Reducing NHS waiting times for elective care

Public Accounts Committee Open Inquiry
Opened: 26 Mar 2025 Parliament page
The NHS’ statutory waiting standards for planned non-emergency, or elective, care are that 92% of patients should begin treatment within 18 weeks. Patients on 59% of pathways, or 4.4m people, were waiting less than 18 weeks at the end of 2024. In 2022 NHS England (NHSE) launched three transformation programmes … Read more
5 Recommendations
24 Conclusions
1 Report
1 Oral session
8 Letters
1 Event
Activity timeline 12 events
12 Feb
2026
Correspondence
19 Jan
2026
Report published
24 Nov
2025
Correspondence
19 Nov
2025
Report published
13 Nov
2025
Correspondence
13 Nov
2025
Correspondence
13 Nov
2025
Correspondence
11 Sep
2025
Oral evidence
11 Sep
2025
Correspondence
11 Sep
2025
Formal meeting (oral evidence session) · The Grimond Room, Portcullis House
10 Sep
2025
Correspondence
10 Sep
2025
Correspondence
Oral evidence sessions 1 session
11 Sep 2025
View on parliament.uk
Mark Cubbon · NHS England Matt Style · Department for Health and Social Care Professor Meghana Pandit · NHS England Samantha Jones · Department of Health and Social Care Sir Jim Mackey · NHS England
Title HC No. Published Items Response
55th Report - Reducing NHS waiting times for elective care HC 820 19 Nov 2025 29 Responded
Recommendations & Conclusions
29 results
2 Conclusion Accepted
55th Report - Reducing NHS waiting…
NHS England's outpatient transformation programme failed due to inadequate clinical engagement.
NHS England’s plans to transform outpatient services were not credible, even though it had already acknowledged that more efficient outpatient services would make a material difference to the waiting list. The outpatients transformation had aimed to free up capacity in … Read more
Government Response
The government agreed and stated the recommendation is implemented, citing a published review of governance, integration of outpatient transformation work, and ambitious proposals in the Medium Term Planning framework to reduce unnecessary follow-ups and improve triage.
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3 Conclusion Accepted
55th Report - Reducing NHS waiting…
Establish early data collection to track costs and benefits for new and transformed services.
NHS England’s approach to transformational change was deeply flawed in both monitoring of progress and the delivery of intended outcomes. NHS England’s diagnostic transformation programme displayed positive features of programme management and achieved planned increases in numbers of diagnostic tests. … Read more
Government Response
The government agrees and will merge the Diagnostic and Elective capital boards into a single Planned Care Capital Assurance Board from January 2026 to consolidate monitoring of outcomes, benefits, and policy aims. A NIHR evaluation of 2022-2025 Targeted Investment Fund schemes will also start in January 2026 and report in 2028.
HM Treasury
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4 Recommendation Accepted
55th Report - Reducing NHS waiting…
Require NHSE and Department to set out plans for elective care digital transformation and IT connectivity.
We are not confident that the Department is being realistic about the immense effort needed to reduce NHS elective care waiting times, and see a significant risk that digital solutions are being treated as a ‘cure- all’ as the 10 … Read more
Government Response
The government agrees and states the 10 Year Health Plan is affordable, committing up to £10 billion for NHS technology and digital transformation by 2028-29, including an additional £300 million capital investment announced at Autumn Budget 2025. It also sets an NHS target for 2% annual productivity growth for the next three years.
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5 Recommendation Acknowledged
55th Report - Reducing NHS waiting…
Require the Department to set out new plans for securing clinical engagement on outpatient transformation.
NHS England’s performance to date has not demonstrated that it can secure the clinical engagement that will be necessary to transform waiting lists. Clinical engagement has worked best when there been close working between national and local clinical leaders, and … Read more
Government Response
The government agrees and states it is strengthening clinical engagement, referencing existing plans and recent engagement events with clinicians, but does not outline specific new actions it will take to secure engagement differently for the outpatients transformation programme.
