NHS Activity and Performance Summary: May and June 2025
Report summarising data on activity and performance in the Welsh NHS for May and June 2025.
A PDF download of this document will be available soon.
In this page
Introduction
A monthly summary of NHS Wales activity and performance. Long term trends are explored in our annual reports, Trends in NHS urgent and emergency care activity and Trends in NHS planned care activity.
Data are provided by Digital Health and Care Wales (DHCW) and Welsh Ambulance Services NHS Trust (WAST). Data for each topic area are also available in more detail on StatsWales.
Main points
Emergency services (June)
There were 5,096 red (life threatening) calls to the ambulance service, 15.1% of all calls. An average of 170 immediately life-threatening calls were made each day.
50.7% of red calls received an emergency response within eight minutes, 0.7 percentage points higher than in May.
There was an average of 3,210 daily attendances to emergency departments, an increase compared to the previous month. Performance against the four hour target worsened while performance against the twelve hour target improved compared with the previous month. The average time spent in emergency departments was similar to the previous month at 2 hours and 45 minutes.
Treatment waiting lists (May)
There were just over 796,100 referral to treatment (RTT) patient pathways waiting to start treatment, an increase of around 6,200 since April. The number of patient pathways is not the same as the number of individual patients, because some people have multiple open pathways. More information is available in the chief statistician’s blog.
Management information suggests there were about 614,300 individual patients on treatment waiting lists.
The proportion of pathways waiting less than 26 weeks decreased to 54.2% in May. The number of pathways waiting longer than 36 weeks increased to just under 274,800.
Just under 10,300 pathways were waiting more than two years, more than three quarters (85.4%) lower than the peak, but a 6.5% increase from the previous month. The average time patients had been waiting for treatment at the end of May was 0.5 weeks lower than the previous month at 22.0 weeks.
There were just over 75,500 pathways waiting longer than one year for their first outpatient appointment, an increase from the previous month, but 26.4% less than the peak in August 2022.
Diagnostics and therapies (May)
Diagnostics patient pathways waiting increased to just over 117,000 in May. The number waiting longer than eight weeks (the target maximum wait) increased to just over 43,100. For therapies, pathways waiting increased to just under 58,500 and the number waiting longer than fourteen weeks (the target maximum wait) increased to just under 4,200.
Cancer services (May)
1,947 people started their first definitive treatment in May, 9 fewer than the previous month. The number of patients informed they did not have cancer decreased to 14,253. Performance improved against the 62 day target in May, increasing to 61.3%.
Ambulance calls
A wider range of ambulance quality indicators are published on StatsWales and on the NHS Wales Joint Commissioning Committee website.
Calls to the ambulance service are categorised as red (immediately life-threatening), amber (serious but not life-threatening) or green (non-urgent). This edition of these statistics will be the final one based on the current clinical response model. A new model was implemented from 1 July 2025, meaning the next statistical release will present data reflecting new call categories and performance measures.
Activity
Figure 1: average daily emergency ambulance calls, by call type and month [Note 1]
Description of figure 1: a line chart showing the number of emergency calls received by the Welsh Ambulance Services NHS Trust. Amber calls are the most common type of call, while the number of red calls has trended upwards in recent years.
Source: Welsh Ambulance Services NHS Trust
Emergency ambulance calls and responses to red calls, by local health board and month, on StatsWales
In June, just over 33,800 emergency calls were made to the ambulance service. An average of 170 red calls were made per day in June, 2 more than the previous month.
In June, the proportion of all calls that were immediately life-threatening was 15.1%, 0.2 percentage points lower than May. The number of green calls has steadily decreased over time, while the number of red calls has steadily increased.
Performance
Target
- 65% of red calls (immediately life-threatening – someone is in imminent danger of death, such as a cardiac arrest) to have a response within 8 minutes.
Figure 2: percentage of red calls which received an emergency response at the scene within 8 minutes, by month
Description of figure 2: a line chart showing that performance for emergency response calls has trended downwards over the long-term. Performance remains below the target of 65%.
Source: Welsh Ambulance Services NHS Trust
In June, 50.7% of emergency responses to immediately life threatening (red) calls arrived within 8 minutes of patient location and chief complaint being established. This was 0.7 percentage points higher than in the previous month.
The proportion of red calls responded to within 8 minutes has fallen in recent years from a peak of 80% in 2017, but over the same period there has been a significant increase in the number of red calls received. For example, in the latest twelve months there were around 65,000 red calls, almost three times as many as in 2017 (22,000). The overall increase in demand largely reflects two things; changes in how some calls are handled, as some calls that used to be categorised as amber are now categorised as red; and a large increase in respiratory conditions in recent winters.
