Surgeons: if we are to meet NHS waiting list targets, we need further investment in crumbling estates

The NHS waiting list for routine hospital treatment in England has fallen for the sixth consecutive month, with 7.4 million patient pathways recorded at the end of February 2025, down 26,161 from January 2025. 

While there has been progress, only 59.2% of patients began treatment within 18 weeks, highlighting the ongoing challenge of meeting the government's interim target of 65% of patients starting treatment within this timeframe by March 2026. There were 193,516 patient pathways waiting over 52 weeks for treatment.

The poor state of NHS buildings and IT continues to slow progress, even with the downward trend. Across England, NHS staff are working in crumbling buildings with outdated computer systems. If an operating theatre is out of action due to its roof leaking, for example, this may lead to a cancelled operation for someone whose life may have been in limbo while they have waited months, or even years, for treatment. 

While the government has outlined many vital modernisation efforts, including infrastructure investment and operational reforms, NHS trusts face financial constraints. More capital is needed to make these changes. 

Professor Peter Friend, Vice President of the Royal College of Surgeons of England (RCS England), said:

"The six-month decline in waiting lists indicates valuable progress, but increasing productivity enough to cut waits to the levels the government has promised relies on fixing multiple problems, especially NHS estates and IT systems. 

"A broken lift can lead to a cancelled operation. A leaking pipe can mean a whole area of a hospital isn’t fit to use. Slow IT systems can delay critical decision making or stop vital information from being accessed.

“Surgeons are excited about the implementation of new technology, including AI, in healthcare and the benefits this will bring to patients, but we also need to get the basics right through increased capital investment. Modernising the infrastructure that supports operations going ahead is not an option - it is a necessity.”

ENDS

Notes to editors:
1. NHS England’s latest consultant-led referral-to-treatment waiting times data is available here: https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/rtt-data-2024-25/#Feb25. The total waiting list stood at 7,402,148 in February 2025.
2. The Royal College of Surgeons of England provides world-class education, assessment, and development to 30,000 surgeons, dental professionals, and members of the wider surgical and dental care teams at all stages of their careers. Our vision is to see excellent surgical care for everyone. We do this by setting professional standards, facilitating research, and championing the best outcomes for patients.
3. For more information, please contact the press office: telephone: 020 7869 6053/6054/6047; email: pressoffice@rcseng.ac.uk; out-of-hours media enquiries: 0207 869 6056.