health and care · the national record
The NHS waiting list: what 7.4 million pathways actually means
At the end of August 2026 there were 7,370,100 referral to treatment pathways on which a patient was waiting to start consultant led hospital treatment in England, NHS England's own headline figure including its estimates for four trusts that did not submit data. Because some people wait on more than one pathway at once, NHS England estimates this represents around 6.2 million individual patients. 65.2 per cent had been waiting up to 18 weeks, against a standard of 92 per cent that has not been met since September 2015.
How to read this
A pathway starts when a GP or other clinician refers a patient for consultant led treatment, and ends when treatment starts (or the patient is removed for another reason). The waiting list is the count of unfinished pathways at month end, not a count of people: NHS England's linkage of the August 2026 list to unique NHS numbers found 85 pathways per 100 belonged to distinct patients, which is where the estimate of around 6.2 million people comes from. The 18 week standard is that 92 per cent of the list should have been waiting 18 weeks or less.
Read next: A&E waiting times in England, How long an ambulance takes to arrive in England: monthly response times and NHS dentistry in England
Computed from NHS England's RTT Overview Timeseries (including estimates for missing trusts) and the August 2026 full CSV extract, both published 8 October 2026. Every headline figure on this page is asserted at build time against NHS England's own statistical press notice for August 2026; the build fails on any mismatch.
the list
7,370,100 pathways, around 6.2 million people
The 7,370,100 figure includes NHS England's estimates for Sheffield Teaching Hospitals, Torbay and South Devon, University Hospitals Plymouth and Northampton General, which submitted no August data. Without those estimates the reported list is 7,158,164. The list is 33,512 pathways smaller than a year earlier, a fall of 0.5 per cent.
how it grew
From 4.6 million to 7.8 million and part way back
On the eve of the pandemic, in February 2020, the list stood at 4,573,675 with 82.9 per cent within 18 weeks. It peaked at 7,768,573 in September 2023. Three years of slow decline have brought it to 7,370,100: still roughly 61 per cent larger than before the pandemic, on a standard last met in September 2015.
Incomplete RTT pathways at the end of August each year, England, including NHS England’s estimates for non-reporting trusts where published. The list peaked at 7,768,573 in Sep 2023. Source: NHS England RTT overview timeseries.
the long tail
113,339 waiting more than a year
In May 2019 just 1,255 pathways had been open more than 52 weeks. The pandemic took that to 436,127 by March 2021. It now stands at 113,339: vastly better than the peak, still more than ninety times the pre pandemic norm. The very longest waits have been almost eliminated: two year waits peaked at 24,424 in January 2022 and now number 222.
Pathways open longer than each threshold at the end of August 2026, England, including estimates for non-reporting trusts, with each measure’s post-2012 peak. In May 2019 only 1,255 pathways were open more than 52 weeks. Source: NHS England RTT overview timeseries.
the treadmill
1.7 million joined in a single month
The list is not a queue that stands still. During August 2026, 1,717,335 new pathways were started, 292,411 were completed with admitted treatment and 1,138,396 were completed in other ways. The list shrinks only when completions and removals outpace a relentless intake; this is why even record treatment volumes move the total slowly.
where the waiting is
Trauma and orthopaedics is the biggest queue
Incomplete pathways by specialty, from the August 2026 full extract. These figures are on a commissioner basis and exclude the four non-reporting trusts, so they sum to the reported 7,158,164 rather than the estimated headline. Percentages are the share of each queue waiting up to 18 weeks.
843,419 waiting · 19,741 over 52 weeks
622,784 waiting · 4,975 over 52 weeks
620,378 waiting · 6,111 over 52 weeks
589,316 waiting · 12,001 over 52 weeks
585,378 waiting · 12,849 over 52 weeks
473,107 waiting · 8,159 over 52 weeks
422,625 waiting · 5,254 over 52 weeks
384,427 waiting · 8,199 over 52 weeks
366,130 waiting · 5,198 over 52 weeks
360,799 waiting · 2,768 over 52 weeks
357,430 waiting · 3,621 over 52 weeks
321,302 waiting · 3,868 over 52 weeks
315,652 waiting · 7,537 over 52 weeks
205,335 waiting · 1,950 over 52 weeks
182,132 waiting · 535 over 52 weeks
158,987 waiting · 1,424 over 52 weeks
118,118 waiting · 1,065 over 52 weeks
108,674 waiting · 3,521 over 52 weeks
53,980 waiting · 788 over 52 weeks
Incomplete pathways by treatment function, England, end of August 2026, specialties with at least 50,000 waiting. Bars show queue size; red marks specialties below the national 18 week share. Excludes Sheffield Teaching Hospitals, Torbay and South Devon, University Hospitals Plymouth and Northampton General (no August submission) and 31,049 non-contracted pathways. Source: NHS England RTT full CSV extract.
the postcode dimension
18 week performance by integrated care board
The share of the list waiting up to 18 weeks in each of England's 36 integrated care boards, best to worst, on the same reported (no estimates) basis as the specialty table. Boards whose patients are treated by a non-reporting trust are understated accordingly.
