NHS 18-week waiting time target ‘unlikely’ to be met, research suggests

It is “unlikely” that the Government will achieve its ambition of getting NHS waiting times down to 18 weeks before the end of Parliament, according to new research.

Analysis by the Institute for Fiscal Studies (IFS) suggests “no single policy lever will likely be enough by itself” and meeting the target will require large increases in activity, as well as a reduction in demand and greater prioritisation for people facing long waits.

However, it warned the latter measures “have potential negative consequences for some groups of patients”.

Health leaders also said that “hard-won progress” is being “offset by soaring demand and more people joining waiting lists”.

The Government has outlined its ambition to ensure 92% of patients receive care within 18 weeks by the end of Parliament in 2029.

For the study, IFS researchers, funded by the Economic and Social Research Council, modelled a number of different scenarios.

It estimated that if the NHS increases treatment volume by 3.5% per year without other changes, some 74% of patients would be waiting 18 weeks by mid-2029, below the 92% target.

According to the IFS, treatment volume would have to grow by 4.9% per year, in the absence of other changes, to meet the goal, which it claims would be double the average growth rate of the 2010s.

The report highlights that waiting times “depend on how many patients are referred to join the list”.

It points out that the Government is planning to cut referrals to the waiting list by greater use of advice and guidance, where GPs consult hospital doctors on whether there are community pathways available to patients.

Combined with a 3.5% increase in treatments, as modelled by the IFS, it suggests this could mean the 18-week performance target climbs to 82% by mid-2029.

The IFS also suggests that prioritising those waiting longer, combined with its scenario of a 3.5% increase in treatments, could mean the target stands at 78% by the end of Parliament.

Report author Olly Harvey-Rich, a research economist at the IFS, said: “There is widespread agreement that achieving the 18-week target within this Parliament – reversing nearly a decade of worsening performance in five years – will be challenging.

“Our new analysis quantifies just how challenging. Increasing the number of patients treated by the NHS – whether by increasing funding or improving productivity – is highly unlikely on its own to be enough to meet the target.

“Meeting the target will likely require historically large increases in activity and reducing demand and prioritising reducing long waits.

“The latter two routes have potential negative consequences for some groups of patients.

“It’s by no means impossible, but we judge it unlikely, that the 18-week target will be met during this parliament.”

Last week, the latest performance data from NHS England showed the overall waiting list had fallen for the fifth month in a row.

Some 7.43 million treatments were waiting to be carried out at the end of January, down from 7.46 million at the end of December and the lowest figure since April 2023.

Some 6.25 million patients were estimated to be waiting for treatment at the end of January, up slightly from 6.24 million at the end of December.

The Government’s upcoming Plan for Change will also focus on sickness prevention, shifting more care from hospitals into the community and a greater use of technology.

Responding to the IFS report, Saffron Cordery, interim chief executive of NHS Providers, said: “Trust leaders don’t want patients to wait a moment longer than needed for vital care and are doing all they can to see patients as quickly as possible.

“But sometimes it feels like they’re running just to stand still.

“Hard-won progress on delivering more checks, tests and treatments is being offset by soaring demand and more people joining waiting lists.”

It comes after an NHS Providers survey found 71% of trust leaders think it is unlikely the NHS will meet key health targets, including the 18-week standard, over the coming years.

However, Ms Cordery said trust leaders are “not giving up”.

“Alongside implementing the elective reform plan, they’re doing everything they can to boost productivity across the NHS and minimise long waits across all parts of the NHS, including mental health, ambulance and community services,” she added.

“Trust leaders will also continue to tackle the root causes of poor health and health inequalities in their communities, which must not be sidelined while the shake-up across the NHS plays out.”

An NHS spokesperson said: “NHS teams have made considerable progress in bringing down the longest waits and we are laser-focused on the 18-week target – with around 200,000 fewer patients waiting that long in January compared to the same month in 2024.

“Our elective care reform plan already sets out precisely what the IFS is proposing – including supporting two million patients to get specialist advice sooner to avoid joining the waiting list this year – and the NHS will continue to focus on boosting productivity, innovation and the expansion of measures like surgical hubs and community diagnostic centres, ensuring patients get better, more appropriate treatment closer to home.”

A Department for Health and Social Care spokesperson added: “We have always been clear that cutting the longest waiting times from 18 months to 18 weeks will be challenging but we are pulling every available lever to achieve it.

“Our Elective Reform Plan sets out how we are doing exactly what the IFS report suggests is needed: investing in GPs to reduce demand and care for more patients in the community, at the same time as using independent sector providers to cut waiting lists, expanding Community Diagnostic Centres to run on evenings and weekends, and boosting the number of surgical hubs.”