Surgeons: Investment and flexibility ‘key’ to cutting waiting times as NHS under mounting pressure

The Royal College of Surgeons of England (RCS England) is calling on the government to ensure NHS Trusts have the flexibility to make the capital investments needed to expand capacity and modernise infrastructure, so patients can receive timely care. 

Across the NHS, hospitals are contending with growing patient demand, workforce shortages, crumbling estates, and limited space to deliver care – across emergency and elective services alike. Without significant extra investment or giving Trusts the flexibility needed to manage their capital investment, the NHS simply does not have the tools it needs to meet waiting times targets.

The latest NHS consultant-led referral to treatment waiting times data shows that the total waiting list decreased by 15,845 in September 2025, reaching 7.29 million.  

Analysis reveals 178,532 patient pathways were waiting longer than 52 weeks. The percentage of patients who began treatment within 18 weeks increased to 61.8%, indicating some progress has been made towards achieving the interim target of 65% of patients starting treatment within 18 weeks by March 2026. 

Mr Tim Mitchell, President of the Royal College of Surgeons of England (RCS England), said:

“Heading into the winter, we are seeing pressure on the NHS intensify. High levels of flu and Emergency Departments under strain will have a knock-on effect on reducing the waiting list. For surgeons, hitting ambitious government targets is made more difficult by outdated infrastructure, which limits capacity. Too few operating theatres, existing facilities in poor condition, and ageing IT hardware and software slow them down and leave them competing for theatre time.  

“If the Chancellor cannot spare any extra investment in the upcoming Budget, Trusts must at least be given greater flexibility to raise and invest their own capital. Expanding capacity is key to meeting targets, cutting waiting times, and, most importantly, delivering care for patients without delay.”  

ENDS 

Notes to editors:

1. NHS England’s latest consultant-led referral-to-treatment waiting times data is available here: Statistics » Consultant-led Referral to Treatment Waiting Times Data 2025-26 

2. The total waiting list stood at 7,298,187 in September 2025. 

3. The Royal College of Surgeons of England provides world-class education, assessment, and development to 30,000 surgeons, dental professionals, and members of the wider surgical and dental care teams at all stages of their careers. Our vision is to see excellent surgical care for everyone. We do this by setting professional standards, facilitating research, and championing the best outcomes for patients. 

4. For more information, please contact the press office: telephone: 020 7869 6053/6054/6060; email: pressoffice@rcseng.ac.uk; out-of-hours media enquiries: 0207 869 6056.