Highest share within 18 weeks
54,352 waiting
375,486 waiting
94,894 waiting
250,052 waiting
73,901 waiting
68,115 waiting
110,297 waiting
249,427 waiting
Lowest share within 18 weeks
283,275 waiting
227,338 waiting
131,898 waiting
109,727 waiting
78,994 waiting
411,464 waiting
97,654 waiting
212,432 waiting
Share of incomplete pathways within 18 weeks by the commissioning integrated care board, end of August 2026, all 36 boards ranked, best and worst eight shown. Reported data only, no estimates for non-reporting trusts. Source: NHS England RTT full CSV extract.
honest questions
What this page can and cannot tell you
- 1.
Is the waiting list 7.4 million people?
No. It is 7.4 million pathways. One person referred for a hip and a cataract is on two pathways. NHS England's own linkage puts the number of individual patients at around 6.2 million, and that estimate is published alongside the headline, not buried.
- 2.
Is the list falling?
Barely. It is 33,512 smaller than a year ago, 0.5 per cent, and is below the September 2023 peak, but it has risen in each of the last two months, from 7,272,291 in June 2026. Returning to the February 2020 size is not in sight; the more achievable target being pursued is the 18 week share, which has risen 4.2 percentage points in a year.
- 3.
Why do different NHS waiting figures disagree?
This page covers consultant led elective care in England only. Diagnostic tests, cancer pathways, mental health referrals and community services have separate waiting lists with separate standards, and Scotland, Wales and Northern Ireland publish their own figures on different definitions. Adding any of them together produces a number no publisher stands behind.
- 4.
How solid are these numbers?
Four acute trusts submitted nothing for August 2026, so NHS England estimates their contribution from their latest returns; this page uses those official estimates for headlines and the reported data for breakdowns, labelling each. Past months are also revised: NHS England revised December 2025 and March 2026 data on 9 July 2026.
Sources & method
Data provenance
- NHS England, Referral to Treatment (RTT) Waiting Times, August 2026 (overview timeseries including estimates for missing trusts; full CSV extract; statistical press notice), published 8 October 2026 ↗· Open Government Licence v3.0
Caveats & data notes
- Pathways, not people. Around 6.2 million unique patients stand behind 7,370,100 pathways (85 pathways per 100 are distinct patients, from NHS England's waiting list minimum data set linkage of 30 August 2026, extracted 1 October 2026).
- Headline figures include NHS England's estimates for Sheffield Teaching Hospitals, Torbay and South Devon, University Hospitals Plymouth and Northampton General, which did not submit August 2026 data. The specialty and ICB tables use reported data only and are labelled as such.
- The median (12.2 weeks) and 92nd percentile (38.8 weeks) waits do not include estimates for missing trusts; NHS England publishes them on the reported basis only.
- England only, consultant led elective care only. The four nations publish separate, non-comparable waiting lists, and diagnostics, cancer and mental health waits are separate series.
- From February 2024 community service pathways were removed from RTT reporting, a definitional break NHS England flags in the release; comparisons across that date slightly flatter the later figures.
- Figures are revised periodically: NHS England revised December 2025 and March 2026 data on 9 July 2026, and states that revisions have no significant national impact.
- The commissioner basis excludes 31,049 non-contracted pathways (commissioner code NONC); this exclusion is NHS England's own, and reproducing it is how this page's total reconciles exactly with the published figure.
Every figure on this page traces to its official source. Share it as it stands.
Keep going
Related deep dives
How the four hour standard has slipped to 75 per cent, the rise in 12 hour waits, and the worst trusts.
A Category 2 ambulance took 29m 49s on average in July 2026 against an 18 minute target: the monthly response times by category, the fastest and slowest services, and the handover bottleneck.
Only 40.2 per cent of adults in England, 18.8 million people, saw an NHS dentist in the two years to June 2026, leaving about 28 million with no NHS dental contact: the collapse in access since the pandemic and the worst dental deserts, from 24.5 per cent in Somerset to 52.5 per cent in South Yorkshire.
The monthly reading
Get the next one by email
One email a month: the national resilience score, what moved, and the newest analyses like this one, plus The Quarterly Record four times a year. Every figure traced to its official source.