NHS waiting lists are finally getting shorter, but not fairer everywhere

Philip Broadbent, University of Glasgow, writing for The Conversation UK, analyzes NHS England waiting-time data that show a national downward trend in waiting times for planned hospital care but persistent fairness gaps. The piece highlights how publication of deprivation, age, sex, and ethnicity breakdowns reveals that improvements are not evenly shared across the country, and emphasizes the need to sustain data transparency and share best practices to ensure ongoing equity.

• National improvements in 18-week waits coexist with meaningful local disparities.
• Gaps are largest in plastic surgery, dermatology and urology, and vary by integrated care boards.
• Ethnic disparities persist, with South Asian and Black patients experiencing longer waits in some services.
• Optimism comes from the narrowing of the longest waits and the potential of transparent data to drive fairer performance.

Original article by Philip Broadbent, University of Glasgow, published by The Conversation UK.

Overview

In a detailed analysis of NHS waiting-time data, The Conversation UK contributor Philip Broadbent discusses a shift in the English NHS away from grim records toward more encouraging numbers for planned hospital care. Data released by NHS England broken down by deprivation, age, sex, and ethnicity for the first time enable a more nuanced view of who waits and for how long. A separate analysis by the Health Foundation supports the conclusion that the national picture is moving in the right direction, but the distribution of improvements reveals persistent inequalities across regions and specialties.

National progress and the fairness question

On the surface, the NHS has begun edging down the waiting list and improving the share of patients treated within the 18-week target. The share treated within 18 weeks rose from about 59.8% in March 2025 to roughly 63% a year later, with ministers aiming to restore the 92% standard by 2029. Yet, as Broadbent notes, a small national improvement can obscure significant local disparities. The notion of fairness cannot be judged by national averages alone; what matters is where and who is waiting longest.

What the data show

Nationally, growth in shorter waits masks a persistent gap by deprivation. In April 2026, 62.5% of people in the most deprived areas had waited less than 18 weeks, compared with 63.6% in the least deprived, a 1.1 percentage-point gap—the smallest since the breakdown began. While this difference might appear marginal, it translated to about 7,400 people in a single month waiting more than 18 weeks in the most deprived areas, underscoring the real-world impact of seemingly small gaps.

Gaps by specialty and local variation

Disparities appear across many specialties, with the largest gaps in plastic surgery where patients in the richest areas are seven percentage points more likely to be treated on time than those in the poorest areas. Dermatology and urology each show around five-point gaps. The national average can obscure substantial local differences; nearly two-thirds of integrated care boards exhibit gaps larger than the national average, indicating that local conditions shape both speed and fairness.

Ethnicity and the patient population

The analysis highlights ethnic disparities in waiting times. People from Indian, Pakistani, and Bangladeshi backgrounds tend to wait longer on average, with only about 60–61% seen within 18 weeks in some cohorts. Dermatology data illustrate a striking gap: just 54% of South Asian patients were seen within 18 weeks, compared with 63% of white patients. Black patients face a similar pattern, with waits lagging by about six percentage points in some services. The patterns suggest that age and clinical prioritisation explain some differences, but they do not fully account for the observed inequalities across multiple specialties and geographies.

Clinical prioritisation and barriers

Some waiting-time differences reflect legitimate clinical priorities, such as prioritising older or more seriously ill patients or those at greater risk if they wait. However, the persistence of inequalities after accounting for age implies that other barriers—such as transportation, interpreters, time off work, and navigating the NHS system—also contribute to longer waits for certain groups.

Reasons to be optimistic

Despite the gaps, there are notable signs of progress. The longest waits (over 52 weeks) have narrowed substantially, particularly in areas with high deprivation, including Birmingham, Solihull, Greater Manchester, Lancashire, and South Cumbria. Gloucestershire stands out as a system delivering both speed and fairness, suggesting that the relationship between equity and targets is not a zero-sum game. The key takeaway is that publishing data and acting on what it shows—demonstrated in places like Lancashire and South Cumbria—can improve both the number of people treated promptly and the fairness of access.

What comes next

The article concludes with a call to maintain data transparency, to share best practices from high-performing systems, and to treat fairness as an ongoing component of NHS performance rather than a one-off goal. The recovery is still gaining ground, but the combination of robust data and collaborative action offers a genuine opportunity to sustain improvements in both speed and equity.

Author and context

Philip Broadbent is a Wellcome Multimorbidity PhD Fellow and Public Health Registrar at the University of Glasgow. The piece is published by The Conversation UK, with a disclosure noting funding from The Wellcome Trust. The analysis underscores the value of data-driven policy in addressing health inequalities within the NHS.