Hospital Waiting Times · Consultant-led RTT · Monthly Publication

The year-long waits are vanishing. The six-month surgical waits are not.

Three years of monthly waiting-times data tell a genuinely mixed story: England’s list is 600,000 smaller than its 2023 peak and year-long waits have fallen 45% in twelve months — yet a patient admitted for orthopaedic surgery in June 2026 had typically waited six months, and the gap between the best and worst ICBs is wider than the headlines suggest.

By Dr Yogasakaran Arjuna · 9 September 2026 · NHS England RTT data, April 2023 to June 2026 · 537 providers · 36 ICBs

01A smaller list, slowly

The waiting list peaked at 7.78 million pathways in August 2023 and has drifted down since — 7.18 million in June 2026, 3% lower than a year ago.

The scale of churn behind that gentle slope is easy to miss: in the twelve months to June 2026 the NHS opened 21.4 million new waits and started treatment on 18.4 million — roughly 1.8 million clock starts every month. The list is falling not because demand has eased but because activity, plus removals for other reasons, is finally running ahead of it.

02The tail is being cut off

Whatever else is said about elective recovery, the deliberate assault on the longest waits is working.

From nearly 400,000 in mid-2023 to 106,621 in June 2026 — and the extreme tail has all but gone: 9,693 pathways over 65 weeks and just 2,268 over 78 weeks remain across the whole of England. A year ago the 52-week figure was 194,715; it has almost halved again since. This is the clearest success in the data, and it is visible in every region.

03What patients actually wait

The most-quoted number — the median wait of the queue — systematically understates what patients experience, because the queue is dominated by people who joined it recently.

The same publication records how long patients had waited when treatment actually started. For England as a whole in June 2026 the queue snapshot says 12.3 weeks; patients admitted for treatment that month had waited 13.6 weeks. Modest gap — until you split by specialty. For the surgical specialties, the admitted figure is roughly ten weeks longer than the snapshot:

Oral surgery (26.1 weeks), ENT (24.5) and trauma & orthopaedics (24.3) head the admitted-wait table — a patient starting surgical treatment in June had typically joined the queue around Christmas. At the other end, the medical specialties treat quickly once seen (gastroenterology 4.7, neurology 4.3) — their problem is different: neurology’s queue median of 13.9 weeks against a treated median of 4.3 says the wait is overwhelmingly for the first appointment, not the treatment.

04Thirty-six ICBs, twenty-point spread

Eighteen percentage points separate the top of the chart from the bottom. The dashed line is England.

The spread is wide on every measure. At the top, Cornwall and the Isles of Scilly (74.9%), North East and North Cumbria and Gloucestershire (both 73.8%) keep nearly three-quarters of their lists under 18 weeks. At the other end of the chart, the lowest-placed system stands at 56.4% and also carries 13,496 year-long waits — 4.3% of its entire list, six times the national share. The two measures do not always travel together: one of the top three systems holds its year-long count to just 27 pathways even as its list grows faster than anywhere in England (+14.3% in a year).

The starkest postcode difference is in the admitted wait: a patient admitted for treatment in Birmingham and Solihull in June had typically waited 3.7 weeks; in Leicester, Leicestershire and Rutland, 20.9 weeks — over five times longer, within seventy miles of each other. Both figures come straight from the public provider-level data and can be checked on the dashboard. (West and North London, for local readers: 68.0% under 18 weeks, ninth of thirty-six, 582,654 waiting, flat year on year, admitted median 14.5 weeks.)

05Direction of travel

Year-on-year list movement separates systems clearing their backlog from systems accumulating one.

The largest falls: Birmingham and Solihull (−9.2%), Norfolk and Suffolk (−8.2%) and Bristol, North Somerset and South Gloucestershire (−7.6%). The largest rises: Gloucestershire (+14.3%), Staffordshire and Stoke-on-Trent (+12.8%) and North East and North Cumbria (+7.3%). Growth is not automatically failure — North East and North Cumbria carries the second-best 18-week performance in England despite the rise — but a growing list combined with deteriorating performance is the pattern to watch anywhere it appears.

06The independent sector, quietly stable

Just under one in ten NHS-funded elective treatments now starts in an independent-sector provider.

The independent sector delivered 8.5–9.6% of completed pathways in each year of this series — concentrated overwhelmingly in cataracts and other high-volume day-case work, which is why IS providers dominate any list sorted by shortest wait. Their share has drifted slightly down, not up, since 2023: whatever is driving the national recovery, it is mostly NHS theatres doing it.