Handover delays at hospitals can also affect performance, when ambulance crews are unable to respond to new calls while waiting to handover patients to emergency departments. There has been a significant increase in handover delays in recent years, with more than four times as many hours lost in the latest twelve months compared with 2017. In June around 15,300 hours were lost due to handover delays. Further data on handover delays can be found on the Emergency Ambulance Services Committee’s (EASC) Ambulance Service Indicators dashboard.
In June, the average (median) response time to immediately life-threatening ‘red’ calls was 7 minutes 53 seconds. This was 7 seconds quicker than the previous month, and 40 seconds quicker than June 2024.
The majority of calls to the ambulance service are categorised as ‘amber’ calls, for which there is no performance target for call response times. In June, the median response time for amber calls was just under 1 hour 34 minutes. This was just under 1 minute slower than in May, but just over 3 minutes quicker than in June 2024.
Emergency departments
Activity
Figure 3: average attendances in emergency departments, and admissions to hospital resulting from attendances at major emergency departments per day, by month [Note 1]
Description of figure 3: a line chart showing a generally increasing trend in attendances to emergency departments.
Source: Emergency department data set, DHCW
Number of attendances in NHS Wales emergency departments by age band, sex and site, on StatsWales
[Note 1]: Chart shows number of attendances at both major emergency departments and minor injuries units, and the number of admissions resulting from attending major emergency departments only.
In June there were just over 96,300 attendances to all emergency departments, an average of 3,210 attendances per day; this was 43 attendances more per day on average than in the previous month.
Just under 15,200 patients were admitted to hospital following attendance at major emergency departments. This was 1.6% higher than the previous month.
Performance
Targets
- 95% of new patients should spend less than 4 hours in emergency departments from arrival until admission, transfer or discharge.
- No patient waiting more than 12 hours in emergency departments from arrival until admission, transfer or discharge.
Figure 4: percentage of patients admitted, transferred or discharged within 4 hours at emergency departments, by month
Description of figure 4: a line chart showing the percentage of patients admitted, transferred or discharged within 4 hours at emergency departments has been relatively stable in recent years.
Source: Emergency department data set, DHCW
Performance against 4 hour target by hospital, on StatsWales
In June, 66.3% of patients spent less than 4 hours in emergency departments from arrival until admission, transfer or discharge. This was lower than the previous month and remains relatively low by historical standards.
The median waiting time was 2 hours and 45 minutes, down 1 minute from the previous month. Waiting times vary by age, time of day and day of the week, with further detail available in the Trends in NHS urgent and emergency care activity report.
Figure 5: patients waiting more than 12 hours to be admitted, transferred or discharged at NHS emergency departments, by month
Description of figure 5: a line chart showing the number of patients waiting longer than 12 hours to be admitted, transferred or discharged at emergency departments has been relatively stable recently.
Source: Emergency department data set, DHCW
Performance against the 12 hour target by hospital, on StatsWales
In June, 10,133 patients waited 12 hours or more. This was 236 (2.3%) fewer than in the previous month.
Outpatient appointments
Activity
Figure 6: average daily referrals for first outpatient appointment, by month
Description of figure 6: a line chart showing outpatient referrals, which has been fluctuating with an upwards trend.
Source: Outpatient Referral Dataset, DHCW
Referrals by local health board and month, on StatsWales
An average of 4,527 referrals for first outpatient appointments were made per day in May. This is a decrease of 2% (93 fewer referrals per day on average) compared to April.
Performance
Targets
- No one waiting for longer than a year for their first outpatient appointment by the end of 2022 (a target established in the planned care recovery plan).
Figure 7: pathways waiting more than a year for their first appointment, by month
Description of figure 7: a line chart showing a changeable trend in the number of patient pathways waiting longer than a year.
Source: Referral to treatment times, DHCW
In May, the number of pathways waiting longer than one year for their first outpatient appointment increased by 3.2% compared to the previous month to just over 75,500.
Diagnostics and therapies
Activity
Figure 8: patient pathways waiting for diagnostic and therapy services, by month [Note 1]
Description of figure 8: a line chart showing generally upward trends in pathways waiting for diagnostic and therapy services.
Source: Diagnostic and therapy services waiting times, DHCW
Diagnostic and Therapy Services Waiting Times by week, on StatsWales
[Note 1]: From April 2024 audiology and weight management pathways were no longer reported in the therapies data.
