Qualitywatch

A Nuffield Trust and Health Foundation programme

NHS performance tracker

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

 

Headlines

  • In January 2024, 44% of patients waited over two months for a first cancer treatment following an urgent referral from a GP, the second worst performance on record. 
  • The waiting list to start elective (planned) care fell for the fourth month in a row in January 2024, down to 7.58 million. The list was made up of 6.33 million individual people, some of whom are waiting for multiple treatments.
  • The average (median) length of waits to start elective care was 15 weeks in January, the same as the previous month. Since the start of the pandemic, this length of average wait has only been exceeded on one other occasion (July 2020).
  • In February 2024, 29% of people attending A&E spent more than four hours from arrival to admission, transfer or discharge. Though an improvement on the previous month, this still makes it the worst February on record.

 

The analysis below includes the latest data on key activity and performance measures from January and February 2024, as published by NHS England on 14 March 2024. 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 decreased from 7.60 million in December 2023 to 7.58 million in January. This is the fourth month in a row it has decreased, falling by 193,000 since September.
  • 6.33 million people were waiting to start elective care in January 2023. This is lower than the overall waiting list of 7.58 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). There were over 92,000 waits this long in January 2024. After many months of minimal progress, meeting the target is very unlikely.
  • The median time that patients had been on the waiting list was 15.0 weeks in January 2024. This is the same as the previous month, which was the longest it has been since July 2020. Before the pandemic, in January 2020, the median wait was only 8.4 weeks.
  • The number of waits of over 52 weeks to start elective care stood at over 321,000 in January 2024 – a decrease of over 57,000 over the past year. In January 2020, there were only 1,875 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 January 2024. 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 January 2024, 44% of patients who had their first treatment for cancer following an urgent GP referral waited longer than two months. This is the second-worst performance on record, and is 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 7,294 in January 2024. 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.
  • In December, NHS England began publishing new cancer waiting time standards. For the new standard concerning two-month waits from an urgent suspected cancer referral, or breast symptomatic referral, or urgent screening referral, or consultant upgrade to a first treatment for cancer, 38% waited longer than the target time. This also represents the second-worst performance on record for this standard. The 15% standard has not come close to being met during the period for which records are available.

For more information, see our cancer waiting time targets indicator. The statistics for this month have been derived from NHS England’s commissioner-based cancer waiting times data extract. This is due to changes in the cancer waiting times standards which have led to changes in the published national-level data. 

Emergency care

A&E

  • In February 2024, 29% of people attending A&E spent more than four hours from arrival to admission, transfer or discharge. This is half a percentage point worse than February last year and makes it the worst February on record.
  • Performance against the four-hour target needs to improve by 5 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 decreased to 139,000 in February. This is 9% higher than in February last year and 77% higher than it was pre-pandemic in February 2020 when there were about 79,000 instances of waits this long.
  • Trolley waits of over 12 hours decreased to 44,000 in February. This is 27% higher than in February 2023, and 27 times higher than in January 2020, when there were 1,621 12-hour trolley waits. 
  • Total attendances to A&E departments numbered over 2.1 million in February 2024. Compared to the previous February, this represents a 12% increase, and is 9% higher than before the pandemic in February 2020.
  • The number of emergency admissions via A&E remain 1.5% below pre-pandemic levels, with nearly 388,000 emergency admissions in February 2024.

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

Ambulances

  • In February 2024, there was an average response time of 8 minutes 25 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 14 minutes 56 seconds, which means the 15-minute target was just met.
  • Response times to Category 2 incidents (emergency conditions such as stroke or heart attack) improved by nearly four minutes in February, with an average response time of 36 minutes 20 seconds. This is still 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 an average of 54 seconds 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.