NHS England's Latest Data: A Tale of Two Trends
NHS England has released its comprehensive monthly performance data for January, painting a complex picture of the healthcare system's current state. While the overall waiting list for routine hospital treatment has continued its downward trajectory, reaching its lowest point since early 2023, accident and emergency departments are grappling with unprecedented delays. The figures, which include detailed breakdowns of waiting times, cancer referrals, and seasonal pressures like norovirus and flu, underscore the persistent challenges facing the National Health Service.
Routine Treatment Waiting List Shows Encouraging Decline
The waiting list for non-urgent hospital procedures has decreased for the second consecutive month, offering a glimmer of hope. At the end of December 2025, an estimated 7.29 million treatments were pending, affecting 6.17 million patients. This marks a slight reduction from 7.31 million treatments in November and represents the lowest volume since February 2023, when the figure stood at 7.22 million. It is a significant improvement from the record high of 7.77 million treatments and 6.50 million patients recorded in September 2023.
Historically, the list has seen a steady increase, surpassing three million treatments in 2014, four million in 2017, five million in 2021, and seven million in 2022. For context, in February 2020, just before the Covid-19 pandemic, the backlog was at 4.57 million treatments.
Long Waits for Treatment: A Mixed Bag
There has been notable progress in reducing the number of patients enduring excessively long waits. At the end of December 2025, 140,508 individuals had been waiting more than a year to start routine hospital treatment, down from 156,483 in November. This is the lowest figure for such prolonged waits since September 2020. Consequently, the proportion of people on the list waiting over 52 weeks dropped to 1.9% in December, from 2.1% the previous month. The Government and NHS England aim to reduce this to less than 1% by March 2026.
However, the number of patients waiting more than 18 months saw a slight uptick, rising to 1,514 from 1,500 in November, though this is lower than the 2,061 recorded in December 2024. Meanwhile, those waiting over 65 weeks decreased significantly to 7,344 from 9,521 the previous month, a substantial improvement from 15,576 a year earlier.
A&E Departments Under Severe Strain
In stark contrast, accident and emergency services are facing critical pressures. In January, a record 71,517 people waited more than 12 hours in A&E from the decision to admit to actual admission, a sharp increase from 50,775 in December. This is the highest number since monthly records began in August 2010. Additionally, 161,141 patients waited at least four hours under the same metric, up from 137,763 in December, making it the second highest figure on record.
Overall, only 72.5% of patients were seen within four hours in A&Es last month, down from 73.8% in December. The Government and NHS England have set a target of 78% by March 2026 for patients to be admitted, discharged, or transferred within four hours.
Cancer Referrals Show Positive Movement
There is encouraging news in cancer care. In December 2025, 77.4% of patients urgently referred for suspected cancer were diagnosed or had cancer ruled out within 28 days, up from 76.5% in November and exceeding the current target of 75%. Furthermore, the proportion of patients who waited no longer than 62 days from referral to first definitive treatment improved to 71.9% from 70.2% in November. The goal is to reach 75% by March 2026.
Winter Pressures: Norovirus and Flu Trends
Seasonal illnesses continue to impact hospital capacity. Last week, an average of 929 hospital beds in England were occupied daily by patients with norovirus symptoms, a 3% increase from the previous week's 904 but below the peak of 950 in late January. Flu patients averaged 1,119 per day, including 43 in critical care, down 25% from 1,491 the previous week. This winter's peak was 3,140 patients in mid-December, significantly lower than last winter's high of 5,408.
Ambulance Response Times Worsen
Ambulance services are also struggling with delays. In January, the average response time for the most urgent, life-threatening calls was eight minutes and eight seconds, up from seven minutes and 59 seconds in December and above the seven-minute target. For emergency calls such as heart attacks and strokes, response times averaged 35 minutes and four seconds, up from 32 minutes and 43 seconds in December. The target for 2025/26 is an average of 30 minutes, with the current figure at 30 minutes and 33 seconds. Urgent calls, like late-stage labour, averaged two hours, 10 minutes and 54 seconds, up from two hours, one minute and 17 seconds in December.
Delayed Discharges Slightly Improve
On a positive note, delayed discharges have seen a minor reduction. Last week, an average of 13,660 hospital beds were filled daily by patients fit for discharge, down from 13,714 the previous week and below the peak of 14,005 in late January. This indicates some progress in freeing up bed space for new admissions.
The latest NHS England data highlights a healthcare system at a crossroads, with improvements in treatment backlogs and cancer care overshadowed by severe A&E delays and ambulance response times. As winter pressures persist, these figures will be closely monitored by policymakers and the public alike.
