Progress – but is it enough? What the latest NHS waiting times mean for elective recovery

Performance against the headline target has improved, climbing above 65% for the first time since November 2021. In March 2026, 65.3% of waits were within 18 weeks, compared with 59.8% in March 2025 (see Figure 1). In March 2026, 92% of waits were within 38.3 weeks, 3.6 weeks shorter than in March 2025 – but around 1 week longer than we projected would be needed to indicate the NHS was on track to meet the 18-week standard by 2029. Progress towards this target has been, on average, quicker in the last 3 months of this financial year compared with both the first 9 months of the 2025/26 financial year and the same period the previous year. This may reflect recent sprint efforts, or the effects of more sustained change.

The target for NHS trusts included two parts: to increase the percentage of waits within 18 weeks by a minimum of 5 percentage points compared with November 2024 and to reach a minimum of 60% of waits within 18 weeks. Progress against this target has been limited. Over half (71 of 117; 61%) of acute trusts in England (blue dots in Figure 2) met both parts, while nine trusts met neither. Over 3 in 5 (74) trusts achieved an increase of 5 percentage points or more, while 9 in 10 (105) trusts delivered at least 60% of waits within 18 weeks in March 2026. When we additionally included all specialist acute trusts, our conclusions remained unchanged: 79 of 133 trusts (59%) met both parts of the target. Despite not all trusts meeting this target, the variation in performance across trusts has narrowed since March 2025.

As of March 2026, 1.3% of waits were longer than 52 weeks, 1.1 percentage points lower than in March 2025 (2.4%). Despite narrowly missing the target, the percentage of long waits is both the lowest since June 2020 and majorly reduced from its peak of 8.8% in March 2021. However, there are still 94,400 elective care pathways where a patient has been waiting longer than a year – 23,300 more than if the target had been met. This is compared with a much lower average of 1,670 pathways in 2019/2020. Long waits increase the risk that patients will need more complex, and costly, procedures and have poorer health outcomes.   

Cancer care has specific targets as these patients often need to start treatment quickly. Most cancer patients are seen within the general elective care pathway and rely on some of the same elective services for their diagnosis and treatment, so their waiting times impact both the overall and cancer-specific targets. The 28-day cancer target looks at the time from referral to either receiving a cancer diagnosis or cancer being definitively excluded. In March 2026, 79.4% of patients who received a cancer diagnosis outcome did so within 28 days, narrowly missing the target and showing limited progress over the past 12 months (79.0% in March 2025, see Figure 3). This measure is affected by short-term changes and should be interpreted cautiously when assessing performance trends. Comparison of the average in 2025/26 with the 2024/25 average shows no improvement in performance – 76.3% down from 76.4%. 

The second cancer target is a broader measure from referral to beginning a first definitive treatment. In March 2026, 72.8% of patients began treatment within 62 days, 1.4 percentage points higher than in March 2025 (71.4%) and 2.2 percentage points below the target (Figure 3). Comparison of the average percentage of patients beginning treatment within 62 days across 2025/26 with the average in 2024/25 shows a small improvement in performance, from 68.5% to 69.4%.

The achievement of the 65% headline target is a positive sign of progress in restoring elective care in the NHS. Progress against the other targets shows the NHS is making headway, despite not yet meeting them. Cancer-specific targets have seen limited progress in the past year. These signs of improvement come despite a very difficult time for the NHS, with tight financial plans across acute trusts alongside periods of industrial action from resident doctors and wider workforce pressures. 

There has been a quicker pace of change to the headline 65% interim target in the months leading up to March 2026. This may signal that improvements across the NHS are helping patients’ needs be met more quickly. However, these increases could instead be a result of recent sprint efforts from hospital trusts to meet targets. These sprints are often delivered as additional evening and weekend clinics, making the faster improvements of recent months unlikely to be sustainable over the longer term. Performance in the months following March will indicate whether achieving the 65% target may have been the result of unsustainable sprints. 

The size of the waiting list also has fallen over the past year, from 7.4 million to 7.1 million incomplete pathways, which will likely have some impact on future waiting times. To deliver sustained progress, trusts must make the most of the resources available to them, given the limited growth in NHS funding. Whether the 18-week standard is restored by the end of parliament will largely be determined by the number and complexity of referrals and activity that make up the waiting list. Forthcoming analysis will update our projections of whether the government is on track to meet its pledge. 

Targets for March 2027 and 2029 are even more ambitious and will require national and trust-level progress to accelerate. Interim targets should help build momentum across trusts and restore confidence that the NHS can deliver improvements – achieving targets may be secondary to the motivating role they can play. Even without a future target for long waits, sustained progress here remains essential to bring down the median waiting time and minimise poorer health outcomes. The focus on making progress in elective waiting times needs to be balanced against the need to deliver the wider changes to health services promised in the government’s 10 Year Health Plan.

The announcement of targeted support for trusts is welcome, but the recovery programme may need to operate at a larger scale to achieve progress among all trusts needed to meet the 2029 target. While it is feasible to reach a 65% national target with many trusts far below the target, reaching 92% of waits within 18 weeks nationally will require substantial improvements across the vast majority of trusts – there is less scope for trusts above 92% to offset underperformance elsewhere. The introduction of trust-level cancer care targets for March 2027 should support efforts to reduce inequalities in cancer-specific waiting times. In order to meet both the 18-week standard and its commitment to equitable recovery, the government cannot afford to leave any trusts behind.

The NHS has made encouraging progress in reducing the time people wait for elective care. But looking forward, there is a risk that recent gains reflect short-term measures that will be difficult to sustain as the required pace of improvement increases. Sustained investment alongside productivity improvements will be needed to support trusts to restore the 18-week standard and deliver lasting change by 2029.