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6 Conclusion Acknowledged
55th Report - Reducing NHS waiting…
Require Department to confirm no unfunded commitments and assess costs of structural changes.
We are concerned that the Department for Health and Social Care and NHS England are still announcing major reforms without either delivery plans or secured funding. We do not accept that it is prudent to make a major change, such … Read more
Government Response
The government agrees, stating ICBs are designing new staffing structures within existing budgets and discussing strengthened Health and Wellbeing Boards' coordination with local authorities, but it does not confirm it will not announce unfunded commitments or provide the requested costs, funding, and impact assessment for ICB redundancies and the absorption of NHS England.
HM Treasury
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1 Conclusion Accepted
55th Report - Reducing NHS waiting…
Committee gathered evidence on NHS England's elective care waiting time programmes
On the basis of a report by the Comptroller and Auditor General, we took evidence from the Department for Health and Social Care (the Department) and from NHS England (NHSE) regarding NHSE’s management of transformation programmes to reduce elective care … Read more
Government Response
The government agrees with the committee's introductory statement and details actions already implemented or underway, such as publishing waiting list information disaggregated by demographic data since July 2025, expecting systems to analyze and mitigate inequalities, and implementing processes to manage long waits and ensure patient safety.
HM Treasury
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7 Conclusion Deferred
55th Report - Reducing NHS waiting…
Multiple factors contribute to rising elective care demand and capacity shortfalls
We also received written submissions from a range of individuals and organisations including clinicians and academics, royal colleges representing medical disciplines, care providers, think tanks and charitable organisations. A full list of the written evidence we received is available on … Read more
Government Response
The government's response is entirely off-topic, detailing actions related to illegal meat imports, thereby failing to address the Public Accounts Committee's concerns regarding NHS elective care waiting times.
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8 Conclusion Deferred
55th Report - Reducing NHS waiting…
NHS England consistently missed statutory and recovery elective care waiting targets
NHSE’s 2022 recovery plan ambition was to eliminate waits of longer than a year for elective care by March 2025. Within this, NHSE aimed that no one would wait longer than two years by July 2022, that there would be … Read more
Government Response
The government's response is entirely off-topic, detailing actions related to animal vaccine availability, thereby failing to address the Public Accounts Committee's factual conclusions regarding NHS elective care recovery plan ambitions and missed statutory targets.
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9 Conclusion Deferred
55th Report - Reducing NHS waiting…
Increased diagnostic capacity overwhelmed by surging demand, stalling waiting time progress
NHS England (NHSE) told us that the additional diagnostics capacity it had created had been quickly backfilled by growth in demand. Its progress on achieving the diagnostics recovery target remained stuck, with the number of patients waiting more than six … Read more
Government Response
The government's response is entirely off-topic, detailing actions related to animal disease resilience and a Sanitary and Phytosanitary agreement with the EU, thereby failing to address the Public Accounts Committee's factual conclusions regarding NHS diagnostics capacity and targets.
HM Treasury
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10 Conclusion Accepted
55th Report - Reducing NHS waiting…
Long elective care waiting times pose serious risks to patient health and mortality
We received written evidence that long waiting times can put patients at risk. Evidence from Dr Rob Findlay noted that if it is not known what is wrong with undiagnosed patients then some of them will unexpectedly turn out to … Read more
Government Response
The government outlines existing measures to manage risks associated with long waits, including publishing waiting list information broken down by demographics, examining waiting list information, implementing management interventions, validating waiting lists, introducing a tiering system, and implementing harm review processes.
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11 Conclusion Accepted
55th Report - Reducing NHS waiting…
Deprived communities and minority groups experience longer elective care waiting times
In July 2025 NHSE started publishing new data alongside the existing monthly Referral to Treatment Waiting Times data that showed that people from deprived communities and minority backgrounds are more likely to be waiting longer than 18 weeks for care … Read more
Government Response
The government outlines existing measures to tackle health disparities in access to and waiting time for elective care, including publishing waiting list information broken down by demographics, examining waiting list information, implementing management interventions, validating waiting lists, introducing a tiering system, and implementing harm review processes.
