Doctors warn hospitals under pressure as NHS waiting lists rise

Hospitals in England are under increasing pressure as the NHS waiting list for routine treatment rose for a second consecutive month, NHS England data show. An estimated 7.4 million planned procedures were awaiting treatment in July, up 34,000 from June and the highest level since March.

The rise coincided with continuing high demand across the health service and disruption from industrial action. A five-day strike by junior doctors in July resulted in the cancellation of about 50,000 appointments, NHS England said. The number of patients waiting more than 18 months for routine treatment increased to 1,429 in July from 1,103 in June, although that figure remains well below levels seen a year earlier.

Routine treatment covers care booked in advance, from specialist consultations to minor and major operations. The proportion of patients treated within 18 weeks of referral was 61.3% in July, slightly down on June but up from 58.8% in the same month last year. The government has set a target of treating 65% of patients within 18 weeks by March 2026 and 92% by March 2029.

Medical bodies warned that pressure on buildings and workforce capacity is contributing to delays. The Royal College of Surgeons said operating theatres and physical space were under strain, with surgeons competing for limited capacity. "Crumbling hospital buildings are leading surgeons to have to compete for space, directly contributing to delays and leaving patients waiting for the care they need," said the college’s vice president, Professor Frank Smith, calling for funding for new theatres in the autumn budget.

Independent analysts pointed to seasonal and systemic factors. Tim Gardner, assistant director of policy at the Health Foundation, said the waiting list typically increases at this time of year but noted the government would be disappointed not to have made more progress on reducing backlogs. NHS Providers, which represents hospitals and ambulance services, warned that staff were "running to stand still" as emergency departments and ambulance services faced relentless pressure.

NHS England said it delivered 3% more planned treatments in July compared with the same month last year and that the number of patients joining the waiting list rose by 5%. The organisation also reported record activity in urgent care, describing the busiest August on record for A&E attendances and emergency calls to the ambulance service.

Cancer services are measured separately from routine waiting lists and showed some improvement. The proportion of patients who started treatment within 62 days of an urgent suspected cancer referral was 69.2% in July, up from 67.1% in June. The government’s target is 75% by March 2026. Senior cancer doctors told the BBC that regulatory and administrative barriers can hinder access to newer treatments such as immunotherapies and advanced radiotherapy. The government plans to publish a national cancer strategy for England by the end of the year.

Professor Meghana Pandit, NHS national medical director, noted that despite industrial action, a record number of cancer patients received care in July and that ambulance response times were the fastest in over four years even as services faced high demand. Health Secretary Wes Streeting said the government had delivered two million extra NHS appointments in its first year in office and reiterated plans for a 10-year health strategy aimed at shifting care out of hospitals and into community settings.

Trusts and professional bodies urged targeted investment and reform to reduce waits and relieve pressure on emergency services. NHS Providers’ chief executive, Daniel Elkeles, said more care delivered closer to home and stronger prevention measures were needed to make a meaningful dent in waiting lists. The government and NHS leaders face upcoming budget and strategy decisions that health organisations say will be critical to addressing capacity, workforce and infrastructure challenges across the system.