Introduction

In 2022, IHPN published a report with the Patients Association “Time to Choose” which looked at how patients exercising their right to choose can help clear the NHS elective backlog. It found that across England, patients needed to travel just 13.2 miles – around 30 minutes by car – to cut over three and a half months off their waiting time, moving from providers with an average of 22 weeks to an average of just 8 weeks.

These included some specific regional disparities, particularly in the South West where the difference between the providers with the best and worst waits was over 18 weeks (four months). General surgery patients, for example, in the South West waiting in the bottom third of providers currently were waiting on average over 35 weeks for treatment. This compares with patients waiting in the top third of providers who were waiting on average just 9 weeks – a disparity of over 26 weeks (6 months).

Three years on, and with welcome cross-party consensus around the importance of patient choice, we were keen to understand the variations in waiting times across the country and if it’s still possible for patients to access faster care by choosing an alternative provider in their region.

Key findings

Overall, our analysis of NHS waiting times across the country found that patients in England can cut months off their wait for care by exercising their right to choose a different provider for their NHS treatment. Across England, patients need to travel on average just under 13 miles – typically under 30 minutes by car – to cut over two and a half months off their waiting time.

Looking at the data in more detail, there are significant variations in NHS waiting times across both regions and specialties, with the opportunities for patients to access much faster care.

The disparities can be seen clearly in the South East, where the difference between the providers with the best and worst waits averages at over 3 months. Looking at individual specialties in the South East, General Surgery patients waiting in the bottom third of providers currently wait on average 27 weeks for treatment. This compares with patients waiting in the top third of providers who wait on average just 6 weeks – a disparity of around 21 weeks (almost 5 months). 

Looking at individual specialities, there are significant differences in waiting times in each region.

Trauma and orthopaedics

Patients waiting for trauma and orthopaedics treatment in the East of England in the bottom third of providers, wait almost 20 weeks for treatment (5 months), while patients waiting in the top 1/3 of provider wait just under 9 weeks – a disparity of 11 weeks (2.5 months).

Likewise in the South West, patients waiting in the bottom 1/3 of providers wait on average almost 19 weeks, while patients waiting in the top 1/3 of provider wait just over 8 weeks – a disparity of over 10 weeks (almost 2.5 months).

General Surgery

There are significant disparities in waiting times for General Surgery Patients. Those waiting in the bottom 1/3 of providers in the South East wait on average around 27 weeks, while patients in the top 1/3 of providers wait around 6 weeks – a disparity of almost 21 weeks (5 months).

In the London, patients waiting for general surgery in the bottom 1/3 of providers wait almost 18 week on average, while patients in the top 1/3 of providers wait just over 7 weeks – a disparity of over 11 weeks (2.5 months).

Ear, Nose and Throat

Patients waiting for ENT treatment in the bottom 1/3 of providers in the North East and Yorkshire wait on average over 21 weeks, while patients in the top 1/3 of providers wait under 10 weeks – a disparity of almost 12 weeks (3 months).

In the North West, patients waiting for ENT treatment in the bottom 1/3 of providers wait on average almost 20 weeks, while patients in the top 1/3 of providers wait just under 6 weeks – a disparity of almost 14 weeks (over 3 months).

Urology

Patients waiting for Urology treatment in the bottom 1/3 of providers in the Midlands wait on average over 18 weeks, while patients in the top 1/3 of providers wait around 7.5 weeks – a disparity of almost 11 weeks (2.5 months).

In the South East, patients waiting for Urology treatment in the bottom 1/3 of providers wait on average over 19 weeks, while patients in the top 1/3 of providers wait around 7 weeks – a disparity of 12 weeks (almost 3 months).

Ophthalmology

Waits for ophthalmic care in the East of England vary from 13.5 weeks for the bottom third of providers, down to just over 3 weeks in the top third – a range of over 10 weeks (almost 2.5 months)

Gynaecology

Patients waiting for gynaecological treatment in the bottom 1/3 of providers in London wait on average over 23 weeks, while patients in the top 1/3 of providers wait under 7 weeks – a disparity of 17 weeks (almost 4 months).

How far do patients need to travel to access faster care?

As part of our analysis of waiting times, we also looked at how far a patient waiting in the worst performing third of providers would have to travel to get faster care in the top third of providers. Overall, our analysis has found that across the country, the average distance a patient would need to travel to move from a provider with one of the longest waits to a provider with one of the shortest waits is just under 12 miles – typically under a 30 minute drive. Doing so would potentially translate to saving more than 10 weeks’ waiting by moving from providers with an average of over 17 weeks to an average of around 7 weeks.

Looking at this on a regional level this means that, in the South East for example, a patient waiting for treatment in one of the third lowest performing providers would need to travel an average of just 10.4 miles to one of the top third of providers to see their average waiting time go from 20 weeks down to under 7 weeks – a saving of over 13 weeks (over 3 months).

In the North West you would need to travel just 12 miles to see your waiting times cut by an average of 10 weeks from 16 weeks to 6 weeks.

What do the public think about patient choice?

We commissioned polling from Savanta ComRes on the public’s current awareness and attitudes to patient choice, as well as their willingness to travel to receive faster care.

Overall, a slim majority (59%) said they knew that there was a legal right to choose a hospital or clinic for a first NHS outpatient appointment. This reduced to 55% who were aware of their legal right to change hospital if they had to wait more than 18 weeks before starting NHS treatment. Just 49% of the public knew that they can choose to receive their first NHS outpatient appointment in an independent/private sector provider with no additional cost to the NHS.

The polling overall showed that the public are, however, enthusiastic about patient choice. Almost three quarters (72%) of people believe they “should have a right to choose where I receive my NHS treatment, including with an independent/private sector provider”. This rises to over eight in ten people (80%) agreeing that they are happy to receive NHS care with an independent/private sector provider as long as they are subject to the same quality standards as the NHS and it costs the standard NHS price.

Overall, the polling also found that people are comfortable with travelling outside their local area to receive their NHS care. Almost three quarters (74%) of people reported being happy to travel more than 30 mins outside of their local area to get faster treatment. Only 5% of people said they would not travel outside their local area to get quicker treatment from the NHS.

This willingness to travel for treatment emphasises the importance of empowering patients with knowledge on their choice of providers. Our analysis shows, for example, that 96% of people in England live within 30 minutes driving distance of an independent provider that delivers NHS treatment. Moreover,while there is a perception that independent providers are primarily located in more affluent areas, our analysis shows that drive times to independent healthcare providers for those people living in the most deprived areas of England are broadly the same as for the general population. If anything, those living in more deprived areas are slightly closer than average to independent providers. In recent years, independent providers have increasingly opened new locations in areas of greater deprivation.  For those that are less able to travel independently, NHS have introduced measures to support travel and accommodation needs to help improve equality of access to these treatment options. 

When asked about any potential barriers to accessing NHS treatment outside of their local area, the polling found their biggest concern was around the cost of travel (24%), followed by where follow-up care would be available (identified by 18%).

Methodology

Waiting time data based on RTT times for August 2025 published by NHS England in October 2025

Drive times obtained from openroute service

IMD and population data from ONS’s ONS Postcode directory published in August 2025