NHS England’s latest Referral to Treatment data shows that 18-week performance slipped in April 2026, after the March position reported in the June Board papers exceeded the national ambition for that month. 

The April RTT dashboard, refreshed on 11 June 2026, shows that 65.0% of elective patients were waiting within 18 weeks at the end of April 2026. 

This was down from 65.3% in March 2026, when NHS England reported that performance had exceeded the 65% target for the month. 

The latest figures show that the March improvement was a positive access milestone, but not yet a secure recovery trend. 

Key Developments

In April 2026, 65.0% of elective patients were waiting within 18 weeks. 

This was 0.3 percentage points lower than March 2026, when performance stood at 65.3%. 

The annual position remained stronger. In April 2025, 59.7% of elective patients were waiting within 18 weeks, meaning April 2026 performance was 5.2 percentage points higher than a year earlier. 

The total number of patients waiting within 18 weeks increased from 4,640,608 in March 2026 to 4,689,667 in April 2026. 

However, the total elective waiting list also increased over the same period, rising from 7,106,135 pathways in March to 7,218,231 pathways in April. 

Long waits also increased month-on-month. The number of pathways waiting more than 52 weeks rose from 94,406 in March to 99,781 in April. 

Why It Matters

The April RTT data shows that 18-week performance remains fragile. 

NHS England’s June 2026 Integrated Performance Report presented the March position as a positive elective recovery signal. At that point, RTT performance had reached 65.3%, the total waiting list had fallen, and long waits had reduced. 

The April refresh changes the tone. It does not remove the year-on-year improvement, but it shows that the March position was not yet self-sustaining. 

This matters because Referral to Treatment remains a core measure of elective recovery. The NHS is expected to continue improving the proportion of patients waiting within 18 weeks while also reducing the total waiting list and long waits. 

The latest data suggests that maintaining progress will require more than short-term performance focus. Sustained improvement will depend on diagnostic capacity, pathway flow, workforce availability, provider-level variation and continued operational grip. 

The April position also reinforces the importance of interpreting Board-paper performance data as a snapshot. The June Board papers reported March improvement, but the latest RTT data shows that access recovery remains vulnerable to month-on-month movement. 

Source Reference 

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