NHS England’s latest Referral to Treatment data shows that the elective waiting list rose again in April 2026, after the improvement reported in the June Board papers for March.

The April RTT dashboard, refreshed on 11 June 2026, shows that the total waiting list stood at 7,218,231 pathways at the end of April 2026. This was up from 7,106,135 in March, an increase of 112,096 pathways, or 1.6%, in one month.

The latest figures change the interpretation of the March improvement. NHS England’s June 2026 Integrated Performance Report showed that the waiting list had fallen to 7.11 million in March, with Referral to Treatment performance improving and long waits reducing. That was a positive Board-level signal.

However, the April refresh shows that elective recovery remains fragile.

Key Developments

The total elective waiting list increased to 7,218,231 in April 2026.

This was up from 7,106,135 in March 2026, a rise of 112,096 pathways, or 1.6%.

The proportion of patients waiting within 18 weeks fell from 65.3% in March to 65.0% in April.

The number of pathways waiting more than 52 weeks increased from 94,406 to 99,781, a rise of 5,375 pathways, or 5.7%.

Longer waits also increased month-on-month. Pathways waiting more than 65 weeks rose from 4,342 to 5,776, an increase of 33.0%. Pathways waiting more than 78 weeks rose from 1,047 to 1,145. Pathways waiting more than 104 weeks rose from 154 to 191.

Despite the month-on-month deterioration, the annual position remains better than April 2025. The total waiting list was 170,834 pathways lower than a year earlier, and the number waiting more than 52 weeks was 90,242 lower than April 2025.

Why It Matters

The April RTT data shows why elective recovery should be treated as fragile rather than settled.

The March data reported in NHS England’s June Board papers showed clear improvement. The waiting list had fallen, 18-week performance had improved, and long waits had reduced. But the April refresh shows how quickly that progress can weaken when underlying demand, diagnostic capacity, workforce pressure and pathway constraints remain finely balanced.

This does not remove the year-on-year progress. The waiting list remains lower than April 2025, and long waits over 52 weeks remain substantially lower than a year earlier. But it does mean the recovery cannot be described as a straightforward or secure trend.

The latest data also reinforces the importance of diagnostics. NHS England’s June Integrated Performance Report showed that diagnostic six-week waits had deteriorated in March, despite diagnostic activity exceeding target. If diagnostic capacity does not keep pace with demand, elective recovery, cancer pathways and planned care productivity are all likely to remain under pressure.

The central message is therefore more cautious: March showed elective recovery can move, but April shows it is not yet secure.

Source Reference

• NHS England, Referral to Treatment Waiting Times Dashboard, April 2026, refreshed 11 June 2026.
• NHS England, Integrated Performance Report, June 2026.