Long waits in A&E rise sharply but overall NHS waiting list continues to fall

The number of people waiting more than 12 hours in A&E departments for a hospital bed has risen sharply – though the overall NHS waiting list continues to drop, figures suggest.

New data for England shows that the number of people waiting more than 12 hours for a hospital bed following a decision to admit them stood at 71,517 in January, up sharply from 50,775 in December.

This is the highest number since monthly records began in August 2010.

Meanwhile, the number waiting at least four hours from the decision to admit to admission stood at 161,141 last month, up from 137,763 in December and the second highest figure on record.

Some 72.5% of patients in England are being dealt with within four hours, against a March 2026 target of 78%.

When it comes to the overall NHS waiting list, this has fallen for the second month in a row.

An estimated 7.29 million treatments were waiting to be carried out at the end of December 2025, relating to 6.17 million patients.

This is down from 7.31 million treatments at the end of November, while the figure for patients has remained at 6.17 million.

The list hit a record high in September 2023, with 7.77 million treatments and 6.50 million patients.

Some experts have raised concerns about how the drop in the waiting list is being achieved, owing to the practice of “list cleaning”.

The Nuffield Trust has argued that the balance between referrals for treatment versus treatment delivered has not changed very much, meaning a big proportion of waiting list reductions have happened due to other reasons, such as list cleaning.

List cleaning can occur for various reasons, such as when people no longer need treatment, when they choose not to have treatment, their condition has got better or they have died while on the waiting list.

Parliamentary answer figures published by the Government last month, in response to a question from shadow health secretary Andrew Stuart, show NHS England paid NHS trusts £18,818,566 for “validation exercises” – list cleaning – from April to September 2025.

NHS England said staff “delivered a historic high” of 18.4 million treatments and operations in the whole of 2025, up from 18 million in 2024.

It said there were 1.43 million treatments delivered in December – an increase of 91,775 on last year – despite five days of strikes by resident doctors.

NHS England also said A&E staff experienced a record high January of 2,320,266 A&E attendances – 4.6% higher than in January 2025.

Four-hour NHS performance has been at 73.5% across winter so far, it added, up from 72.1% last year and under 70% the year before.

Chris Roebuck, head of profession for statistics at NHS England, said of list cleaning: “Unreported removals have accounted for around 15% of patients who come off the waiting list for decades – they are actually lower now than before the pandemic and it is the record level of operations, tests and scans being delivered by NHS staff that is now getting the waiting list down.

“Validation is not new and does not mean patients miss out on care – it is a routine clinical process that ensures people needing specialist care aren’t stuck behind patients left on the list in error or who no longer need treatment.”

Health and Social Care Secretary Wes Streeting said: “Despite having to deal with flu and industrial action, the NHS has managed to continue cutting waiting lists, thanks to a Herculean effort this winter.

“This Government has cut waiting lists by more than 330,000, with hundreds of thousands more people treated within 18 weeks. That’s not happening by chance – it’s because we delivered record levels of care in 2025.

“This progress is driven by unprecedented investment and modernisation of our health service, and above all by the dedication of NHS staff.

“Whether it’s by opening up new community diagnostic centres, rolling out surgical hubs to tackle backlogs, or investing in modern equipment and technology, we are rebuilding our NHS.

“There’s so much more to do, but people can take hope and optimism from the fact that the NHS is finally on the road to recovery.”

Duncan Burton, chief nursing officer for England, said: “Completing a historic high of elective activity is a triumph for NHS staff who continue to innovate and go above and beyond to treat more patients, faster.”

Dr Vicky Price, president of the Society for Acute Medicine, said long waits in A&E were getting worse.

“These are people unwell enough to need admission, often older and frail with complex needs, who are at the greatest risk of harm when care is being delivered in corridors and hospitals are operating beyond safe limits,” she said.

“The overcrowding we are seeing in emergency departments reflects sustained pressure in acute medical wards and throughout hospitals, where bed capacity has fallen, staffing is stretched and flow is routinely blocked.

“Financial constraints are now compounding the problem.

“Hospitals are being asked to deliver more activity with the same or fewer staff, while ward closures and vacancy gaps reduce the system’s ability to absorb pressure. That is not a performance issue but a capacity issue.”

Tim Gardner, assistant director of policy at the Health Foundation, said: “Today’s data paints a picture of very mixed fortunes for the NHS.

“While it is positive to see a reduction in the overall waiting list, A&E departments continue to remain overwhelmed, with far too many patients facing unacceptably long waits.”

Nuffield Trust deputy director of research, Sarah Scobie, said: “Pressure is building to meet the March target for having under 22% of patients facing waits longer than four hours in A&E.”

She said a 6% improvement by spring “may not sound like much, but the NHS has struggled to make even tiny incremental improvements in recent months, despite staff working flat out”.

She added: “It’s optimistic that the planned treatment waiting list fell again in December, but it was only a small reduction, so the NHS is clearly finding it very difficult to maintain progress on getting through the backlog.

“Referrals usually drop during December, since fewer people will have joined the waiting list around Christmas.

“With just three more monthly data releases to go before the March deadline for the NHS to get 65% of patients treated within 18 weeks of referral, there will be a big push to get the overall waiting list figure down.

“But we hope to see more of this reduction coming from extra treatment rather than other things like administrative processes.”

The new data out on Thursday showed the Government is hitting its 28-day target for cancer diagnosis, and there was a slight improvement on people being treated for cancer on time.