Wales falling behind on surgical hubs as waiting lists reduce too slowly, surgeons warn
20 Mar 2026
New Senedd Election manifesto from surgeons urges next Welsh Government to expand surgical capacity and deliver a long-term workforce plan
With new NHS Wales waiting time figures out yesterday, surgeons warn that Wales risks slipping further behind the rest of the UK unless progress on surgical hubs and workforce growth accelerates.
The latest figures show a decrease in the total number of patient pathways, falling from just under 741,000 in December 2025 to just over 713,000 in January 2026. Surgeons welcome this reduction but warn that progress remains too slow. Since the waiting list reached its post‑Covid peak of 802,268 in November 2024, only 89,220 pathways have been removed.
The Royal College of Surgeons of England (RCS England), which represents surgeons across Wales and the wider UK, has today launched its 2026 Senedd Election manifesto, calling on the next Welsh Government to expand long-term surgical capacity through new surgical hubs and to publish a comprehensive workforce strategy for health and social care. The College says both measures are essential to accelerating reductions in waits and supporting an overstretched workforce.
Surgical hubs are used across the UK to separate planned operations from emergency pressures and protect elective capacity. Wales currently has just one operational hub for a population of 3.2 million. England has more than 120, and Northern Ireland has six for a population of 1.9 million – underlining how far Wales lags behind.
Findings from the 2025 UK Surgical Workforce Census reinforce the scale of the challenge. A higher proportion of surgeons in Wales than in any other UK nation reported difficulty accessing operating theatres, with six in ten (60.5%) citing it as a major barrier to delivering care. Almost two-thirds (63.7%) reported burnout, highlighting the strain on the surgical workforce.
Professor Jon Barry, Director in Wales at the Royal College of Surgeons of England (RCS England),said:
“Behind every statistic is someone living in pain and waiting too long for treatment. Without dedicated, protected space for planned operations, waiting lists in Wales will continue to be disrupted by winter pressures and spikes in emergency demand.
“That is why we are calling on the next Welsh Government to commit to the actions outlined in our manifesto. Establishing surgical hubs and developing a long-term workforce strategy would allow the NHS to treat more patients, reduce last-minute cancellations and make better use of the surgical workforce.
“Without urgent action now, patients across Wales will continue to face long waits for surgery.”
These concerns come amid wider questions about the performance of public services in Wales, with recent analysis from the Institute for Fiscal Studies (IFS) showing NHS waiting times in Wales remain significantly longer than in other parts of the UK.
Surgical hubs: first-year actions
To accelerate progress, RCS England is calling for the Welsh Government to deliver the following within its first year:
- A Surgical Hub Implementation Group bringing together NHS Wales organisations, clinical leaders and the Royal Colleges to agree locations and specialty priorities.
- A minimum of four surgical hubs, established on existing NHS sites and accredited through a process similar to England’s GIRFT model.
RCS England says that making better use of existing NHS sites would speed up the expansion of surgical hubs. Once in place, these hubs would help reduce last-minute cancellations and improve productivity across planned care.
Long-term workforce strategy for health and social care
Workforce planning in Wales has long been fragmented, with responsibilities spread across multiple parts of the system. This has led to short-term decisions rather than a coordinated, long-term approach. RCS England urges the next Welsh Government to commit to a national workforce strategy for health and social care, published by the end of 2027, supported by a new Strategy Development Board led by Welsh Government and NHS Wales.
Other key asks
The manifesto also sets out further priorities, including:
- Cosmetic surgery regulation: Strengthen licensing for non-surgical procedures and require that surgical cosmetic procedures are performed only by Board Certified surgeons. Without action, Wales risks becoming the only UK nation without robust licensing for cosmetic procedures.
- Sexual misconduct and harassment: Improve reporting mechanisms, data collection and transparency. The NHS Wales Staff Survey 2024 found over 4% of respondents had experienced unwanted sexual behaviour from colleagues, and almost a quarter lacked confidence concerns would be addressed.
- Child dental health: Commission an expert-led review of the Designed to Smile programme to understand why progress on reducing childhood dental decay has stalled. In 2022–23, 32.4% of five‑year‑olds in Wales had experienced dental decay, compared with 23.7% in England.
RCS England says decisive leadership in the next Senedd term will be vital to restoring timely access to surgery and improving patient outcomes, and stands ready to work with the next Welsh Government and NHS Wales to deliver the necessary reforms.
ENDS
Notes to editors:
- The manifesto is available on our website at https://www.rcseng.ac.uk/about-the-rcs/about-our-mission/senedd-manifesto-2026/
- Institute for Fiscal Studies report: Public service spending and performance in Wales | Institute for Fiscal Studies
- RCS England 2025 UK Surgical Workforce Census: 2025 UK Surgical Workforce Census — Royal College of Surgeons
- *The Getting It Right First Time (GIRFT) programme is a national NHS England programme designed to improve the treatment and care of patients through in-depth review of services, benchmarking, and presenting a data-driven evidence base to support change. The programme undertakes clinically-led reviews of specialties, combining wide-ranging data analysis with the input and professional knowledge of senior clinicians to examine how things are currently being done and how they could be improved. GIRFT is part of an aligned set of programmes within NHS England. The programme has the backing of the Royal Colleges and professional associations. Getting It Right First Time - GIRFT
- 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.
- For more information, please contact the RCS England press office: telephone: 020 7869 6053/6054/6060; email: pressoffice@rcseng.ac.uk; out-of-hours media enquiries: 0207 869 6056.