The Government's elective care target to treat 92% of patients within 18 weeks by the end of Parliament is achievable but will be dependent on a significant rise in treatments and how fast referrals increase, new analysis by The Health Foundation has found.

The Government elective reform plan in January 2025 set out the target of treating 92% of patients within 18 weeks by March 2029. An interim target of 65% has been set by March 2026.

The 92% NHS standard has not been met since 2015/16 with 59% of patients currently waiting 18 weeks or less and 234,000 patients waiting over a year.

The elective plan sets out a number of initiatives that will help reach this target, including greater use of the private sector, performance incentives, fewer follow-up appointments and reductions in necessary referrals. It also confirms the Government's target of providing an extra 40,000 appointments a week (2m in total) within the first year of Parliament.

The report by The Health Foundation finds the number of people being removed from the waiting list will need to rise from 20.8m a year in July 2024 to 23.5m a year in July 2029 in order to achieve the Government's target. This corresponds to a significant rise in extra treatments from 500,000 in the first year to increasing to a cumulative total of 2.6m by the final year, equivalent to an annual increase of 2.4%. This would see the waiting list decline from 7.6m in July 2024 to 4.4m in July 2029.

The Government's commitment of 2m appointments is equivalent to around 400,000-700,000 additional treatments so is enough to cover the initial 500,000 additional treatments required (2.4% growth) in the first year. However, a similar increase in growth would be needed every year to meet the additional 2.6m additional treatments required by 2029. This would be equivalent to around 10m appointments in year five, 8m more than the 2m that has so far been pledged.

The Health Foundation says the 2.4% annual growth in treatments needed is similar to the growth rate of 2.3% before the pandemic, which looks achievable. However, if referrals grow by 2% rather than the assumed 1.5% over the next five years treatments would need to grow by 2.9%.

Assuming the 1.5% referral growth rate see in the year to October 2024 continues over the next five years, The Health Foundation expects the number of new referrals to rise from 20.8m in the year to July 2024 to 22.4m in the year to July 2029.

The think-tank notes the Government's targets look achievable based on the record of Labour when was in power in the 2000s but cautions this was delivered in better economic conditions, over a longer period of time and with significantly greater increases in investment than are likely to be available. Given this, The Health Foundation says improving elective care productivity will be vital.