HM Treasury
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12 Conclusion Accepted
55th Report - Reducing NHS waiting…
NHS England failed to reduce outpatient follow-up appointments, abandoning its 25% target
NHSE has aimed to free up capacity in outpatient services to allow more patients from the waiting list to be seen. In 2022, NHSE set a target to reduce outpatient follow-up appointments by 25% compared with 2019–20 levels by March … Read more
Government Response
DHSC and NHS England undertook a review of programme governance to ensure the right structures are in place to deliver the ERP, which was published in January 2025. The Medium Term Planning framework (2026-27 to 2028-29) has set out ambitious proposals for the further use of Advice and Guidance (A&G) asking systems to ensure all referrals go through a single point of access.
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13 Conclusion Accepted
55th Report - Reducing NHS waiting…
Outpatient transformation efforts failed to increase remote consultations and PIFU uptake
In 2022 our predecessor Committee was told by NHSE that the area where it has most potential to free up clinical time and see more patients is in outpatients services because “80% of the waiting list is tied 18 NIHR … Read more
Government Response
The government states that DHSC and NHS England undertook a review of programme governance and integrated outpatient transformation work to improve performance and deliver the Elective Reform Plan. It also sets out aims for transforming outpatient care with single points of access, reduced follow-ups and use of technology.
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14 Conclusion Accepted
55th Report - Reducing NHS waiting…
Outpatient transformation hampered by industrial action, under-resourcing, and organisational challenges
NHSE told us that it had got very close to achieving large changes to outpatients services, but a long period of industrial action had disrupted appointments and that a new plan and better clinical engagement was required.26 NHSE told us … Read more
Government Response
The government states that DHSC and NHS England undertook a review of programme governance and integrated outpatient transformation work to improve performance and deliver the Elective Reform Plan. It also sets out aims for transforming outpatient care with single points of access, reduced follow-ups and use of technology.
HM Treasury
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15 Conclusion Accepted
55th Report - Reducing NHS waiting…
GP advice and guidance scheme demonstrates significant growth in specialist input
NHSE said that it had made progress in some areas, partly where necessity during the Covid 19 pandemic had driven the adoption of technology. NHSE highlighted the advice and guidance scheme, which allows GPs to request specialist input without going … Read more
Government Response
The government acknowledges the importance of monitoring and evaluation of policy development and provides details of progress on A&G, investing in e-RS to support data collections and governance, with the aim of supporting tracking of costs and benefits of A&G by October 2026.
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16 Conclusion
55th Report - Reducing NHS waiting…
Department confirmed significant funding and operational numbers for diagnostic and surgical centres.
The Department wrote to us on 10 September 2025 to confirm that it has drawn down £2.2 billion of capital funding for diagnostic transformation and £1.04 billion for surgical hubs. It also confirmed that 122 surgical hubs were operational in … Read more
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17 Conclusion Accepted
55th Report - Reducing NHS waiting…
Diagnostic and surgical hubs show activity below planned levels, failing waiting list targets.
The NAO report found that while CDCs are operational and have provided an increasing proportion of diagnostic activity, NHSE analysis in June 2024 showed that it would not meet waiting list targets due to a shortfall of around 3.6 million … Read more
Government Response
Data collections and processes for tracking costs and benefits for the national diagnostics programme have been in place since 2021.
HM Treasury
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18 Conclusion
55th Report - Reducing NHS waiting…
Diagnostic capacity rapidly absorbed by demand, compounded by confusion over surgical hub delivery numbers.
NHSE told us that the additional diagnostic capacity it has created has been quickly taken up by growth in demand and that the NHS was also trying to control non-elective urgent demand.37 We were told however that while it was … Read more
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19 Conclusion
55th Report - Reducing NHS waiting…
Surgical hub governance structures less developed, with metrics misaligned to actual activity outcomes.
