Changing provisions and access

Despite herculean efforts across both independent and NHS organisations, the current NHS elective waiting list remains stubbornly around 7.5 million, just 2% lower than its level a year ago. While progress has been made on addressing of the very longest of waits, delayed care remains a major issue for far too many patients.

Independent providers have a key role to play in addressing these challenges and we look forward to making further contributions as part of implementing the elective reform plan and NHS/Independent Sector Partnership Agreement published early in 2025.

If we take a decade-long view, we see that the volume of NHS elective activity undertaken by the sector has grown considerably. The plot shows that over the past decade:

• Completed Referral to Treatment (RTT) admitted pathways by independent providers have risen from under 40,000 per month to over 100,000 
• RTT non-admitted pathways have risen from around 34,000 to 60,000 per month. 

While the volume of activity carried out by the sector has increased, waiting times remain generally considerably lower at independent providers compared to their NHS peers. Moreover, throughout 2024 the number of NHS patients waiting for treatment by independent providers was comfortably below levels experienced throughout 2022 and 2023. This suggests that valuable capacity to reduce waiting times is being overlooked by referrers.

We can obtain an insight into how the NHS waiting list relates to capacity by dividing total waiting by the number of pathways completed per month. The plot below shows how that ratio has changed for independent and NHS organisations over the past decade. By the end of 2024, the waiting to activity ratio for independent providers was broadly at the same level as that of NHS organisations in 2015[1]. By contrast, the waiting list to activity ratio at NHS providers is almost double the level of a decade ago.

[1] 275 people were waiting at independent providers per 100 people treated each month during 2024. Between 2015 and 2019 inclusive, 295 people were waiting for every 100 people treated each month by NHS providers.