‘Ominous Signs’ of Winter Pressure as NHS Waiting List Grows

NHS leaders are warning of “ominous signs” of winter pressure across England after new figures showed the waiting list for routine hospital treatment has increased for a second consecutive month.

An estimated 7.37 million treatments were waiting to be carried out at the end of August, involving around 6.24 million patients.

The figure is the highest recorded since October 2025 and raises further questions about whether the NHS will meet the government's target of ensuring 92% of patients receive treatment within 18 weeks by 2029.

The latest figures come despite the NHS delivering record levels of planned care during the summer.

Record demand across the NHS

NHS England carried out around 4.7 million planned treatments, procedures and appointments between June and August — the highest total recorded during a summer.

But demand for services has also reached record levels.

September was the busiest September on record for both A&E departments and ambulance services, adding to concerns about the ability of hospitals to cope as the colder months approach.

Professor Frankie Swords, NHS England's national medical director, said frontline staff were already seeing early signs of winter pressure.

She said more patients were arriving at A&E with flu and other respiratory viruses than would normally be expected at this time of year.

She also acknowledged that many patients were continuing to wait longer than the NHS would like for treatment.

Waiting lists rise again

The rise in the waiting list comes despite efforts to increase the amount of planned care being delivered.

The NHS Alliance, which represents NHS trusts, has warned that the government's 18-week target could prove difficult to achieve by the end of the current parliamentary term.

The target has not been consistently achieved for around a decade.

The Health Foundation has also reported that progress in reducing waiting times has stalled over the past year.

Its analysis found that referrals onto waiting lists have been increasing faster than the number of patients being treated.

Sir Ciarán Devane, chief executive of the NHS Alliance, said the NHS was continuing to respond to record demand but that the growth in demand was placing staff under significant pressure.

A&E pressure builds

The pressure is also being reflected in emergency departments.

The proportion of patients seen within four hours in A&E fell from 75.0% in August to 74.4% in September.

More than 50,000 patients in September waited at least 12 hours from the decision to admit them to actually being admitted to hospital.

The figure was 50,582, compared with 44,951 in August.

The measure is often associated with what has become known as corridor care, where patients can remain in emergency departments for extended periods because no suitable inpatient bed is immediately available.

Dr Vicky Price, president of the Society for Acute Medicine, said the figures should raise serious concerns as winter approaches.

She highlighted the number of people waiting more than 12 hours and said those figures represented vulnerable patients waiting for beds while staff attempted to provide safe care in increasingly crowded emergency departments.

Respiratory illnesses add to pressure

Flu and other respiratory viruses are already contributing to increased pressure on emergency services.

NHS leaders traditionally expect demand to rise during the winter months, particularly when respiratory illnesses become more widespread.

The concern this year is that hospitals are already experiencing increased demand before the winter period has fully developed.

That could leave hospitals with less capacity to absorb further increases in emergency admissions.

Government points to investment

The government says the 18-week target remains achievable.

It has pointed to investment in NHS buildings and equipment, arguing that improving infrastructure and productivity can help increase the amount of treatment being delivered.

The government has also highlighted disruption caused by industrial action by resident doctors as a factor affecting NHS performance.

That dispute has now been settled.

The challenge ahead

The latest figures present a mixed picture.

On one hand, the NHS has delivered record levels of planned care during the summer.

On the other, demand for emergency and routine services is continuing to increase, while the waiting list has begun rising again.

The proportion of patients being treated within four hours in A&E has also fallen, while tens of thousands of people are experiencing extremely long waits before being admitted.

For NHS staff and patients, the key question is what happens as winter demand increases.

If flu and other respiratory infections continue to rise, hospitals could face further pressure on beds, emergency departments, ambulances and planned treatment.

The NHS has made progress in delivering more care, but the latest figures suggest that demand is continuing to challenge the health service's ability to reduce waiting times and prepare for winter.