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Flagship NHS pledge hanging in the balance

September 25, 2025
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The government’s flagship NHS pledge to get back to hitting the 18-week waiting time target in England by the end of the parliament is hanging in the balance, experts say.

An analysis by the Health Foundation shows, on current trends, waiting times will still be over 20 weeks by July 2029.

The think-tank is warning the huge efforts being put into reducing waiting times also risks distracting from other priorities in the NHS, including improving access to GPs.

But the government said it was pleased with the progress being made – and expected the pace of improvement to increase.

The 18-week target requires 92% of patients to wait less than that amount of time. It has not been hit for a decade.

Waiting times ballooned during the pandemic as hospitals scaled back on the amount of routine care they were doing.

When Labour came to power, there were 7.6 million patients on waiting lists for treatments such as knee and hip replacements with 58.8% waiting less than 18 weeks.

Over the past year that has improved to 61.3%.

But even if the current rate of improvement continues, it will not be quite enough to hit the target, the Health Foundation said.

Just over a third of trusts are making the necessary progress set out under the government’s waiting time plan published at the start of this year, the analysis said.

And the think-tank warned progress could suffer if the rate of referrals rises more quickly than expected – something that is quite possible given the ageing population.

The prospect of more industrial action – resident doctor members of the British Medical Association are still in dispute with the government – could further complicate matters, it added.

Dr Francesca Cavallaro, from the Health Foundation, said: “The government has clearly made progress in reducing 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.

“The scale of the challenge remains significant and even getting close to meeting the target would be a considerable achievement.

“But placing so much emphasis on the 18-week target risks slower progress on other key issues, such as improving access to GPs, which we know is the public’s top priority for the NHS.”

A Department of Health and Social Care spokesman said a lot of progress was being made and productivity in the health service was improving.

He said the extra money being invested in the NHS, which was introducing modern technology and leading to more evening and weekend working, would help accelerate progress.

But he acknowledged strikes had caused problems.

“We urge the BMA to work with us, not against us, as we drive down the longest waits and get the NHS back on track.”

Tim Mitchell, president of the Royal College of Surgeons of England, said: “This analysis otherwise confirms what surgeons see every day – the NHS is still struggling to meet demand, and unless surgical capacity expands, the government will almost certainly fall short of its target.”



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