The government’s high-profile promise to slash NHS waiting times is under intense scrutiny, as new analysis reveals it is on track to narrowly miss its own ambitious targets—leaving millions of patients still facing long delays for treatment by the end of this parliament. Despite a year of headline pledges and incremental improvements, experts warn that the Labour administration will fall just short of meeting its manifesto commitment that 65 percent of patients would be treated within 18 weeks of referral by July 2029, a standard that has eluded the health service for over a decade.
According to a report published Thursday by the Health Foundation, a leading think tank, the NHS waiting list currently stands at 7.4 million, a modest reduction from the 7.6 million recorded when Labour assumed power in July 2024. If the current downward trend continues, projections suggest the waiting list could shrink to 4.7 million by the time of the next election. Yet, the pace of improvement is not expected to be enough to reach the government’s central promise.
“The government has clearly made progress in reducing NHS waiting times. But on current trends, our analysis shows that the NHS would just fall short of meeting the 18-week standard by the end of the parliament,” said Dr Francesca Cavallario, Senior Analytical Manager at the Health Foundation, in comments reported by The Independent. “The scale of the challenge remains significant, and even getting close to meeting the target would be a considerable achievement.”
The 18-week target, which Labour pledged to restore, has not been met since before 2015. The Health Foundation’s analysis points out that while there has been steady progress—helped in part by the government’s pledge to deliver an additional 40,000 appointments every year—waiting times have only improved modestly. The report notes that it is difficult to determine precisely how much of the improvement is attributable to the new government’s policies, given that Labour has largely continued the approach of the previous Conservative administration.
Supporters of the government argue that even approaching the 18-week benchmark would represent a significant achievement, especially considering the enormous backlog and the pressures facing the NHS. Critics, however, contend that missing the target is a sign that patients are still being let down, with many forced to wait months—or in some cases, years—for essential care. According to The Independent, the debate over waiting times has become a lightning rod for public frustration, with some asking: how long is an acceptable wait for a routine NHS appointment?
Adding to the complexity, the Health Foundation report highlights that NHS trusts were caught “between a rock and a hard place” last winter, as they struggled to meet elective care targets while also managing urgent emergency care demands. The researchers analyzed patterns in referrals and the number of patients removed from the national waiting list, but they caution that their calculations are not definitive predictions. Several factors could affect the trajectory, including future changes in the rate of referrals, the impact of potential further industrial action, and the accuracy of data on patients removed from the list.
One concerning finding is a “glitch” in the NHS’s e-referrals system, which automatically deletes patient referrals after 180 days if there has been no action. The report suggests it is impossible to tell, based on current data, whether patients have been inappropriately removed from the waiting list, but notes the lack of transparency could be a cause for concern.
Looking ahead, the government has set interim targets for March 2026, aiming for every NHS trust to meet the 65 percent within 18 weeks standard and for waits longer than 52 weeks to fall below one percent of the national waiting list. Yet, the Health Foundation’s projections indicate the NHS will likely reach only 63.4 percent of patients seen within 18 weeks by that date, narrowly missing the target. Meanwhile, the proportion of patients waiting more than 52 weeks is expected to be 2.2 percent—again, just above the government’s threshold.
Despite these near misses, the report offers a glimmer of optimism. If the current pace of improvement holds, by the end of the next parliament, 92 percent of patients could be seen within 20 weeks—a level of performance not achieved since 2017. Still, the report cautions that continued progress is far from guaranteed. The NHS faces ongoing threats of strike action from doctors, nurses, and other staff, which could slow or even reverse recent gains. While the Health Foundation previously estimated that industrial action has had only a “limited” direct impact on operations and appointments, it warns that further strikes could compromise productivity and take the government further away from its 18-week target.
Dr Cavallario also sounded a note of caution about the government’s singular focus on the 18-week target. “By placing so much emphasis on the 18-week target, the government risks making progress on other areas, such as improving access to GPs,” she said. This echoes wider concerns within the health sector that a narrow focus on headline waiting times could come at the expense of broader improvements in patient care and access.
The Health Foundation report further observes that more patients are currently being removed from the waiting list than are being referred to it. This dynamic, if sustained, could accelerate reductions in the backlog. However, the report also highlights uncertainties in the data, particularly regarding the reasons patients are removed from the list—whether due to completed treatment, starting treatment, or other, less clear reasons.
In response to these findings, both the Department for Health and Social Care and NHS England were approached for comment, but had not provided a statement as of publication. The ongoing debate over NHS waiting times is likely to remain a central issue in British politics, especially as the next general election approaches and public expectations remain high.
For now, the government faces a delicate balancing act: maintaining momentum on waiting list reductions, managing the risk of further industrial action, and ensuring that improvements are felt by patients across the board—not just in headline statistics, but in the lived reality of those seeking timely care. As the Health Foundation’s analysis makes clear, the road ahead is fraught with challenges, and the margin for error is slim. The coming months will test whether incremental gains can be turned into lasting progress—or whether the NHS, and the millions who rely on it, will be left waiting a little longer for relief.
