NHS elective performance at 5-year high amid record demand

The NHS delivered its best 18-week elective performance for more than five years in September, as staff manage record demand on services.

New NHS figures published today show almost 66% of patients on the waiting list have been waiting less than 18 weeks – the highest proportion since September 2021.

The progress comes alongside a record number of diagnostic scans and tests being delivered for September, following investment in NHS diagnostic capacity. The improvement in elective performance came despite a record number of people being referred onto the waiting list.

But pressure on services is showing no sign of easing as winter approaches.

October was the busiest month ever for A&E, with more than 2.5 million people attending emergency departments – equivalent to the combined populations of Manchester, Liverpool, Sheffield, Leeds and Bristol.

Ambulance crews also faced their busiest month on record, responding to almost 870,000 incidents – an average of 28,046 a day. That was 7.7% higher than the daily average of 26,032 recorded in October 2025.

The high demand on emergency services came even as the NHS delivered more care outside of hospitals and at more convenient places for patients. Urgent community response teams delivered 169,410 care contacts in August, 2.7% more than a year earlier.

The UK Health Security Agency has also issued its first cold health alerts of the season for parts of England, warning that falling temperatures could have a “serious impact” on people with existing health conditions as Arctic air moves across the UK.

The NHS moved earlier than ever to prepare for winter this year, asking all hospital trusts to stress-test their plans by the end of September. Flu vaccination bookings were also opened earlier than ever before.

NHS national medical director Professor Frankie Swords said: “Today’s figures show just how hard our local teams are working.

“Easier access to primary care is leading to extreme demand for services, but the NHS is still delivering improvements for patients.

“Performance on the waiting list is the best it’s been for more than half a decade, while the number of patients being seen within four hours in A&E is high.

“It really shows how important the significant preparation for winter has been this year.

“The most important thing people can do as we head into winter is to protect themselves and their families by getting the vaccinations they are eligible for against viruses like flu.

“As ever, if you need life-saving care please use A&E and 999, and otherwise use our high street pharmacies, 111 and 111 online.”

Health and Social Care Secretary Yvette Cooper said: “This Autumn has been the busiest ever for our NHS – with record numbers of people attending A&E and record numbers of elective appointments and treatments. Despite the relentless pressure, the NHS has delivered a record 30.6 million diagnostic tests, checks and scans over the last 12 months, and more people are being treated within 18 weeks than the same time last year. I want to pay tribute to all the NHS staff whose commitment and hard work has made that possible.

“As we head into winter, those pressures will increase. That’s why we are bringing in a new £40 million GP programme to help frail elderly people stay well at home and expanding the Pharmacy First scheme, so people can get care where they need it most.”