The NHS in England achieved the second largest monthly reduction in its elective waiting list in 15 years in November, despite facing the busiest year on record for emergency and ambulance care.
New data shows the waiting list fell by more than 86,000 to 7.31 million, one year on from the launch of the Elective Reform Plan. The improvement came during a period of exceptional pressure, with 27.8 million A&E attendances recorded across 2025 and a further surge in ambulance incidents during December.
Sir Jim Mackey, chief executive of NHS England, said the figures demonstrated what could be delivered through sustained operational focus and the collective effort of staff across the system. He highlighted that progress on elective care had been maintained alongside rising winter demand, increased flu admissions and continued pressure on hospital capacity.
The scale of activity remains significant. NHS staff carried out 2.45 million tests and checks in November alone, while more patients were seen within the four-hour A&E standard than in the same period last year. The NHS also recorded its highest ever number of ambulance incidents in December, contributing to a record total of 9.31 million incidents across 2025.
Professor Meghana Pandit, NHS National Medical Director, said staff had delivered tangible improvements for patients despite sustained pressure. She noted that the Elective Reform Plan had supported faster diagnosis and treatment over the past year, even as services experienced record levels of demand across urgent and emergency care. Pandit cautioned that winter pressures remain intense, with bed occupancy still very high and cases of flu and norovirus continuing to place strain on hospitals. She reiterated the importance of using NHS 111, GP and pharmacy services where appropriate to help protect emergency capacity.
Health and Social Care Secretary Wes Streeting described the reduction in waiting lists as a sign that long-promised reforms are beginning to translate into real-world improvements for patients. He said the progress reflected record investment, modernisation and the continued commitment of NHS staff, including expanded evening and weekend clinics, new diagnostic capacity and more efficient care pathways. Streeting acknowledged that significant challenges remain, particularly through the remainder of winter, but said the government would continue to back NHS leaders and frontline teams to sustain momentum and improve access to care.
Taken together, the figures underline a system operating at extraordinary scale. They point to meaningful progress on waiting lists delivered in parallel with record demand, while also reinforcing the reality that resilience is being tested daily as winter pressures persist.