In May there were just over 117,000 patient pathways waiting for diagnostics, an increase of 1.0% compared with the previous month.
In May there were just under 58,500 patient pathways waiting for therapies, an increase of 1.0% compared with the previous month.
Performance
Targets
- The maximum wait for access to specified diagnostic tests is 8 weeks.
- The maximum wait for access to specified therapy services is 14 weeks.
- The planned care recovery plan established a target date of Spring 2024 to reach these targets.
Figure 9: patient pathways waiting over the target time for diagnostic and therapy services, by month [Note 1]
Description of figure 9: a line chart showing a fluctuating trend in diagnostics pathways waiting longer than 8 weeks and a recent downward trend in therapies pathways waiting longer than 14 weeks.
Source: Diagnostic and therapy services waiting times, DHCW
Diagnostic and Therapy Services Waiting Times by week, on StatsWales
[Note 1]: From April 2024 audiology and weight management pathways were no longer reported in the therapies data, meaning they are not directly comparable with data up to March 2024.
In May, just over 43,100 pathways were waiting longer than the target time for diagnostics, an increase of 12.1% compared to April. There were just under 4,200 therapies pathways waiting longer than the target time, an increase of 13.5%. The median waiting time for diagnostic tests was 5.2 weeks, 0.3 weeks longer than in April, and for therapy services it was 4.6 weeks, the same as in April.
Referral to treatment waiting times
Referral to treatment statistics cover open and closed pathways following referral by a GP or other medical practitioner to hospital for treatment. Open pathways are those that remain on the waiting list for treatment, whereas closed pathways are those removed.
Activity is measured by patient pathways, which differs to the number of patients. More information on this difference is available in the Welsh Government’s chief statistician’s blog.
Management information for the number of individual patients on treatment waiting lists is also published (StatsWales).
Performance
Targets
- No patients waiting longer than two years in most specialties by March 2023, and no patients waiting longer than one year in most specialties by Spring 2025 (targets established in the planned care recovery plan).
- 95% of patients waiting less than 26 weeks from referral.
- No patients waiting more than 36 weeks for treatment from referral.
Figure 10: patient pathways waiting to start treatment, by month
Description of figure 10: a line chart showing a long term upward trend in pathways waiting. The number waiting longer than one year is changeable and two year waits have fallen recently.
Source: Referral to treatment times, DHCW
In May there were just over 796,100 patient pathways waiting to start treatment, an increase from the April figure (789,900).
Headline measures for open pathways across the UK are not comparable. There are large differences in coverage between Wales, Scotland and Northern Ireland statistics, meaning they should not be compared at all. With England, a broadly comparable number can be produced for Wales by removing some known non-consultant led pathways which are not counted in England. On that basis, there are around 720,100 open pathways on consultant-led pathways in Wales, equivalent to 23 pathways for every 100 people. For England, the figure in May was 13 pathways for every 100 people. These comparisons are explored further in this Chief Statistician’s blog.
Just under 163,000 pathways were waiting more than one year in May, 2.1% higher than last month. Just under 10,300 were waiting more than two years, 6.5% higher than last month, but still the third lowest figure since May 2021, and more than three quarters (85.4%) lower than the peak in March 2022.
The number of patient pathways is not the same as the number of individual patients, because some people have multiple open pathways. Management information suggests there were around 614,300 individual patients on treatment waiting lists in Wales. Estimates for the number of individual patients waiting to start treatment by health board can be found on StatsWales: Unique Patient Estimates.
Figure 11: percentage of patient pathways waiting less than 26 weeks, by month
Description of figure 11: a line chart showing the percentage of patient pathways waiting less than 26 weeks has been between 50% and 60% in recent years.
Source: Referral to treatment times, DHCW
Of the just over 796,100 patient pathways waiting to start treatment, by the end of May, 54.2% had been waiting less than 26 weeks. This was lower than the previous month.
Figure 12: patient pathways waiting more than 36 weeks, by month and weeks waited
Description of figure 12: a line chart showing the number of pathways waiting more than 36 weeks has fluctuated in recent years.
Source: Referral to treatment times, DHCW
In May, just under 274,800 patient pathways had been waiting more than 36 weeks. This was 1,616 higher than in the previous month and represents 34.5% of all pathways waiting to start treatment.
The median time waiting to start treatment in May was 22.0 weeks, 0.5 weeks lower than the previous month.
