Waiting times for elective and cancer treatment are too dependent on where people live and there is no national plan to address this postcode lottery. In September 2021, patients in the worst-performing geographic areas were more than twice as likely as patients in the best-performing areas to have been waiting over 18 weeks for elective care or more than 62 days for cancer treatment following an urgent referral. The difference between the worst and best areas in the proportion of patients waiting over 52 weeks for elective care was around 12 times. NHSE&I is expecting the same levels of improvement across NHS areas but, if this were the end result, it would mean continuing large disparities between these areas. Recommendation: NHSE&I should investigate the causes of variations between its 42 geographic areas and provide additional support for recovery in those that face the biggest challenges. NHSE&I should write to us in December 2022 on the NHS backlogs and waiting times in England 7 actions it has taken to address geographical disparities in waiting times for cancer and elective care and include a summary of any analysis it has done on differences in health outcomes for elective and cancer care in different parts of the country since the start of the pandemic.