The Government is on course to miss its commitment to cutting elective-care waiting times, according to analysis released by the Health Foundation.

A target which would see 92 per cent of all elective care referrals met within 18-weeks is set to be missed by ‘a considerable margin’ if trends on referrals and removals continue, a report published today by the healthcare think-tank has warned.

Following election to office in 2024, the Labour government under then prime minister Kier Starmer pledged it would restore the 18-week standard for elective-care waits by 2029.

At that time, the NHS’s waiting list for elective care stood at 7.62 million with the foundation’s report ‘Two years down, three to go’, noting that just 59 per cent of all waits were met within a period of 18 weeks.

It adds that, since coming to office, the total waiting list for elective care under Labour has fallen in the past two years and now stands at 7.3m as of July 2026, with 65.4 per cent of waits being met within 18 weeks.

Despite total removals from the waiting list increasing by 2.3 per cent between the year to July 2024 and the year to July 2026, the foundation’s report notes that the growth rate in new referrals has risen from 1.5 per cent July 2025 to 3 per cent in July this year.

This increase means that the rate of new referrals is now matching the rate of waiting list removals with the Health Foundation warning that it now projects that by the end of the current Parliament, 92 per cent of waits will be within 35 weeks, rather than 18 weeks.

It said: ‘Our projections indicate that, despite the NHS achieving its interim target for March 2026, restoring the 18-week standard by 2029 will be very challenging.

‘This analysis shows that, over the 12 months to July 2026, the percentage of waits within 18 weeks improved from 61.3 per cent to 65.4 per cent. The waiting list also fell by 62,000 to 7.33 million, and the share of waits longer than 52 weeks improved from 2.6 per cent to 1.5 per cent.

‘[However], removals from the waiting list need to exceed referrals on to it to make meaningful progress on reducing waiting times. Between July 2024 and July 2026, both referrals and removals grew at a similar rate of 2.3 per cent per year.’

It added: ‘If referrals and removals continue to grow at the same rate as they have over the past two years, we project that by July 2029 the waiting list will have fallen slightly to 7.11 million (from 7.33 million currently) and 92 per cent of waits will be within 34.9 weeks, rather than 18 weeks.

‘While there is time for new initiatives to speed up progress, on current trends the government’s target would be missed by a considerable margin.’

In its report, the Health Foundation credits the increase in the rate of removal from the elective-care waiting list as the result of a number of factors.

These include the ‘sprint’ launched by NHS England in January this year which saw up to £120m invested towards increasing outpatient activity.

The foundation noted that, while this initiative proved ‘crucial’ in helping the health service to reach the interim target for the 18-week standard, it questioned whether this level of progress could be sustained long-term.

Meanwhile, the report notes that referrals by GPs appeared to be driving growth in this area with 531,000 more referrals from primary care made in the year to July 2026 compared with the previous year.

Acknowledging the findings of today’s report, BMA council chair Tom Dolphin warned that, while some welcome progress had been made, effectively addressing the waiting list was a marathon effort rather than a ‘sprint’.

Dr Dolphin added that rather than setting ambitious targets, the Government should instead reflect on the root causes behind the historic backlog in unmet elective care; an understaffed, under resourced and overstretched health service. 

He said: ‘This Government made a reduction in waiting lists one of its key pledges coming into office, but despite some progress and a sterling elective recovery "sprint" effort from NHS staff, we feel like we are treading water.

‘One reason is that we can only use the workforce we have, and there’s only so far you can push the same understaffed, under-resourced set of people to go further and faster – especially with no commensurate reward or recognition.'

Specialist, associate specialist and specialty doctors and consultants continue to be in dispute with the Government regarding pay and terms and conditions.

‘We cannot sprint our way to recovery; that will clearly be a marathon. Rota gaps are already being filled by non-doctors in an effort to deal with medical shortages. The real test will come with the long-delayed publication of the Workforce Plan: will the Government commit to the skills and training needed over the long term to bring these lists down and provide the service patients deserve?’

Dr Dolphin added: ‘In the shorter term however it may be unwise to make over-ambitious targets the centrepiece of the Government's rhetoric. The determinants of health such as welfare, public health and economic inequality have been left by the wayside by policymakers for too long, and the increasing referrals we are seeing from GPs are the result of an ever-sicker population.

‘With the prime minister yet to make any substantive statement on his plans to improve elective performance, this is a good time to take a breath and learn the lesson on making specific time-bound promises on progress in a complex system that isn’t easily reshaped. He should go back to the root causes of the stubborn backlog – an exhausted, undervalued workforce and a sick population – and ask what a long-term solution would look like.’

Read the report