NHS Performance – Pre and Post COVID-19 Pandemic
Before 2020, the NHS in England experienced increased demand alongside declining performance on its main waiting time measures.
In many cases these pressures have increased following the COVID-19 pandemic.
Here are the main key performance indicators (KPIs) pre and post pandemic. The data is taken from a regular House of Commons library report on NHS Key Statistics (May 2025).
How long is the the waiting list for hospital treatment?
- This is judged by the 18 Week Target (for elective care) = 92% of patients should have definitive treatment within 18 weeks of referral from GP to hospital (e.g. GP to hospital consultant for an operation like a hip replacement or cataract).
- Currently 58% of people achieve the target
- This leads to waiting list for hospital treatment, which rose to a record of nearly 7.8 million in September 2023. Since then it has fallen by around 4% (to 7.4 million) but remains higher than pre- pandemic levels. In other words, post-pandemic, there is now some indication of the waiting list improving again – but it is still far too high
- The 18-week treatment target has not been met since February 2016.
Source: NHS England, Consultant-Led Referral to Treatment Waiting Times
How long are waiting times in A&E?
- This is judged by the 4 hour target = 95% of patients should be admitted, transferred, or discharged within four hours.
- The number of people going to A&E was slightly above pre-pandemic levels in the winter of 2024/25. The proportion of patients spending more than 4 hours in hospital A&E grew substantially between 2015 and 2020
- A new record low of 51.4% achieved the 4 hour target in December 2022. It has now stabilised ..
- Post-pandemic, with currently, 60% achieving the 4 hour target (April 2025). But this means almost all patients going through ‘majors’ (the sicker patients) will breach the 4 hour target
- The 4 hour target was last achieved in July 2015
- The number of patients waiting over 12 hours for admission after a decision to admit has increased substantially since the middle of 2021.
Source: NHS England, Accident and Emergency Attendances and Emergency Admissions
How long are waiting times for cancer treatment?
- This is (partly) judged by the 62 day target = 85% or more of people should wait no more than 62-days (two months) wait from referral to first treatment
- Pre-pandemic, 62 day performance was falling, reaching record low levels of about 65% in the pandemic
- In March 2025, post-pandemic, using a new standard (see below), 71.4% of patients were treated within 62 days of referral. In other words cancer data has stabilised and shows some signs of improvement
- Average time to treatment data is not collected
- Targets have recently changed. Previously, the standard measured only waits after GP referral, but now other routes are included, covering around 43% more patients.
- The 62-day waiting time standard for cancer has not been met in recent years.
Source: NHS England, Cancer Waiting Times
How long are waiting times for ambulances?
- This is judged by the Category 2 ambulance response time = 18 minutes
- Ambulance response times have risen, with the average response to a Category 2 call (for e.g. suspected heart attacks and strokes) at over 1 hour 30 minutes in December 2022 (during the pandemic)
- Post-pandemic, ambulance performance has subsequently improved but remains outside the target (currently about 34 minutes).
Source: NHS England, Ambulance Quality Indicators
How have NHS staff numbers changed over time?
- NHS staff numbers have increased – with doctor numbers up 26% and nurses up 25% over the five years to February 2025
- So, higher numbers of staff have not led to better NHS performance
- The NHS vacancy rate was 6.7% in March 2025, down from 6.9% in March 2024.
Source: NHS Digital, NHS Workforce Statistics
