Waiting times for elective (non-urgent) treatment: referral to treatment (RTT)

Waiting times consistently rank as one of the public’s main concerns with the NHS, and have a big impact on patient experience. Here we explore the data on how many people are waiting for treatment, and for how long. 

How quickly are people on the waiting list treated?

The NHS Constitution sets a standard that 92% of patients should wait no longer than 18 weeks from elective (non-urgent) referral to their first treatment (for example cataract surgery or a knee replacement). The waiting list and waiting times have been rising since 2012, and the constitutional standard was last met in September 2015. Performance against the standard rapidly deteriorated during and after the Covid-19 pandemic. It has stabilised more recently, but as just 62% of patients were waiting less than 18 weeks in October 2025, performance remains significantly below both the 92% NHS constitutional standard and the interim target of 65% by March 2026.

The government has made tackling elective care waiting lists a priority for the NHS and pledged that the 92% constitutional standard will be met again by March 2029.

Of those who are waiting longer than 18 weeks, the overwhelming majority start treatment within one year of referral. However, in October 2025 around 171,000 people (2%) had been waiting longer than one year for treatment.

How long are the waiting lists for different specialties?

All specialties performed worse against the 18-week referral to treatment (RTT) standard in October 2025 than they did in October 2019. Between October 2022 and October 2025, some specialties improved the proportion of patients receiving treatment within 18 weeks of referral, but this worsened in other specialties. Trauma and orthopaedics has the largest waiting list, with almost 860,000 people waiting for treatment in October 2025. Oral surgery has the highest proportion of waits of more than 18 weeks, with nearly half of patients (49%) waiting over 18 weeks for treatment. The impact of long waiting times on patients is not regularly captured but can mean that people are waiting in pain for longer and that their condition may deteriorate while they are waiting.

Is the waiting list getting shorter?

Although the number of treatments provided each month is generally increasing, people are still joining the waiting list (being referred) at a faster rate than people are leaving it (being treated), causing the waiting list to grow. There are lots of factors that can contribute to this – for example, a growing population leading to more demand, and workforce shortages in some specialties and roles, limiting the capacity to deliver treatment.

From September 2024 to May 2025, the waiting list generally decreased. However, the reduction was due to an increase in ‘unreported removals’ – patients being taken off the waiting list through data cleansing processes for reasons such as treatment no longer being clinically appropriate, the patient declining treatment or not attending their appointment after their referral, or to correct administrative errors.

Are there inequalities in waiting times?

Waiting times are not equal across demographic groups. People living in the most deprived areas of England are more likely to be waiting longer for elective care than people from less deprived areas. In November 2025, of those waiting for treatment in the most deprived 10% of areas, 59.8% had been waiting less than 18 weeks for treatment since being referred, while 2.4% had been waiting over a year. By contrast, for those in the least deprived 10% of areas, 61.7% had been waiting less than 18 weeks for treatment, while 2.2% had been waiting more than a year.

People in different age groups also experience different waiting times for treatment, with 64.1% of people over 65-years-old waiting less than 18 weeks in November 2025 compared with 59.0% of those aged 19–64 and 59.1% of those under 18-years-old. This difference is also reflected in the proportions of people experiencing very long waits, with 1.9% of those over 65-years-old waiting over a year since referral compared with 2.5% of 19–64-year-olds and 2.2% of those under 18-years-old.

The King's Fund view

Improving waiting times for hospital appointments consistently ranks as one of the public’s top priorities for the NHS, alongside ease of getting a GP appointment and increasing the number of staff, and has a big impact on patient experience of the service. Although the waiting list has started to reduce from its all-time high in September 2023 and there have been some modest improvements to waiting times, long waits for elective care remain all too common, and there are worrying differences in waiting times between more and less deprived areas.

More patients join the waiting list each month than receive treatment, and while this remains the case it will be difficult to make significant progress on bringing down both waiting times and the number of people on the waiting list. The recent reduction in the size of the overall waiting list has been in large part down to the removal of more people who for various reasons should no longer be on it. NHS England has acknowledged that the NHS has ‘more to do’ to meet the interim target of 65% of patients waiting less than 18 weeks for treatment, and multiple independent analyses have found that the NHS is not on track to meet its waiting list pledge by 2029.

Although it is beneficial to have an accurate waiting list, increasing the number of treatments in comparison to the number of new referrals each month is the only route to improving performance against the NHS constitutional standard of 92% of patients beginning treatment within 18 weeks of referral by March 2029. This has been achieved before. The King's Fund has previously looked into successful strategies to reduce waiting times.

Learn more about waiting times for other NHS services in our A&E, diagnostics and patient waiting times nutshells.