Figure 13: closed patient pathways, by month
Description of figure 13: a line chart showing an upward trend in the number of patient pathways closed.
Source: Referral to treatment times, DHCW
Closed patient pathways by month, local health board and weeks waiting, on StatsWales
The number of patient pathways closed in May was just over 107,100, an average of 5,356 per working day. This was a decrease of 103 patient pathways (or 1.9%) closed per working day from the previous month.
Hospital discharge delays
Hospital discharge delays occur when patients who are clinically ready for discharge cannot leave hospital because the necessary ongoing care and support or suitable accommodation is not yet accessible. The figures represent the number of adults who were ready to return home or move on to the next stage of care, that experienced a delay in their transfer of more than 48 hours The data are a snapshot of delays on a given day each month, meaning they do not tell us the total number of delays over the month.
Figure 14: pathway of care delays, April 2023 to June 2025
Description of figure 14: line chart showing the number of delays has seen a slight downward trend in recent months.
Source: Pathway of Care Delays, DHCW
In June there were just under 1,400 pathway of care delays on the day the data were collected, a slight fall compared with May.
Cancer services
Activity
Figure 15: closed suspected cancer pathways in the month, by month and outcome
Description of figure 15: a line chart showing the number of patient pathways informed they do not have cancer, which fluctuates, and the number starting their first definitive treatment, which is relatively stable.
Source: Suspected Cancer Pathway, DHCW
Suspected cancer pathway (closed pathways), on StatsWales
In May, 1,947 pathways started cancer treatment, 9 fewer than in April. 14,253 pathways were closed after patients were informed they did not have cancer, a decrease of 4.6%. There were 17,266 new suspected cancer pathways, an increase of 771 (4.7%) from April. In recent years the number of new pathways opened has been relatively stable.
Performance
Target
- At least 75% of patients should start treatment within 62 days (without suspensions) of first being suspected of cancer.
Figure 16: percentage of pathways where the patient started their first definitive treatment within the target time, by month
Description of figure 16: a line chart showing the percentage of patients starting treatment within 62 days of a suspicion of cancer has generally fluctuated between 50% and 65% in recent years.
Source: Suspected Cancer Pathway, DHCW
Suspected cancer pathway (closed pathways), on StatsWales
In May, 61.3% of pathways started their first definitive treatment within 62 days of first being suspected of cancer. This was 0.8 percentage points higher than the previous month.
Focus on Local Health Boards
Local health board performance is covered in the quarterly release NHS performance for Welsh local health boards. For the months this is not produced, summary analyses will be provided in this section.
Of the measures covered in this report; Swansea Bay currently has no pathways waiting longer than two years, no one-year waits for a first outpatient appointment, and has less than 1% therapies pathways waiting over 14 weeks; Hywel Dda also has less than 1% pathways waiting two years and less than 1% pathways waiting one year for first outpatient appointments. Powys currently has no pathways waiting longer than two years and no one-year waits for a first outpatient appointment; All other health boards are not currently meeting any of the performance targets.
For emergency ambulance calls in June, Swansea Bay had the highest 8-minute response rate (53.4%) and Powys had the lowest (44.8%).
In emergency departments, Aneurin Bevan had the best 4-hour performance (77.7%) and the lowest proportion of 12-hour breaches (7.3%). Betsi Cadwaladr had the lowest 4-hour performance (58.0%) and the highest 12-hour breaches (16.7%).
Betsi Cadwaladr had the highest proportion of RTT pathways waiting longer than one and two years in May (27.4% and 3.3%). Powys had the lowest proportion over one year (< 1%) and Swansea Bay and Powys both had no pathways waiting longer than two years.
For first outpatient waits over one year, Betsi Cadwaladr had the highest at 28.2% of pathways, while both Swansea Bay and Powys had none.
Cardiff and Vale has the highest proportion of diagnostic breaches over 8 weeks (60.1%) and Aneurin Bevan has the lowest (10.5%).
For therapies, Hywel Dda has the highest proportion over 14 weeks (22.6%), while both Swansea Bay and Aneurin Bevan have the lowest (< 1%).
For cancer services, Cardiff and Vale had the highest proportion of patients starting treatment within 62 days (69.6%), and Betsi Cadwaladr the lowest (51.2%).
More detailed data is available on StatsWales: Health and Social Care.
Figure 17: local health board performance summary, May and June 2025 [Note 1]
Description of figure 17: a series of charts showing comparative performance for the health boards for selected measures across emergency and planned care in Wales. The key points are summarised in the narrative section above.
