NHS A&E Waits Surge to Record Levels Amid Mixed Performance Data
New figures from England indicate a concerning spike in Accident and Emergency (A&E) waiting times, even as the overall NHS treatment waiting list continues a gradual decline. The data, released on Thursday, highlights persistent pressures within the healthcare system, with experts warning of capacity constraints and controversial practices influencing the statistics.
Record-Breaking Delays in Emergency Departments
In January, the number of patients waiting more than 12 hours in A&E for a hospital bed after a decision to admit them soared to 71,517, a sharp increase from 50,775 in December. This marks the highest monthly figure since records began in August 2010, underscoring severe overcrowding and operational challenges.
Additionally, those waiting at least four hours from admission decision to actual admission reached 161,141 last month, up from 137,763 in December, representing the second highest figure ever recorded. Currently, only 72.5% of patients in England are seen within the four-hour target, falling short of the March 2026 goal of 78%.
Modest Drop in Overall NHS Waiting List
Conversely, the overall NHS waiting list has decreased for the second consecutive month. By the end of December 2025, an estimated 7.29 million treatments were pending, affecting 6.17 million patients. This is down from 7.31 million treatments at the end of November, though the patient count remained steady at 6.17 million.
The list peaked in September 2023 at 7.77 million treatments and 6.50 million patients. NHS England reported delivering a historic high of 18.4 million treatments and operations throughout 2025, up from 18 million in 2024, with 1.43 million treatments completed in December alone despite five days of strikes by resident doctors.
Concerns Over List Cleaning Practices
Some experts have raised alarms about how the reduction in the waiting list is being achieved, pointing to the practice of list cleaning. The Nuffield Trust argues that the balance between treatment referrals and deliveries has not significantly changed, suggesting that a substantial portion of the decline stems from other factors.
List cleaning occurs when patients are removed from waiting lists for reasons such as no longer needing treatment, opting out, improved conditions, or death. Government data revealed that NHS England paid trusts £18,818,566 for validation exercises—essentially list cleaning—from April to September 2025, in response to a query from shadow health secretary Andrew Stuart.
Official Responses and Expert Warnings
Health and Social Care Secretary Wes Streeting praised the Herculean effort of NHS staff, noting that waiting lists have been cut by over 330,000, with hundreds of thousands more treated within 18 weeks. He attributed this progress to record investment, modernisation, and staff dedication, including initiatives like community diagnostic centres and surgical hubs.
Duncan Burton, chief nursing officer for England, hailed the historic high in elective activity as a triumph for innovative and dedicated staff. However, Dr Vicky Price, president of the Society for Acute Medicine, warned that long A&E waits are worsening, particularly for vulnerable patients like the elderly and frail, who face harm from care delivered in corridors and overcrowded settings.
She cited financial constraints, reduced bed capacity, staffing shortages, and blocked patient flow as key issues, emphasising that this is a capacity issue rather than a performance one. Tim Gardner of the Health Foundation described the data as painting a picture of very mixed fortunes, with positive waiting list reductions offset by overwhelmed A&E departments and unacceptable delays.
Additional Performance Metrics
The new data also showed that the Government is meeting its 28-day target for cancer diagnosis, with slight improvements in timely cancer treatment. A&E attendances hit a record high of 2,320,266 in January, 4.6% higher than January 2025, while four-hour NHS performance across winter stood at 73.5%, up from 72.1% last year but still below optimal levels.
As the NHS navigates these challenges, the contrasting trends highlight the complex landscape of healthcare delivery, where incremental gains in some areas are tempered by critical pressures in others, calling for sustained focus on capacity and resource allocation.
