NHS trusts lag on 18‑week target as progress stalls

Hospital trusts are falling short of the 18-week waiting-time target as progress remains stalled, prompting warnings from clinicians and patient advocates. An analysis of hospital performance shows that over a third are seeing a smaller share of patients within 18 weeks since the NHS improvement plan was announced in January. While some individual trusts have shown notable progress, the broader national picture remains far below the constitutional standard.

Waiting times and the interim goal

The government has set a series of milestones to address the backlog. The government has promised to hit the target by March 2029, which requires 92% of patients to be seen within 18 weeks. In January, every hospital trust was given their own individual performance targets to meet by March 2026 as the first step in achieving that pledge. The interim targets for March 2026 mean trusts either have to be seeing 60% of patients within 18 weeks of referral or improve on their November 2024 position by five percentage points - whichever is the greater.

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Performance variance across trusts

The pace of improvement has been uneven. Among the trusts showing the most significant gains, the Princess Alexandra Hospital Trust (PAHT) in Harlow increased its performance from 41.8% in November 2024 to about 48.8% in April 2026. PAHT chief executive Thom Lafferty said they were “delighted” with their progress. Similarly, Mersey and West Lancashire Hospitals NHS Trust rose to 64.2% in April, up from 58.7% in November, while East Sussex Healthcare NHS Trust reached 60.1% in April, up from 54.9% in November.

Conversely, some trusts have seen their figures decline. Mid and South Essex NHS Trust started out with 52.8% of patients waiting less than 18 weeks in November. But when the clock started in April, it had fallen to 47%. Others that have fallen despite requiring large improvements include the Robert Jones and Agnes Hunt Orthopaedic Hospital (RJAH) in Shropshire (down from 48.3% to 44.9%) and Countess of Chester, down from 49.6% to 47.1%. Cathy Chadwick, chief operating officer for Countess of Chester, said more clinics and investment in new technology would bring down waiting lists and the trust was confident of meeting the target by next March.

Clinical and patient concerns

The physical and mental toll on patients remains a primary concern for advocacy groups. John Winnik, a 73-year-old consultant who has been on an NHS waiting list for nine months, described the impact of his condition:

"I'm living in constant pain," said Mr Winnik, a self-employed consultant in the glass lamination industry. "I've forgotten what it is like to not be in pain, to be honest."

Professional bodies have expressed frustration at the rate of recovery. Tim Mitchell, president of the Royal College of Surgeons of England, cautioned:

"The NHS is changing course, but the sails still lack wind."

Deborah Alsina, chief executive of the patient group Versus Arthritis, echoed these sentiments, noting the broader societal impact of patients dropping out of the workforce due to prolonged delays. She asserted:

"It is impossible to overstate the personal, physical and mental toll of being stuck on a waiting list in daily pain, sometimes for years."

Broader system pressures

The challenges facing elective care are compounded by ongoing pressures in emergency services. In May 2026, 75.7% of people attending A&E were admitted, transferred or discharged within 4 hours in May 2026, a decrease from the previous month (76.9%). Additionally, the number of patients waiting over 12 hours for an emergency admission increased from approximately 48,000 in April 2026 to 50,000 in May 2026. The British Medical Association (Bma) has highlighted that workforce shortages and the need for ongoing infection-control measures continue to impede the clearing of backlogs.

Health Secretary Wes Streeting stated that progress would go "further and faster" in the coming years, helped by the extra money being invested and the 10-year NHS plan. He said lots had been achieved so far, including millions more appointments being carried out and the total number of patients on the waiting list dropping to below 7.4 million, its lowest level for two years. Over 8.7 million tests, checks and scans have been carried out in CDCs between July 2024 and June 2025.

In addition to waiting list pressures, the NHS has recently grappled with high-profile safety concerns. A trainee NHS surgeon, Salil Korambayil, was jailed for 14 years after being convicted at a retrial for rape. reports regarding maternity care standards have surfaced, with Dr Bill Kirkup resigning as an expert adviser to a government-commissioned review, claiming that critical findings regarding "normal birth ideology" were omitted from the final report.