After years of deteriorating performance, English hospitals have reached a milestone that felt distant not long ago: 65.3% of patients are now being treated within 18 weeks, meeting the Labour government's key target for the first time since November 2021. The achievement arrives as former health secretary Wes Streeting departs his post, pointing to the result as proof that "our plan for the NHS is working."
The waiting time standard, known as the Referral to Treatment (RTT) target, matters because it's the foundation of Labour's larger NHS recovery strategy. The government has committed to restoring the metric to 92% by 2029 — a promise repeated so often it has become central to the party's health agenda. When Streeting set the 65% threshold as a mandatory target to be met by March, sceptics wondered whether it was achievable. The answer came in the form of March's figures: hospitals hit exactly what was asked of them.
The numbers paint a picture of genuine momentum. The waiting list has shrunk by 517,000 people over five months, falling from 7.62 million in July 2024 to 7.11 million by March. In a single month, the NHS achieved what Streeting called "the biggest cut in waiting lists in a single month in 17 years." The improvement marks a reversal of the chronic, grinding backlog that has haunted the health service. For patients and their families, the data translates into something concrete: fewer people enduring months of anxiety waiting for surgery or vital tests.
Sir Jim Mackey, NHS England's chief executive, called the achievement "a huge moment for the NHS." Sarah Woolnough, chief executive of The King's Fund, described it as "a significant achievement," noting that it brings relief to "patients and their loved ones" from the distress of extended delays.
Yet the path to this milestone reveals uncomfortable truths about how the improvement happened. Hospitals received £120 million in extra funding from January specifically to undertake what the NHS called a "sprint" toward the target. Trusts were offered financial incentives to undertake "validation sprint" exercises — essentially removing unnecessary or duplicate appointments from waiting lists. Shrewsbury and Telford Trust, for example, removed 14,148 patients from its list and earned more than £460,000 through the process, earning £33 per removal. Notably, 70% of the progress toward the 65% target since April occurred in the final two months before the deadline, suggesting a concentrated push rather than steady improvement.
The Conservatives criticized the approach as "fiddling the figures," a charge that carries some weight when considering the acceleration's timing. Yet experts and hospital leaders counter that the exercise also involved genuinely seeing more patients and reducing duplicate care — legitimate efficiency gains.
The sobering caveat comes from those who study the NHS closely. Bea Taylor of the Nuffield Trust warned that the system is unlikely to sustain this pace of improvement as it chases the 92% target by 2029. "Huge waves of patients are flowing on to waiting lists each month," Taylor explained, making it difficult for the NHS to keep ahead of demand. The March milestone is real and worth celebrating, but it may represent the peak of what short-term mobilization can achieve rather than the beginning of a new era of stability.