NHS waiting list rises for fifth month as minister admits figures ‘not good enough’

Mark Mansfield

NHS waiting lists in Wales have risen for a fifth consecutive month, prompting Health Minister Mabon ap Gwynfor to admit the figures are “not good enough”.

There were just over 714,200 treatment pathways open at the end of August, around 4,500 more than in July. These represented an estimated 558,100 people, as some patients were waiting for more than one treatment.

Provisional figures suggest the total rose again to around 721,400 in September, although waits exceeding two years fell.

Mr ap Gwynfor said: “Too many people are still waiting too long for the treatment they need, and that is simply not acceptable.”

Just under 5,100 pathways had exceeded two years in August, up by 337 on the previous month but 92.8% below the peak in March 2022.

September’s provisional figure was around 4,900. That estimate is subject to confirmation when the official statistics are published next month.

The Welsh Government has committed an additional £145m to plans led by clinicians to change how planned care is delivered and eliminate waits of more than two years.

“I expect to see progress soon. I have made it clear to health boards they are responsible for delivering these plans to reset how planned care is delivered in Wales,” Mr ap Gwynfor said.

More than a quarter of treatment pathways had been open for over 36 weeks at the end of August, with the number rising by around 7,100 to just under 179,500.

The median waiting time increased from 16.3 to 17.2 weeks. Separately, more than 13,100 pathways involved waits of over a year for a first outpatient appointment.

Pressure on emergency departments increased in September, with more than 98,700 attendances. The daily average of 3,291 was the second highest on record.

The proportion of patients admitted, transferred or discharged within four hours improved slightly to 63.9%, but remained well below the 95% target.

Meanwhile, 11,616 patients spent at least 12 hours in emergency departments, an increase of 653 on August.

Betsi Cadwaladr had the weakest performance on both measures:57.4% were admitted, transferred or discharged within four hours while 17.5% spent more than 12 hours there.

Hospitals also continued to struggle to discharge patients who were ready to leave. September’s snapshot recorded more than 1,400 delays exceeding 48 hours, up on August. Those patients had collectively accumulated almost 60,600 days of delay.

Mr ap Gwynfor warned of a difficult winter and said health boards had plans to support timely discharge. He will publish a new emergency and acute care policy framework next month.

Change

Future figures will also reflect a change in how emergency department waits are measured.

Guidance dating from 2011 allowed the clock to stop for certain patients when treatment ended, even if they remained in the department for observation, recovery or hospital transport.

Since October 1, the full time until patients leave has counted towards their wait.

Statisticians estimate the change will lower reported four-hour performance by between three and five percentage points. Figures from October will therefore not be directly comparable with earlier months.

The minister said this would improve the “quality and credibility” of information used to monitor patients’ experiences.

Ambulance response times lengthened in September. The median for red calls, covering major trauma and other emergencies where patients risk cardiac or respiratory arrest, was nine minutes and 32 seconds, missing the six-to-eight-minute target.

For purple calls, involving cardiac or respiratory arrest, the median was seven minutes and 31 seconds, within target.

Cancer treatment

Cancer treatment performance worsened in August, with 59.9% starting their first definitive treatment within 62 days of cancer first being suspected. The target is 75%.

A total of 2,000 people began treatment, 248 fewer than in July. Swansea Bay had the lowest proportion treated within the target time, at 41%, compared with 66.2% in Cwm Taf Morgannwg.

Diagnostic waiting lists fell to just over 111,600 pathways, their lowest level since September 2024. Despite that reduction, the number exceeding the eight-week limit increased to more than 38,200.

Therapy waiting lists also fell slightly, to just over 65,600, but remained the second highest on record. Nearly 8,100 pathways had exceeded the 14-week target, an increase of 18.4% on July.

There were substantial differences between health boards. Hywel Dda recorded 31.8% of therapy pathways waiting beyond the target, while Swansea Bay had none.

Troubling

Welsh Conservative Shadow Cabinet Minister for Health and Social Care, Natasha Asghar MS said: “These figures make for troubling reading ahead of what promises to be a difficult winter.

“More people are stuck waiting for treatment, and they are waiting even longer than before. Fewer people are starting their cancer treatment within the target, our A&E performance is deteriorating, and ambulances are taking longer to respond to the most serious incidents as they consistently miss targets.

“Our NHS is in crisis. Plaid Cymru have been focused on trying to break up the United Kingdom whilst we Welsh Conservatives have been demanding they declare a health emergency to mobilise the necessary apparatus of the Welsh Government to surge capacity and improve outcomes for patients across Wales.

“Wales expects the Welsh Government’s attention to be on fixing our NHS, not on distracting itself with an ideological obsession to break up our country.

“They cannot keep blaming others. These failures fall at the feet of Plaid Cymru’s Government, they must now focus relentlessly on getting our health services ready for winter before more patients suffer needlessly.”

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