Key findings

The NHS elective waiting list in England was already growing pre-pandemic, as growth in demand for care outstripped growth in the service’s ability to provide it. 

The elective waiting list grew rapidly during the pandemic, peaking at 7.8 million in September 2023.

The NHS and government have failed to achieve most of their waiting list and waiting time targets in England since 2010. 

The elective waiting list has risen in every region and area of England, but there are large differences in the extent of the increase. 

The size of the waiting list has risen much more quickly for some clinical specialties than for others.

Other NHS waiting lists and waiting times (for things other than pre-planned care) in England were also rising before the pandemic and have risen even faster since it started. 


The government has made cutting NHS waiting lists one of its five key priorities (Prime Minister’s Office, 2023). Similarly, one of the Labour party’s five national missions is to ‘get the NHS back on its feet’, including by cutting waiting times (Labour Party, 2024). NHS waiting lists and the NHS more generally are a key public concern, with health reported as the second most important issue facing the country and 80% of the public reporting that the government is handling the NHS badly (YouGov, 2024a and 2024b). It is therefore highly likely that NHS waiting lists will be an important part of the debate during the upcoming general election.  

In this IFS pre-election briefing, we discuss the past and future of NHS waiting lists. In the first part, we outline five key facts about past NHS waiting list performance, including pre-pandemic trends, changes during the pandemic and regional variation. In the second part, we produce a range of scenarios for what could happen to NHS waiting lists over the next four years under different assumptions.

For most of this report, we focus on the elective waiting list – that is, the list of people waiting for pre-planned hospital treatment or outpatient appointments. This is what politicians, experts and the general public normally mean when they talk about ‘NHS waiting lists’. But this elective waiting list is not the only NHS waiting list that matters, and so we also briefly outline what has happened to a range of other NHS waiting lists (e.g. for diagnostic tests). 

Health is a devolved matter, and our objective here is to provide context relevant for the UK-wide general election expected this year. Our analysis therefore focuses on the NHS in England, for which responsibility lies in Westminster.