The Royal College of Physicians (RCP) has responded to the latest NHS England performance data, saying that tackling both the outdated model of outpatient care and the social determinants of health are key to bringing down waiting lists.
Despite improvements in recent months, the total waiting list for treatment in England stood at 7.4 million in February 2025. Just 59% of patients received treatment within 18 weeks – far from the 2029 government target of 92%.
The majority of patients currently waiting for care in the NHS are not waiting for surgery, but for an outpatient appointment — to get a diagnosis, treatment plan, or follow-up. With the NHS under increasing strain, the RCP argues that improving outpatient care is key to delivering more efficient, person-centred healthcare that meets patients’ needs earlier and closer to home.
The new data comes just days before the RCP is set to launch its landmark report Prescription for outpatients: reimagining planned specialist care (Wednesday 16 April), which outlines a long-term vision to transform outdated outpatient services.
Dr Theresa Barnes, RCP clinical lead for outpatients, said: “Today’s figures highlight the ongoing strain across the NHS — a reality that we know is being felt in outpatient services. Most patients on the waiting list are waiting to be seen, not operated on – and this can mean months or years of pain, uncertainty and worsening health.
“Our current outpatient model is outdated and fragmented. If we want to truly bring down NHS waiting times and deliver better care, we need a radical shift towards early intervention, integrated care, and services built around patients’ needs – not the system’s limitations.”
Dr John Dean, RCP clinical vice president, said: “To tackle the backlog, we must recognise the profound impact of where people live, work, and grow old has on health. A recent RCP survey of UK doctors revealed that nearly 90% believe health inequalities are harming patients they see on a daily basis.
“Linking the government’s 10-year health plan to its health mission is essential for prioritising prevention and achieving health equity. That means ensuring the NHS is supported to transform how care is delivered – but also investing in environments that keep people healthy in the first place.”
Doctors across the UK are already seeing how new approaches can make a difference — but also how limitations in the current system are holding back progress:
Dr Mashkur Khan, RCP regional adviser for South London, said: “In my local area and nationally, outpatient clinics are outdated. Waiting lists are so long that patients’ conditions often worsen while they wait, requiring additional tests and treatment.
“Patients need a proactive approach and services that are better at preventing illness and disease progression. For example, treating patients’ balance issues early on, rather than waiting for them to fall, and enabling patient initiated follow up are examples of the shift required to transform the way outpatient care should be delivered by the NHS.”
The RCP's upcoming report on outpatient care sets out over 40 recommendations for transforming outpatient care – including more postgraduate training places for doctors, investment in NHS facilities and infrastructure, and the reform of funding and commissioning models – to bring down waiting lists and improve patient outcomes and experience.