On 6 January 2025, NHS England published the “Reforming Elective Care for Patients” plan [1]. This outlined its approach to meeting the government's commitment to deliver the formal target for fewer than 95% of patients to be waiting less than 18 weeks from referral to elective treatment by March 2029 – a target announced as one of six national “milestone” priorities for the UK by the Prime Minister. The proportion is currently below 60%, following a prolonged decline both before and following the outbreak of COVID-19. Polling shows that waits for planned care [2].
An interim target requires 65% of patients to receive treatment within 18 weeks of referral by March 2026. Each NHS trust is expected to achieve a minimum five percentage point improvement against the 18-week target by the same date.
The plan commits to creating 17 new and expanded surgical hubs by June 2025 to expedite common surgical procedures on separate sites to the provision of acute care. It calls for five additional Community Diagnostic Centres. This continues a previous policy of introducing these focused, small locations which aim to move patients through all required diagnostic procedures at one site on a single occasion: more than 165 already exist. It mandates that all Community Diagnostic Centres (CDCs) operate 12 hours per day, seven days a week, delivering same-day tests and consultations.
Around 75% of adults in England are registered for an NHS app. The plan aims to make this a central tool for managing elective care, allowing patients and proxy carers to book, change, or cancel appointments directly. Patients will be able to select from a broader range of NHS and independent sector providers for treatment. Diagnostic test bookings and sharing of results will also be integrated into the app. The plan emphasizes real-time updates on waiting times and appointment availability to improve transparency and enable more informed decision-making about treatment options and locations.
There are also commitments to:
- Work with patient representatives on a set of minimum standards for experience in elective care by September 2025.
- Collect and publish data on health inequalities, recognizing the longstanding issue in the NHS of inequality in access between more and less deprived areas for elective care.
- Work with the independent sector, with whom an accompanying memorandum of understanding was drawn up, to expand choice, with private providers committing to improve their capacity for patients with more complex problems, and for orthopaedics and gynaecology where waits are particularly long [3].