4.57 million in February 2020, as reported by BBC and other outlets.
Streeting, speaking on November 13, 2025, declared, "There's a long way to go, but the NHS is now on the road to recovery." He attributed the progress to recent government investment and modernization efforts, stating, "Thanks to the investment and modernisation this Government has made, waiting lists are falling and patients are being treated sooner. We are cutting waste to reinvest billions over the coming years in frontline care—less unnecessary bureaucracy and more services for patients." He also emphasized that the Chancellor is safeguarding NHS investment in the upcoming Budget, aiming to "rebuild after more than a decade of decline."
Despite the optimism, the data reveals the scale of the task ahead. The proportion of patients waiting less than 18 weeks for treatment—the NHS’s key performance benchmark—rose to 61.8% in September, its best showing in over two years. However, it remains a far cry from the government’s target of 92%, which officials have pledged to reach by the end of the current parliamentary term. Tim Gardner, assistant director of policy at the Health Foundation, told The Guardian, "While figures for September show a slight decrease in the elective waiting list to 7.39 million, and a welcome reduction in waiting times, restoring the 18-week standard by the end of this parliament remains a tall order."
The waiting list for planned treatment had previously risen through June, July, and August, peaking before this recent drop. Notably, improvements have also been seen in the most severe cases: the number of people waiting more than a year for routine hospital treatment fell to 180,329 in September from 190,549 in August. The proportion of patients waiting over 52 weeks is now at 2.4%, down from 2.6% the previous month, with a government goal to reduce this to under 1% by March 2026. However, the number of those waiting more than 18 months saw a slight uptick, from 1,418 in August to 1,489 in September, though still dramatically lower than the 2,701 recorded a year earlier.
Performance on cancer treatment targets, however, slipped further behind. Only 73.9% of patients urgently referred for suspected cancer were diagnosed or had cancer ruled out within 28 days, down from 74.6% in August and below the 75% target. The government and NHS England are aiming for this figure to reach 80% by March 2026. Similarly, just 67.9% of patients received their first definitive cancer treatment within 62 days of urgent referral, down from 69.1% in August, and short of the 75% target set for 2026.
Emergency departments are feeling the strain most acutely. October saw record A&E attendances and ambulance incidents, with 54,314 patients waiting more than 12 hours in A&E from the decision to admit to actual admission—up from 44,765 in September and nearly 10% higher than the same month last year. The number of patients waiting at least four hours for admission also rose, reaching 142,734 in October. The trend of so-called "corridor care"—patients waiting on trolleys in hallways for beds—shows no sign of abating.
In the mental health sphere, new transparency efforts have shed light on troubling delays. According to the Nuffield Trust, about 1 in 10 people experiencing a mental health crisis waited over 24 hours in busy A&E departments in October. Sarah Scobie, the Trust’s Deputy Director of Research, praised the publication of these figures as "a commendable step towards greater transparency" but warned, "patients will continue to suffer through unacceptably long waits." She added, "To begin publishing more A&E data now is particularly timely and somewhat brave, as with flu rates above average for this time of year, we can expect a very difficult winter ahead for urgent care services."
The NHS is also grappling with a surge in seasonal flu. More than one million people received flu vaccinations in the week leading up to November 6, bringing the total to 14.4 million—about 160,000 more than at the same point last year. Yet, flu prevalence rates are three times higher than last winter, raising fears of additional strain on already stretched services. Professor Meghana Pandit, NHS England’s national medical director, commented, "Flu is peaking early and looking like it will be long lasting, while industrial action starting on Friday comes on the back of the busiest October in A&E in NHS history." She urged the public to get their flu, Covid, and RSV jabs if eligible, and to use NHS 111 for non-urgent help.
As if these challenges weren’t enough, thousands of resident doctors across England are set to begin a five-day strike at 7am on Friday, November 14—the thirteenth such strike in an ongoing dispute with the British Medical Association. Recent negotiations between healthcare unions and the government have failed to yield a resolution. Gardner of the Health Foundation stressed, "An urgent resolution to the dispute between the government and resident doctors is also vital."
Regional disparities persist. At Cornwall Partnership NHS Foundation Trust, 539 patients were waiting for non-urgent elective operations or treatment at the end of September, up from 434 in August but down from 829 a year earlier. None had been waiting longer than a year, and the median wait time was six weeks—well below national averages. Across England, 1.7 million people were waiting for key diagnostic tests in September, unchanged from August.
While the modest drop in the waiting list is a welcome sign, the NHS faces a gauntlet of challenges: ballooning demand, persistent staff shortages, missed cancer targets, and a winter season already marked by high flu rates and industrial unrest. As Streeting put it, "There’s a long way to go, but the NHS is now on the road to recovery." Whether this road will be smooth or strewn with further obstacles remains to be seen, but for now, the small step forward offers a glimmer of hope in a landscape still dominated by daunting numbers and anxious patients.
