New Health Secretary must match reform plans with investment in surgical capacity

With data published today showing that NHS waiting lists have risen again, the Royal College of Surgeons of England (RCS England) has said the latest figures make clear just how fragile recent progress is, and that there is still a significant journey ahead before patients see the timely care they deserve.  

The NHS is still at risk of missing the constitutional standard of 92% of patients starting treatment within 18 weeks by March 2029 unless further action is taken to expand surgical capacity and modernise infrastructure. 

The NHS met its interim target of 65% of patients starting treatment within 18 weeks by March 2026, demonstrating that measures such as outpatient reform are beginning to improve access to care. However, reaching the 92% standard will require a significant acceleration in progress over the next three years.  

Surgeons across England continue to report significant barriers to treating patients on time, including ageing hospital buildings, limited operating theatre capacity, and ongoing shortages of beds and staff.   RCS England’s most recent workforce census found that restricted access to theatres remains one of the biggest constraints on surgical activity. Without significant investment to address these pressures, patients will continue to face long waits, and the NHS will struggle to meet its recovery ambitions.

The latest NHS consultant led referral to treatment (RTT) waiting times data for April 2026 show that 65.0% of patients started treatment within 18 weeks. The overall waiting list has increased to 7.2 million. 

In April 2026, 99,781 people had been waiting longer than one year for treatment.  The NHS missed the target to reduce the proportion of people waiting over 52 weeks for treatment to less than 1% of the total waiting list by March 2026. 

Commenting on the figures, Professor Frank Smith, Vice President of the Royal College of Surgeons of England (RCS England), said: 

“These figures underline how fragile recent progress has been. Patients are still waiting far too long for treatment, and we remain a long way from meeting the NHS constitutional standard.  

“Reforms to the way care is delivered are beginning to make a difference, but they can only go so far. Clearing the backlog and meeting the 2029 target will require a step change in surgical capacity, backed by significant capital investment. 
 
“NHS staff continue to go above and beyond, often working in ageing buildings with too few theatres and beds. There are limits to what can be achieved without the facilities needed to treat more patients.  

“Our message to the new Secretary of State is clear: if the Government wants waiting lists to fall faster, reform must be matched with investment. Expanding theatre capacity, increasing bed numbers and modernising NHS infrastructure will give teams the headroom to treat more patients and reduce waits more quickly.” 

ENDS 

Notes to editors: 

1. Progress – but is it enough? What the latest NHS waiting times mean for elective recovery - The Health Foundation 
2. NHS England » 2025/26 priorities and operational planning guidance 
3. The latest Public Accounts Committee report states that many New Hospital Programme (NHP) schemes may not be completed until 2045-46, adding that the NHP is now the government’s main estates strategy: https://committees.parliament.uk/work/9512/new-hospital-programme-update.   
4. The NHS maintenance backlog is now estimated at £15.9bn: https://digital.nhs.uk/data-and-information/publications/statistical/estates-returns-information-collection/summary-page-and-dataset-for-eric-2024-25 
5. Latest NHS England RTT data is available at: Statistics » Referral to Treatment (RTT) Waiting Times 
6. Latest data on the UK surgical workforce: UK Surgical Workforce Census — Royal College of Surgeons  
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.