Acute sector

High levels of demand persist in A&E, with the second busiest month ever recorded in May. A&E performance improved compared to last month, but further progress is necessary to meet the aims for winter preparedness set out in the UEC delivery plan.
Signs of stretched capacity throughout hospitals continue, with discharge delays higher than last year and measures of patient flow, such as 12 hour waits related to A&E, remaining high.
In planned care, activity increased again across all cancer pathways, and we saw the highest April figure on record for diagnostic activity. Performance slipped back against key targets in diagnostics and cancer care, signalling ongoing delivery pressures.
The waiting list decreased slightly in April to the smallest it has been in two years. Trusts have worked hard to more than halve long waits from their peak during the covid pandemic.

There were 2.4 million A&E attendances in May, the second highest month on record, surpassed only by May 2024.
Despite high demand, this month saw the strongest May performance in four years: three-quarters (75.4%) of patients were seen in four hours. The UEC delivery plan outlines this as one of the key areas of focus for winter preparedness, with a performance aim of 78%. You can read our summary of the delivery plan for recovering UEC services here.
In May, 42,890 patients waited at least 12 hours from the decision to admit to admission. While this figure has been gradually declining each month since the January peak of 61,500, it remains over 130 times higher than pre-pandemic levels. 
135,220 patients waited more than 12 hours from arrival at A&E in May, down from highs of over 176,000 seen in January.
The urgent and emergency care delivery plan outlines this as one of key areas to deliver against for winter preparedness, aiming for less than 10% of patients waiting over 12 hours in A&E. Currently waits of over 12 hours occur 9.3% of the time, but this will be a challenge to maintain over winter, based on performance in previous years (see figure 1).

Figure 1
Percentage of A&E attendances that spent more than 12 hours from arrival at A&E

The proportion of patients remaining in hospital at the end of each day despite no longer meeting the criteria to reside was 56.1%, down on last month but higher than last year (53.3%).

The size of the waiting list dipped slightly to 7.39 million in April, which is the smallest it has been in over 2 years (since March 2023). It remains 68% larger than six years ago, before the pandemic. 
In April, 84.4% of patients on the waiting list were unique patients. This is an estimated 6.23 million people.
The number of treatments waiting more than 18 weeks fell by 8,000 to 2.98 million treatments, equivalent to 59.7% of all waits. The planning guidance sets out an aim for 65% of treatments to be waiting no longer than 18 weeks by March 2026. 
190,070 treatments had been waiting over 52 weeks in April, totalling 2.6% of all waits. Trusts have worked hard to more than halve the March 2021 peak of over 400,000 long waits. There is, however, a way to go to meet planning guidance aims for waits over a year to make up 1% of all waits by March 2026.

Monthly activity across all three pathways (28-day faster diagnosis standard, 31-day and 62-day) in April was higher than last year – up by around 2-3% for each pathway. Activity is now double 2019 figures for the 31-day and 62-day pathways (28-day FDS is not comparable to this time period).
In April, 76.7% of patients with an urgent referral were told they have cancer, or if it was excluded within 28 days – the second consecutive month of slipping performance but it still remains higher than last year.
69.9% of referrals met the 62-day standard this month, a slight fall from last month but an improvement compared to last year (66.6%).

Figure 2
Percentage of patients seen within 28-day FDS pathway and 62-day pathway standards

In April 2025, 2.4 million diagnostic tests were carried out – the highest April figure on record and an increase of 3% on last year.
Despite record levels of activity, demand for diagnostic testing is high and the diagnostic waiting list continues to increase – it totalled above 1.7m treatments for the second month running. This is nearly 60% higher than before the pandemic.
In April 2025, 21% of patients waited for longer than six weeks for diagnostic tests, an improvement since last year (23%) but some way from the 5% ambition set out in the 24/25 planning guidance for March 2025.