Surgeons: despite falling waiting lists, lack of NHS capacity still threatens the government’s 18-week pledge

The latest NHS consultant-led referral-to-treatment data shows that the total waiting list decreased by 145,179 in November 2025, with 7.15 million people on the waiting list.  

While the reduction is welcome, performance remains off track to meet the Government’s pledge to restore the 18-week standard.   

Findings from RCS England’s recently published 2025 surgical workforce census highlight deep-rooted constraints on surgical recovery, with 73% of surgeons citing a lack of theatre space. 

The proportion of patients who began treatment within 18 weeks slightly decreased to 61.6%, while 154,121 patient pathways were waiting longer than 52 weeks. 

Taken together, the latest figures (which include a period of industrial action) underline the urgent and ongoing need for increased investment in NHS infrastructure, including the surgical workforce, estates, equipment and temporary care environments. 

Professor Vivien Lees, Senior Vice President of the Royal College of Surgeons of England (RCS England), said: 

“Irrespective of the reasons, progress on getting patients’ treatment started within 18 weeks remains too slow to meet the government’s own targets, so sustained action is essential.  
 
“Our latest surgical workforce census highlights that surgeons, with the rest of the workforce, want to do more but are being held back. Without further investment in NHS capacity, including operating theatres, it will be challenging for the NHS to meet the government’s manifesto pledge on waiting times.  

“Long-term capital investment, alongside greater flexibility with how trusts can raise their own funds, is vital to build future NHS capacity and ensure patients receive the timely care they deserve.” 
 
ENDS 

Notes to editors:

1. Recently published analysis found that only around a quarter of NHS trusts are on track to meet their original elective target for 2025/26. 

2. UK Surgical Workforce Census — Royal College of Surgeons (December 2025)

3. The government has pledged that by 2029, 92% of patients will begin treatment within 18 weeks of referral. As an interim milestone, the target is for 65% of patients to be treated within 18 weeks by March 2026.   

4. 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 

5. The total waiting list stood at 7,159,010 in November 2025. 

6. Statistics » Consultant-led Referral to Treatment Waiting Times Data 2025-26 

7. 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. 

8. 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.