NHS Faces 'Ominous Signs' of Winter Pressures as Waiting Lists Grow

Senior health leaders in England are warning of "ominous signs" that winter pressures are already impacting the National Health Service (NHS), as new data reveals the waiting list for routine hospital treatment has increased for the second consecutive month.

In August, the estimated number of treatments waiting to be carried out reached 7.37 million, affecting 6.24 million patients. These figures represent the highest numbers seen since October 2025, prompting concerns about the government's target to treat 92% of patients within 18 weeks by 2029.

This rise in waiting lists occurred despite the NHS reporting record levels of planned elective care over the summer months, with demand for services also reaching an all-time high. A record 4.7 million planned treatments, procedures, and appointments were carried out between June and August, surpassing any previous summer.

However, both Accident & Emergency (A&E) departments and ambulance services recorded their highest patient numbers for September. Professor Frankie Swords, NHS England's national medical director, noted that frontline staff are observing early indicators of pressure, including an increase in patients presenting at A&E with flu and other respiratory viruses, and a persistent number of patients experiencing longer-than-desired waits.

"Staff are already seeing the ominous early signs of pressure, with more patients coming to A&E with flu and other respiratory viruses than usual for this time of year, and unfortunately many people are still waiting longer than we would like them to," she stated.

The NHS Alliance, an organization representing hospitals, has expressed doubts about the government's ability to meet its manifesto promise of achieving the 18-week hospital waiting time target by the end of the current parliamentary term in 2029. This target has not been met for the past decade.

An analysis by the Health Foundation, a health think-tank, indicated that progress in reducing waiting times has stagnated over the last year. The rate at which new referrals are added to the waiting list is significantly outpacing the number of patients being treated. Sir Ciarán Devane, chief executive of the NHS Alliance, commented, "The NHS continues to respond to record demand for care, but the relentless growth in demand for services is putting NHS staff under real pressure."

Francesca Cavallaro of the Health Foundation added, "Thanks to the hard work of staff, the NHS has made progress in bringing down waiting times, but a rise in referrals mean that the service is having to run faster just to stand still and the prospects of meeting the government's pledge are receding."

Concerns are mounting as the pressures typically associated with winter appear to be merging with the tail end of a long, hot summer. There has been an increase in patients, including children, attending A&E with flu and other respiratory viruses.

The proportion of patients seen within four hours in A&E departments fell to 74.4% in September, down from 75.0% in August. Furthermore, the number of patients experiencing waits of over 12 hours from the decision to admit to actual admission – known as "corridor care" – rose to 50,582 in September, an increase from 44,951 in August.

Dr. Vicky Price, president of the Society for Acute Medicine, expressed alarm at the figures. "A 13% year-on-year rise in 12-hour emergency department waits as winter approaches should set alarm bells ringing. More than 50,000 patients waited over 12 hours from the decision to admit to admission in September - 1,686 people every day. These are not just numbers. They represent vulnerable people who are waiting far too long for a bed and staff trying to deliver safe care in overcrowded emergency departments."

Government officials maintain that the 18-week target remains achievable, citing investments in NHS infrastructure and equipment aimed at enhancing service productivity. They also pointed to the impact of recent junior doctor strikes, a dispute that has since been resolved, on care disruption.

However, the strain evident in services during September, prior to the full onset of winter, is a significant cause for concern among both NHS leaders and government officials.