Qualitywatch

NHS performance tracker

Our monthly-updated analysis of the NHS's performance against totemic access and waiting times targets.

 

 

The analysis below includes the latest data on key activity and performance measures from September and October 2023, as published by NHS England on 9 November 2023. This includes data on the NHS's performance against some key targets, including some of those set out in the latest planning guidance, as well as other indicators of patient safety and care. 

Planned hospital care and diagnostic test waiting times

• The waiting list to start elective (planned) care increased from 7.75 million in August 2023 to 7.77 million in September. This is the highest the waiting list has been since records began, but represents a smaller month-on-month increase than in recent months. 

• 6.5 million people were waiting to start elective care in September 2023. This is lower than the overall waiting list of 7.77 million because some people are waiting for multiple treatments. 

• There is an objective to have no more people waiting over 65 weeks to start consultant-led elective treatment by March 2024 (except where patients choose to wait longer). However, there were over 109,000 waits this long in September 2023, very similar to the previous month, with no lasting improvement seen since March. 

• The median time that patients had been on the waiting list was 14.7 weeks in September 2023. In September 2019, before the pandemic, the median wait was only eight weeks. 

• The number of waits of over 52 weeks to start elective care stood at nearly 400,000 in September 2023. In September 2019, there were only 1,537 people waits of over 52 weeks. The aim is to have nobody having to wait this long by March 2025. 

• 26% of people waited over six weeks for a diagnostic test in September 2023. This is far beyond the 1% target, as well as the objective of 5% by March 2025. 

For more information, see our treatment waiting times and diagnostic test waiting times indicators

Cancer waiting times

• In September 2023, 41% of patients who had their first treatment for cancer following an urgent GP referral waited longer than two months. Performance on this measure has remained fairly stagnant for well over a year, very far away from the target of only 15% of patients waiting this long. 

• The number of patients who waited longer than two months from an urgent GP referral to a first treatment for cancer was 6,279 in September 2023. When the 15% threshold target was last met in December 2015, only 1,704 patients waited more than two months for their first cancer treatment. 

For more information, see our cancer waiting time targets indicator.

 

Emergency care

A&E

• In October 2023, 30% of people attending A&E spent more than four hours from arrival to admission, transfer or discharge. This is very similar to the percentage in October last year, and is a worsening of 13 percentage points compared to October 2019. 

• Performance against the four-hour target needs to improve by almost 6 percentage points to reach the March 2024 objective of 24% or fewer being seen outside the target time. The long-standing 5% standard is still far from reach. 

• Trolley waits (the time between a decision to admit a patient and them being admitted) of over four hours increased to almost 145,000 in October. This is 4% lower than in October last year, but is 81% higher than it was pre-pandemic in October 2019 when there were about 80,000 instances of waits this long. 

• Trolley waits of over 12 hours increased to over 44,600 in October. This is 2% higher than in October 2022, and more than 60 times higher than in October 2019, when there were 725 12-hour trolley waits.  

• Total attendances to A&E departments numbered almost 2.2 million in October 2023. Compared to the previous October, this represents a 1.4% increase, as well as a 2.2% increase compared to before the pandemic in October 2019. 

• The number of emergency admissions via A&E remain 3% below pre-pandemic levels, with over 400,000 in October 2023. 

For more information, see our A&E waiting times indicator.

Ambulances

• In October 2023, there was an average response time of 8 minutes 40 seconds to Category 1 incidents (life-threatening conditions, such as cardiac or respiratory arrest), missing the seven-minute target. One in 10 people waited over 15 minutes 28 seconds, which means the 15-minute target was missed. 

• Response times to Category 2 incidents (emergency conditions such as stroke or heart attack) deteriorated by four minutes in October, with an average response time of 41 minutes 40 seconds. This is far from the mean target of 18 minutes. 

Note that Category 1 response times for the London Ambulance Service from 19 August 2020 to 22 September 2022 were under-reported, so the actual mean response time during that period was longer than shown. 

For more information, see our ambulance response times indicator.

 

About this data

During this unprecedented time for the health service, QualityWatch continues to provide independent scrutiny of the health and social care system. The most recent data published today reflects changes in access and service use compared to before the pandemic.  

Between May 2019 and May 2023, in response to proposals made in the Clinically-Led Review of NHS Access Standards Interim Report, 14 hospital trusts acted as field testing sites for alternatives to the existing four-hour A&E standard. During this period, these trusts did not report performance on the four-hour standard and are hence absent from the data for May 2019 to May 2023. Reporting on the findings of the Clinical Review of Standards for Urgent and Emergency Care is now available. 

For interactive charts showing the quality of health and social care over time, please refer to our 200+ indicators.