The NAO report found that the diagnostic programme has the most established governance structure and there was evidence of in-depth reporting, while governance was less developed for surgical transformation hubs.40 The Department told us that whilst it had previously had … Read more
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20 Conclusion Accepted
55th Report - Reducing NHS waiting…
Future transformation plans heavily rely on digital technology for patient-centred care delivery.
The Department of Health and Social Care (the Department) told us that future plans for transformation will involve changing the way that care is delivered, including using digital technology in different ways.44 The Department said that in practice the transformation … Read more
Government Response
The government agrees and describes the ongoing shift to digital in elective care transformation, emphasising the need for organisational and cultural change, deploying interoperable Electronic Patient Records, strengthening cyber security, and ensuring transparent data governance.
HM Treasury
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21 Conclusion Accepted
55th Report - Reducing NHS waiting…
NHS digital transformation faces unique challenges; procurement processes hinder adoption of new technology.
NHSE told us that integration and record sharing across the NHS system features heavily within the 10 Year Health Plan, aiming to address a key weakness of the current system. NHSE said that digital transformation in the NHS presents unique … Read more
Government Response
The government agrees and describes the ongoing shift to digital in elective care transformation, emphasising the need for organisational and cultural change, deploying interoperable Electronic Patient Records, strengthening cyber security, and ensuring transparent data governance.
HM Treasury
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22 Conclusion Accepted
55th Report - Reducing NHS waiting…
Technology offers benefits, but many physicians lack essential hardware and software for remote outpatient care.
Evidence submitted by the Royal College of Ophthalmologists and the Royal College of Radiologists noted that technology can be used to eliminate waste in the system and prioritise patients better. However, the Royal College of Physicians told us in their … Read more
Government Response
NHSE and DHSC will publish the most recent outcomes from the Digital Maturity Assessment (DMA) in the near future. They will be working to tackle the gaps identified through a range of programmes, to start delivery in April 2026. This will include the Frontline Productivity programme.
HM Treasury
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23 Conclusion Accepted
55th Report - Reducing NHS waiting…
Clinical engagement for outpatient transformation proved challenging, failing to gain support for targets.
NHS England (NHSE) engaged clinicians on the transformation programmes in various ways including working with representative bodies and embedding National Clinical Directors within the programmes to provide medical leadership. The surgical transformation programme benefited from in-person engagement and support from … Read more
Government Response
The government agrees that securing clinical support is essential for successful outpatient transformation and is strengthening clinical engagement with the aim of delivering outpatient care remotely or in community settings by March 2026.
HM Treasury
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24 Recommendation Accepted
55th Report - Reducing NHS waiting…
NHSE struggled with clinical engagement for outpatients programme, delaying reset despite slow progress.
NHSE told us that it had struggled to get the clinical community uniformly behind the outpatients programme and that engagement had also been highly variable from specialty to specialty. We heard from the Department and NHSE that in their view … Read more
Government Response
The government agrees and commits to strengthening clinical engagement to ensure clinicians are delivery partners in transforming planned care, aiming to deliver outpatient care remotely or in community settings, with a target implementation date of March 2026.
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25 Recommendation Accepted
55th Report - Reducing NHS waiting…
NHSE working to improve clinical engagement for outpatients, but the fundamental care model requires change.
NHSE accepted that any reform or change management programme cannot work without clinical engagement, and told us that it was now carrying out a range of activities to secure clinical support for the outpatients programme. NHSE explained that, among other … Read more
Government Response
DHSC and NHS England are strengthening clinical engagement and ensuring clinicians are delivery partners in transforming planned care. They will continue to use existing forums with Royal Colleges and Getting It Right First-Time specialty leads to test delivery, attend national specialty events and webinars to reach a wider set of clinicians and set up new forums as appropriate to work more closely with frontline clinical staff.
