All NHS acute hospital trusts in England are missing Labour’s 18-week target

Every acute hospital trust in England is failing to meet Keir Starmer’s key target of treating 92% of patients within 18 weeks, analysis of NHS figures has revealed.

The new data shows the scale of the challenge the Prime Minister faces this year as he tries to reform the NHS. The latest waiting list data shows that in some hospitals more than half of patients wait longer than 18 weeks. Of the 124 acute trusts across the country, none are reaching the target, analysis of the figures by the shows Observer.

Starmer set out his ‘milestones’ earlier this month, which include clearing hospital backlogs to meet the NHS standard of 92% of patients waiting no longer than 18 weeks for elective treatments. This standard was last met in September 2015. A 10-year plan for reform of the NHS will be published in the spring.

The latest figures published for October show the waiting list stood at 7.54 million cases, made up of around 6.34 million individual patients waiting for treatment. About 3.1 million cases on the list waited more than 18 weeks for treatment and 234,885 waited more than a year for treatment.

Some specialist and community trusts are meeting the target of treating 92% of patients within 18 weeks, including Kent Community Health NHS Foundation Trust, South West Yorkshire Partnership NHS Foundation Trust and the Royal Marsden NHS Foundation Trust.

Acute hospital trusts provide services such as emergency departments and a wide range of usually short-term treatments. Hospital trusts where more than half of patients waited more than 18 weeks for treatment in October 2024 include Manchester University NHS Foundation Trust, Milton Keynes University Hospital NHS Foundation Trust and University Hospitals Sussex NHS Foundation Trust.

An analysis by the NHS Confederation reported in September that by 2028/29 the NHS will need to undertake 50% more elective activity than it currently achieves to reduce the waiting list backlog sufficiently to meet the 18-week standard.

It said the government’s promise of two million extra appointments, operations and diagnostics per year covered only around 15% of the additional capacity needed to eliminate waiting lists and meet the 18-week target in the long term and that this should be accompanied by additional changes and reforms.

Matthew Taylor, chief executive of the NHS Confederation, the membership body for the healthcare system in England, Wales and Northern Ireland, said progress had been made in reducing long waiting times, but meeting the 18-week standard would be a “stretching target”.

He said: “The crucial figure is how long people wait. The longest wait times are slowly decreasing, and you would expect them to decrease even further.

“We can see the trajectory, but it’s a fairly shallow path, and right now you’re not meeting the 18-week standard.”

Taylor said more fundamental reforms are needed from the NHS to cope with increasing pressure on services. He said the health care system was facing an “ominous graph” with people getting sick at younger ages and staying sick longer.

He added: “The history of the NHS over the last 25 years has been a series of commitments to shift resources upstream, from the acute, to the community, to prevention, all of which have fallen through due to shortages. long-term pressures leading to short-term interventions.

“The crucial thing we need to do is improve healthy life expectancy and better manage multiple conditions in the long term. If we don’t address the ominous graph, not only will healthcare become unsustainable, but so will the entire country.”

Chancellor Rachel Reeves announced a £22.6 billion cash injection towards the daily running costs of the NHS in the autumn budget, plus a £3.1 billion increase for capital investment over two years.

Lord Crisp, who was chief executive of the NHS in England when a major NHS plan was announced in 2000 to improve performance with a new funding package, said he welcomed the focus on community health to prevent hospital admissions and promote healthier lifestyles encourage.

He said the challenges are greater than they were two decades ago and the government should consider a summit with employers, food companies, housing providers and other partners on achieving a healthier country. “The situation is worse than in 2000,” he said. “You won’t reduce waiting lists unless you invest heavily in community care, primary care and social care. You just knock them down a bit, and then they come back up.

An NHS spokesperson said: “Thanks to the hard work of NHS staff embracing the latest technology and introducing innovative measures such as surgical hubs, the latest data from October 2024 shows the waiting list has fallen by more than 160,000 compared to previous year.

“Waiting times of more than two years have been virtually eliminated on target by July 2022, while the number of waiting times longer than a year (234,885) is the lowest since December 2020, and the number of patients waiting longer than 18 weeks (3.1 million ) is the lowest. lowest since June 2023. We will work with the government to return to treating 92% of patients within 18 weeks by the end of parliament.”

A Department of Health and Social Care spokesperson said: “Our plan for change represents an ambitious but achievable milestone in tackling the inherited NHS disadvantage. In our first year we will achieve two million additional appointments – the equivalent of 40,000 additional appointments per week.

“We are already making progress by sending top teams of top clinicians to hospitals across the country to make their operations more productive, and the additional £26 billion we have secured for the NHS will pay for new surgical hubs, scanners and beds as we cut waiting times and get the NHS back on its feet.” A spokesperson for Manchester University NHS Foundation Trust said: “We are committed to achieving our goals of reducing waiting times for elective care and providing the best possible services to patients. We’ve seen really encouraging success with our choice hubs. Our Trafford Hub alone has carried out over 7,500 operations in the last twelve months. We will continue to innovate to provide patients with the care they need, when they need it.”

A spokesperson for Milton Keynes University Hospital NHS Trust said: “Since May this year, the number of patients waiting the longest has been reduced by more than half. Now that we have improved the longest wait times, we will continue to do everything we can to reduce wait times for all patients.”

A spokesperson for University Hospitals Sussex NHS Foundation Trust said: “We are providing additional clinical capacity and making the most of new community diagnostic centres. As a result, our waiting lists have fallen faster than most other trusts in the country, by around 30,000 since the peak, representing a reduction of almost 20%. We will continue to work at this pace to ensure people receive safe and high-quality care.”