The NHS in England continues to experience increased demand pressures

Chart showing hospital waiting lists, with a decrease from 4 million in 2007 to 2.5 million in 2011, followed by a gradual increase to 4.6 million in late 2019

  • The number of emergency admissions to hospital in 2019 was 4.1% higher than in 2018.
  • The number of attendances at major A&E departments in 2019 was 4.9% higher than in 2018.
  • The waiting list for hospital treatment has risen by 44% over five years.
  • The number of urgent GP referrals for suspected cancer has doubled since 2011.
  • The number of diagnostic tests performed has increased by 26% in the last five years.

Performance on many waiting times measures continues to decline

Chart showing the percentage of patients spending over 4 hours in major A&E departments, with figures between 5% and 10% until 2015, followed by an increase marked by seasonal variation to peaks of 30% in late 2019

  • In 2019, 23.8% of people attending hospital A&E spent longer than 4 hours in the department, compared with 18.6% in 2018 and 8.5% in 2014. December 2019 saw a record high of 31.9%.
  • The waiting time measure for consultant-led treatment is now at 24.9 weeks, and has been above the 18-week target since early 2016.
  • The number of ‘trolley waits’ (long waits for admission to hospital) grew substantially in 2019 and has more than trebled since 2014.
  • Cancer waiting times have risen. The target for people to be treated within two months of an urgent GP referral has not been met consistently since 2013. In 2019, annual performance on all eight cancer waiting time measures was lower than previous years.

Improvement is evident on some measures, and staff numbers have increased in most categories

  • The number of delayed discharges has fallen by 24% over the past three years, after a sustained rise between 2014 and 2016. However, there was a small increase in delays in the second half of 2019.
  • The number of NHS hospital and community staff has risen by 3.4% in the past year. The number of hosptial doctors has risen consistently since 2009 and the number of nurses is rising at its fastest rate this decade.
  • However, the number of permanent qualified GPs is estimated to have fallen by 5.8% since 2015 – although the number of GP trainees is rising.

Chart showing the number of delayed transfers of care, with a gradual increase from 4,000 per day in 2014 to over 6,000 per day in 2017, followed by a fall back to around 4,500.

The full PDF briefing paper examines trends in the following areas:

  • Accident & Emergency attendance and performance
  • Ambulance demand and response times
  • Waiting times and waiting lists for routine treatment
  • Waiting times for cancer diagnosis and treatment
  • Cancelled operations
  • Delayed discharges and transfers of care
  • Diagnostic waiting times and activity
  • Waiting times for mental health treatment
  • Workforce numbers for doctors, nurses and other staff
  • Hospital activity, referrals and admissions
  • Bed availability and occupancy

For information on NHS funding and expenditure, please see our separate briefing. Similarly, for information on NHS mental health services, see our briefing on that topic.

Health is a devolved area. These statistics relate to the NHS in England only.


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