HM Treasury
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26 Conclusion Accepted
55th Report - Reducing NHS waiting…
NHSE abolition announced alongside significant cost-cutting demands on Integrated Care Boards
On 13 March 2025, the Government announced that NHSE would be abolished within two years and that the Department would put in place arrangements to deliver the responsibilities currently delivered by NHSE.57 On the same day, as part of our … Read more
Government Response
The government agrees with the committee's observation regarding the abolishment of NHSE and the cost-cutting measures for ICBs, aiming for implementation by Spring 2026 and bringing forward £860 million to support upfront costs.
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27 Conclusion Accepted
55th Report - Reducing NHS waiting…
Expected redundancies at NHSE and ICBs forecast to achieve substantial annual savings
At our March 2025 session, NHSE told us that it was having discussions with the Cabinet Office and HM Treasury and that changes of this scale would require a redundancy scheme. NHSE told us that ICBs employed approximately 25,000 further … Read more
Government Response
The government agrees with the committee's observation regarding discussions with the Cabinet Office and HM Treasury, and the expected savings from ICB staff reductions, aiming for implementation by Spring 2026 and bringing forward £860 million to support upfront costs.
HM Treasury
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28 Conclusion Accepted
55th Report - Reducing NHS waiting…
Uncertainty persists regarding funding for NHSE and ICB redundancy compensation payments
In the September session, NHSE told us that the changes had been very dramatic and that a lot of work had been done very quickly to start to reduce the variation in running costs for ICBs as well as some … Read more
Government Response
The department accepts the Committee’s recommendation and will deliver a modernised health system through the integration of NHS England into DHSC and the associated restructuring of Integrated Care Boards (ICBs). The government will publish proportionate assessments to support the scale of reforms, to enable scrutiny.
HM Treasury
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29 Recommendation Accepted
55th Report - Reducing NHS waiting…
Require a comprehensive impact study to accompany all large policy changes and projects
Reports by this Committee and its predecessors have highlighted the risks to value for money raised by sudden policy changes that are not supported by sufficient funding and planning. In 2023, the Committee reported that the decisions made by the … Read more
Government Response
The government agrees with the Committee’s recommendation and is prioritising record investment in the health and social care system, such that all the reforms and commitments that have been announced are affordable within the Department of Health and Social Care’s settlement, and will aim to ensure announcements are accompanied by a clear plan for delivery and affordability wherever possible and appropriate.
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Government Response AI assessment · 26 of 5 classified
Accepted 21
Acknowledged 2
Deferred 3
Total 5 recs + 24 conclusions
Correspondence 8 letters
12 Feb 2026 To committee Letter from the Chief Executive NHS England regarding Indicative Activity Plans (IAPs) and their impact on waiting list, 23 January 2026
Parliament page
24 Nov 2025 To committee Letter from the Permanent Secretary at the Department of Health and Social Care relating to a follow up to the Committee’s oral evidence session on 11 September 2025 on Reducing NHS waiting times for elective care, 13 November 2025
Parliament page
13 Nov 2025 To committee Letter from the Chief Executive Officer of NHS England to the Chair relating to several matters concerning elective transformation programme performance (Elective care) following from the Committee’s session on 11 September, 6 November 2025
Parliament page
13 Nov 2025 To committee Letter from the Chief Executive Officer of NHS England to the Chair relating to ICB roles and responsibilities (Elective care) following from the Committee’s session on 11 September, 6 November 2025
Parliament page
13 Nov 2025 To committee Letter from the Permanent Secretary of the Department for Health and Social Care relating to overseas patients follow up from the Committee session on 11 September, 30 October 2025
Parliament page
11 Sep 2025 To committee Letter from the Permanent Secretary at the Department of Health and Social Care relating to clarification on the data provided on elective care, 10 September 2025
Parliament page
10 Sep 2025 From committee Letter to the Permanent Secretary of the Department of Health and Social Care relating to further updates on figures ahead of the inquiry into Reducing NHS waiting times for elective care, 03 September 2025
Parliament page
10 Sep 2025 To committee Letter from the Permanent Secretary of the Department of Health and Social Care and the Chief Executive Officer at NHS England relating to the follow up on relevant figures ahead of the inquiry on NHS elective care, 01 September 2025
Parliament page