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

  • The waiting list to start elective (planned) care fell for the third month in a row in December 2023, down to 7.60 million. The list was made up of 6.37 million individual people, some of whom are waiting for multiple treatments.
  • In December 2023, the new two-month cancer wait time target was being missed by 34% of patients. NHS England aim to have no more than 15% of patients waiting longer than two months to start a first treatment for cancer.
  • In January 2024, almost 30% of people attending A&E spent more than four hours from arrival to admission, transfer or discharge. This is a worsening of over two percentage points on January last year, and makes it the worst January on record.
  • Trolley waits (the time between a decision to admit a patient and them being admitted) of over 12 hours exceeded 54,000 in January, making it the second-worst month on record.

 

The analysis below includes the latest data on key activity and performance measures from December 2023 and January 2024, as published by NHS England on 8 February 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 7.61 million in November 2023 to 7.60 million in December. This is the third month in a row it has decreased, falling by 164,898 since September.
  • 6.37 million people were waiting to start elective care in December 2023. This is lower than the overall waiting list of 7.60 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 98,000 waits this long in December 2023. After many months of stagnant progress, meeting the target is very unlikely.
  • The median time that patients had been on the waiting list was 15.0 weeks in December 2023. This is the longest it has been since July 2020. Before the pandemic, in December 2019, the median wait was only 8.3 weeks.
  • The number of waits of over 52 weeks to start elective care stood at over 337,000 in December 2023 – a decrease of 57,720 since August 2023. In December 2019, there were only 1,699 waits of over 52 weeks. The aim is to have nobody having to wait this long by March 2025.
  • 27% of people waited over six weeks for a diagnostic test in December 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 December 2023, 40% of patients who had their first treatment for cancer following an urgent GP referral waited longer than two months. Performance on this measure has fluctuated at this level for about a year, 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 5,730 in December 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.
  • 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, 34% waited longer than the target time. 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 January 2024, almost 30% of people attending A&E spent more than four hours from arrival to admission, transfer or discharge. This is a worsening of over two percentage points on January last year, and makes it the worst January on record.
  • Performance against the four-hour target needs to improve by nearly 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 159,000 in January. This is 12% higher than in January last year and 58% higher than it was pre-pandemic in January 2020 when there were about 101,000 instances of waits this long.
  • Trolley waits of over 12 hours increased by over 10,000 to 54,000 in January, making it the second-worst month on record. This is 27% higher than in January 2023, and 19 times higher than in January 2020, when there were 2,847 12-hour trolley waits.
  • Total attendances to A&E departments numbered over 2.2 million in January 2024. Compared to the previous January, this represents a 13% increase, and is 5% higher than before the pandemic in December 2019.
  • The number of emergency admissions via A&E remain 2% below pre-pandemic levels, with over 409,000 emergency admissions in January 2024.

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

Ambulances

  • In January 2024, there was an average response time of 8 minutes 26 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 59 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 six minutes in January, with an average response time of 40 minutes 6 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.