What does the pledge mean?

The Labour manifesto committed the government to cutting NHS waiting times, in part by funding special out-of-hours shifts, which it hopes will add an extra 40,000 hospital appointments a week, amounting to about two million a year. (This is another pledge we’re tracking.)

Although there are many types of “waiting time”, and many ways to measure them, the manifesto made a specific promise before the election to “return to meeting NHS performance standards”.

It said: “That means patients should expect to wait no longer than 18 weeks from referral for consultant-led treatment of non-urgent health conditions. This standard was achieved with the last Labour government and will be again under the next.”

And in her Budget speech, the chancellor Rachel Reeves said the government would “move towards our target for waiting times no longer than 18 weeks”.

We know how this will be measured because it is actually already set out as a requirement in the NHS Constitution, which says: “More than 92% of patients on incomplete pathways [ie. still waiting to start treatment] should have been waiting no more than 18 weeks from referral.” (The NHS Constitution says the standard is set at 92% rather than 100% to leave “an operational tolerance” for “patients for whom starting treatment within 18 weeks would be inconvenient or clinically inappropriate”.)

In reality, as the chart below shows, NHS England has not reached this level of performance for many years, and it is still far away from doing so.

It’s not entirely clear when Labour is promising to meet the 18-week target by. The manifesto says it will be achieved “under the next [Labour government]”, which could mean by the end of the current parliament (ie, no later than 2029). We asked the Department of Health and Social Care about this in November 2024 but didn’t hear back.

It is likely that the target only refers to the NHS in England, since this is the part of the health service that the UK government directly controls, with the rest devolved to the governments of Wales, Scotland and Northern Ireland. 

What progress has been made?

This pledge currently looks very far away from being met, but we’ve rated it “In progress” because it’s early in the parliament. 

There were about 6.3 million people awaiting treatment, in about 7.6 million cases, at the end of September 2024. Just under 60% of those cases involved waits of less than 18 weeks so far. This figure has been roughly stable for about the past two years, but the government must raise it to 92% by the middle of 2029 at the latest in order to deliver its commitment.

At this early stage, we can’t yet know whether the measures announced so far to help tackle waiting times—including funding for more appointments and capital investment in equipment and buildings—will be enough to achieve this on their own. As we wrote in an article shortly before the election, the pledge to add two million appointments a year amounts to a very small rise in the overall number.

NHS Confederation analysis looking at both the current waiting list and expected demand in the coming years suggests that these proposed appointments will not be enough to deliver this pledge. Its report says: “Based on current levels of growth in the need for care and how care is currently delivered, this means that by 2028/29 the NHS will need to do 50% more elective activity than it is currently doing to clear the wait list and sustain achievement of 18-week performance. 

“Without being accompanied by change and reform, the government’s promise of an extra two million appointments, operations and diagnostics a year addresses about 15% of the additional requirement.”

In its manifesto, Labour did describe the extra appointments as “a first step” to delivering this pledge, so the government may announce measures in future that make achieving it more likely.