Twenty-one trusts delivered their entire 2025-26 elective improvement in March alone, analysis shows, prompting concerns about the “fragility and sustainability” of the NHS’s waiting list recovery.
The NHS’s overall performance on the 18-week standard rose by 2.7 percentage points in March – a very large month-on-month improvement – to secure its 65% year-end target.
HSJ analysis of official data reveals that 21 providers (nearly 20%) of general acute trusts that were able to report improvement in their 18-week performance between April 2025 and March 2026 were in fact entirely reliant on steep gains in the final month.
Between April 2025 and February 2026, the share of their patients treated within 18 weeks had fallen.
Waiting list expert Barry Mulholland told HSJ that where trusts had “effectively delivered their entire annual recovery in March alone… that is extremely hard to achieve through ‘normal’ improvement activity”.
Mr Mulholland, CEO of consultancy MBI Health, said: “It does not mean the gains are fake, but it does suggest fragility, risk, and raises questions about the overall sustainability.
“Similarly, I would want to understand the changes that have been made by the trusts which made large structural improvements, to see what enabled the consistent improvement and if those changes can be replicated more widely.”
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Source: HSJ, 26 May 2026
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