New analysis reveals a stark divide in NHS performance across England, with waiting times for planned care deteriorating at a significant number of hospital trusts despite national progress. While the Labour government has achieved the first reduction in the overall NHS waiting list in a decade, exclusive data shows that 31 hospital trusts have actually gone backwards over the last twelve months.
A National Picture of Contrasting Fortunes
For over a decade under Conservative rule, NHS waiting lists consistently grew longer. The current Labour administration, which came to power in 2024, made a key manifesto pledge to ensure patients receive planned care—such as knee and hip operations—within 18 weeks. Recent data, initially obtained by the BBC through Freedom of Information requests, indicates that while national efforts are bearing fruit, many local hospitals are being left behind.
The government's target requires 92% of patients to be seen within the 18-week period, with an interim national goal of 65% set for March 2026. When Labour published its plan to tackle the treatment backlog a year ago, 59.2% of patients in England were waiting less than four-and-a-half months. This figure has since improved slightly to 61.8%.
Trusts Where Waiting Times Are Worsening
The data highlights specific trusts where performance has declined, hampering broader national efforts to transform the NHS. Out of 129 trusts that provided information, 31 have seen waiting times worsen, while another 17 have made negligible progress against the 18-week target.
East Cheshire NHS Trust recorded the most significant fall. The proportion of patients seen within 18 weeks dropped from 61% in November 2024 to just 51% in November 2025, meaning only around half of patients are now being treated within the target period.
Other notable declines include:
- Barnsley Hospital NHS Foundation Trust: Fell from 75% to 66%. The trust cited staff shortages and a surge in urgent cancer referrals, which must be prioritised over planned treatments.
- Whittington Health NHS Trust: Dropped from 65% to 60%.
- University Hospitals of Leicester NHS Trust: Declined from 57% to 53%.
- Epsom and St Helier University Hospitals NHS Trust: Decreased from 65% to 61%. Management pointed to significant service disruption caused by implementing a new electronic patient record system.
Strike action by junior doctors was also identified as a contributing factor to longer waits at several trusts.
Significant Improvements at Other Hospitals
In contrast, some hospital trusts have delivered remarkable turnarounds. Shrewsbury and Telford NHS Trust improved its performance by an impressive 17 percentage points. A further five NHS trusts recorded substantial improvements of between 9% and 10%, demonstrating that progress is possible.
National Context and Government Response
The latest monthly NHS data for England shows the elective waiting list experienced its largest fall in 15 years outside of the pandemic period. The backlog of operations and appointments fell by 86,000, bringing the total waiting list down to 7.31 million by the end of November 2025—the lowest level since February 2023.
Health Secretary Wes Streeting commented on the figures, stating: "For too long, patients were promised change in the NHS but saw little of it. This government is turning promises into change people can actually feel. Waiting lists are down by more than 312,000 and more patients are being treated within 18 weeks. November saw the second biggest monthly drop in waiting lists in 15 years. That means faster care, less anxiety for families and people back on their feet and back to work."
He attributed the progress to record investment, modernisation initiatives, and the dedication of NHS staff. The government's strategy has included expanding evening and weekend appointments, offering more diagnostic tests in community settings closer to patients' homes, and establishing specialist surgical hubs to increase operation capacity. The adoption of AI-powered notetaking tools for doctors has also been credited with saving valuable clinical time.
However, the overall reduction of 86,517 in the November waiting list—the second-highest drop outside the early COVID-19 pandemic—masks a deeply uneven recovery across the country. The initial pandemic period saw a unique drop in referrals as people avoided contacting the NHS, making the current progress under normal conditions particularly significant, yet incomplete.
The data underscores a challenging reality for the government: while national metrics are moving in the right direction, a substantial minority of hospital trusts are struggling to keep pace, creating a postcode lottery for patients awaiting vital treatment.
