New modelling shows meeting the NHS 18-week target by the end of this parliament will likely require historically large increases in activity alongside reductions in demand and greater prioritisation of those waiting a long time.
Hence, the government will more likely than not miss this 18-week waiting time target.
A scenario under which the NHS increases treatments from the waiting list by 3.5% per year over this parliament would on its own raise the proportion of patients waiting less than 18 weeks from 59% today to 74% by mid 2029.
Such activity growth would be considerably faster than the NHS managed in the pre-pandemic period, and is equivalent to increasing treatments from 18 million in 2024 to 21 million in 2029.
This would deliver a big improvement to 18-week performance, but would still be far short of the Prime Minister’s commitment that the NHS constitutional standard of at least 92% will be achieved in this parliament.
This is one of the key findings based on a new simulation model of NHS waiting times that has been constructed by think tank IFS researchers with funding from the Economic and Social Research Council.
There is general agreement that the target is ambitious, but limited understanding of how likely the government is to meet it, or how it might improve its chances of doing so.
The model shows that achieving the 18-week target by increasing NHS activity alone would require annual increases in activity of around 4.9%. For comparison, treatment volumes grew by 3.8% in 2024, and by an average of 2.4% each year from 2016 to 2019. We judge sustained annual growth of nearly 5% to be highly unlikely to be achieved.
Olly Harvey-Rich, Research Economist at IFS and an author of the report, said:
‘There is widespread agreement that achieving the 18-week target within this parliament – reversing nearly a decade of worsening performance in five years – will be challenging. Our new analysis quantifies just how challenging. Increasing the number of patients treated by the NHS – whether by increasing funding or improving productivity – is highly unlikely on its own to be enough to meet the target. Meeting the target will likely require historically large increases in activity and reducing demand and prioritising reducing long waits. The latter two routes have potential negative consequences for some groups of patients. It’s by no means impossible, but we judge it unlikely, that the 18-week target will be met during this parliament.’
