November saw the second biggest monthly fall in the NHS waiting list for 15 years outside the early pandemic period, with the list dropping by more than 86,000 to 7.31 million. The milestone comes a year after the Elective Reform Plan was published.
The progress occurred despite record demand across urgent and emergency care in 2025. There were 27.8 million A&E attendances during the year, up by over 367,000 on 2024, including 2.33 million attendances in December alone. Hospitals are also managing significant winter illness pressures: an average of 2,725 patients were in hospital with flu each day last week, and norovirus cases rose sharply, with the average number of inpatients with norovirus last week up 57% to 567.
Ambulance services saw their busiest December on record with 846,263 incidents, taking the total for 2025 to 9.31 million — roughly 365,174 more incidents than in 2024 (8.95 million). Despite high pressure, A&E performance improved, with 73.8% of patients seen within the four-hour target in December, around 50,000 more patients seen within the target than a year earlier. Bed occupancy remains very high at 94.1%.
Work under the Elective Reform Plan over the past year has included more evening and weekend clinics, new and expanded community diagnostic centres and surgical hubs, specialist teams sent to 20 trusts with the highest economic inactivity, and reducing unnecessary appointments by sending patients “straight to test.” In November, NHS staff completed 2.45 million tests and checks. Fewer patients were waiting more than 18 weeks for treatment (2.79 million in November 2025 versus 3.1 million in 2024). Progress in cancer care continued, with 76.5% of people receiving either a diagnosis or the all-clear within four weeks of an urgent referral.
Professor Meghana Pandit, NHS National Medical Director, praised staff for shrinking the waiting list amid record patient numbers and said the Elective Reform Plan has helped many patients get faster diagnoses and treatment. She warned that winter pressures remain significant, noting the post-festive rise in flu and high bed occupancy, and urged people to reserve 999 and A&E for life‑threatening emergencies while using NHS 111, local GPs and pharmacies for other conditions.
Health and Social Care Secretary Wes Streeting said the government’s investment and modernisation are delivering faster care, with waiting lists down by more than 312,000 and more patients treated within 18 weeks. He highlighted measures such as extended appointment hours, tests closer to home, surgical hubs and better use of technology, while acknowledging that winter pressures continue and more work is needed.
