NHS Elective Recovery Plan 

20 February 2025

The NHS has responded to the Government’s plan to tackle the vast waiting list crisis: to reduce the waiting list back to the minimum target of 18 weeks and have set out a plan to achieve this target.  

It is widely known that public satisfaction of the NHS is the lowest it has been since the National Centre for Social Research began their survey in 1983. Only 29% of people surveyed in the report published in 2024 said they were satisfied with the NHS. The main reason people gave for being dissatisfied with the NHS were waiting times for hospital and GP appointments, followed by staff shortages and funding issues.

It was clear that waiting lists would be high on the Government’s agenda in combination with their ongoing efforts to reform the NHS through the 10 Year Plan.In January 2025, Kier Starmer announced the Government’s “NHS Elective Recovery Plan”.

This is a plan setting out the ambition to reduce waiting lists and to ensure that the NHS meets the constitutional objective to see 92% of patients within 18 weeks of referral.

The NHS Constitution is a document filled with promises about how people will receive care in the NHS – one of those promises is that the majority of people (92%) will be seen within 18 weeks.

In January 2025, Kier Starmer announced the Government’s “NHS Elective Recovery Plan”. This is a plan setting out the ambition to reduce waiting lists and to ensure that the NHS meets the constitutional objective to see 92% of patients within 18 weeks of referral. The NHS Constitution is a document filled with promises about how people will receive care in the NHS – one of those promises is that the majority of people (92%) will be seen within 18 weeks. 

The most recent information about the waiting lists in England, show a very concerning picture:  

  • There are 7.48 million cases on the waiting lists in England 
  • Over 3 million people have been waiting for more than 18 weeks 
     

The British Medical Association, (BMA) the trade union and professional body for doctors, highlights that this is potentially the tip of the iceberg with regard to the waiting list as the list only shows patients waiting for their first appointment. The BMA talks about the ‘hidden backlog’ of individuals requiring care but haven’t presented and those who need follow up appointments once they’ve begun treatment. The BMA therefore says that the wait list of 7.48 million does not show the full extent of the backlog.  

Currently, the NHS in England is only able to see 59% of people on the waiting list within 18 weeks. The Government’s Elective Care Plan wants to see this improved to 65% by March 2026.  

The Elective Care Plan identifies some ways in which it thinks the NHS can reduce waiting lists – this includes: 

  • Empowering patients by giving them more choice and control; 
  • Reform to deliver more elective care; 
  • Making sure people get care from healthcare professionals in the right setting; and 
  • Financial and performance oversight. 

The plan goes into a lot of detail on how it will achieve these aims and we applaud the Government for its continued expression to improve NHS services for all those who are using them. We know that those individuals at the start of their diagnosis journey, waiting for an appointment, will be pleased to hear the commitment to reducing waiting times and increasing appointments.  

For those waiting for a rheumatology appointment who have or may have RA or Adult JIA, we would encourage you to look at our resources available including those within our SMILE modules. Our SMILE modules include useful information and tips and there is a module on ‘How to get the best from your rheumatology appointment’ and also on ‘How to Manage Pain and Flares’ both of which could be helpful while you are waiting to be seen.  

NRAS remains concerned about the emphasis being put on initial appointments without consideration of the impact this may have on those already within the system, those who the BMA calls the ‘hidden backlog’. It is mentioned that one way to reduce the initial appointment waitlist is to increase the use of Patient Initiated Follow up appointments “PIFU”, including using AI and automation to identify suitable patients.  

PIFU is a system which replaces the traditional scheduled follow-up appointments, by your rheumatology team for patients who are stable on treatment, and puts you onto a pathway whereby individuals are responsible for making an appointment quickly should they need it and have a longer fixed appointment for 12, 18 or even 24 months’ time. The hope of PIFU is to reduce the number of follow-up appointments where people who are well do not have to attend follow-up when they don’t need to be seen, and allow for a rapid review appointment should it be needed. NRAS has been involved in the development of a range of resources to help you understand who is suitable to go onto a PIFU pathway and what this means for you. Find out more here: 

This Elective Care Plan has been developed outside of the process of the 10 Year Health Plan which is due to be released around Spring time 2025. Some commentators have argued that the plan might be achievable but this would leave little resources and energy for the bigger changes wanted in the 10 Year Plan.  

If you’re someone on a waiting list, whether waiting for your first appointment or waiting for a follow-up appointment and want to share your experience, please get in touch with us. Email campaigns@nras.org.uk mentioning “waiting lists” to share your story.