Source: Wales Ambulance Services NHS Trust, DHCW
Health and Social Care statistics, on StatsWales
[Note 1]: The percentage axes of these charts are on different scales and care should be taken when looking at the size of differences between health boards.
Quality and methodology information
All quality and methodology information in relation to this statistical release can be found in the NHS activity and performance summary: quality report
Official statistics status
All official statistics should show the standards of the Code of Practice for Statistic (UK Statistics Authority).
These are accredited official statistics. They were independently reviewed by the Office for Statistics Regulation (OSR) in July 2012. They comply with the standards of trustworthiness, quality, and value in the Code of Practice for Statistics.
It is Welsh Government’s responsibility to maintain compliance with the standards expected of accreditation. If we become concerned about whether these statistics are still meeting the appropriate standards, we will discuss any concerns with OSR promptly. Accreditation can be cancelled or suspended at any point when the highest standards are not maintained, and reinstated when standards are restored.
Accredited official statistics (OSR) are called National Statistics in the Statistics and Registration Service Act 2007.
Statement of compliance with the Code of Practice for Statistics
Our statistical practice is regulated by the OSR. OSR sets the standards of trustworthiness, quality and value in the Code of Practice for Statistics that all producers of official statistics should adhere to.
All of our statistics are produced and published in accordance with a number of statements and protocols to enhance trustworthiness, quality and value. These are set out in the Welsh Government’s Statement of Compliance.
These accredited official statistics demonstrate the standards expected around trustworthiness, quality and public value in the following ways.
Trustworthiness
These statistics are compiled from a range of sources derived from administrative data systems in use across the NHS in Wales. Data on the 111 service, 999 ambulance calls and ambulance response times are provided by the Wales Ambulance Services NHS Trust (WAST), and all other data sources are collected by the Welsh Local Health Boards and provided to Digital Health and Care Wales (DHCW) to enable them to be collated at a national level.
The data collections are overseen by the Welsh Information Standards Board (WISB), which is the custodian of the Information Standards Assurance Process. WISB mandates data collections through the NHS and Local Heath Boards, appraises information standards and provides assurance on matters related to confidentiality and consent.
The published figures are compiled by professional analysts using the latest available data and applying methods using their professional judgement and analytical skillset.
These statistics are pre-announced on the Statistics and Research area of the Welsh Government website. Access to the data during processing is restricted to those involved in the production of the statistics, quality assurance and for operational purposes. Pre-release access is restricted to eligible recipients in line with the Code of Practice.
Quality
Statistics published by Welsh Government adhere to the Statistical Quality Management Strategy which supplements the Quality pillar of the Code of Practice for Statistics and the European Statistical System principles of quality for statistical outputs.
Data standards and definitions are established by the WISB. Guidance is issued to the data providing organisations and training provided to staff responsible for collecting the data at source. DHCW collates and validates health board level data and queries anomalous and missing data directly with the health boards. Before validated datasets are provided by DHCW to Welsh Government, all data are signed off by health boards. DHCW provides validated datasets to Welsh Government, where analysts process the data to produce the aggregate statistics in the format required for publication. Welsh Government undertakes final validation checks which can be queried with DHCW and the health boards before publication. The statistical release is signed off by senior statisticians before publication.
Value
The purposes of this statistical release and the accompanying data published on StatsWales are: to provide evidence for policy development; to inform the media and wider public about activity and performance in the Welsh NHS; to enable service providers such as Local Health Boards and WAST to monitor their own performance.
Reliable statistics on the volume of activity undertaken in the NHS, the size of waiting lists, ambulance response times and emergency department and cancer waiting times are vital to inform users about the state of NHS services and the performance of the Welsh government and the Local Health Boards. These services have a significant impact on citizens’ lives and these topics feature prominently in media coverage and political discourse.
The information published here also supports the Welsh Government’s long term plan for health and social care: A Healthier Wales.
The timeliness of the data provides the most recent update using reliable data.
You are welcome to contact us directly with any comments about how we meet these standards. Alternatively, you can contact OSR by emailing regulation@statistics.gov.uk or via the OSR website.
Well-being of Future Generations Act (WFG)
The Well-being of Future Generations Act 2015 is about improving the social, economic, environmental and cultural wellbeing of Wales. The Act puts in place seven wellbeing goals for Wales. These are for a more equal, prosperous, resilient, healthier and globally responsible Wales, with cohesive communities and a vibrant culture and thriving Welsh language. Under section (10)(1) of the Act, the Welsh Ministers must (a) publish indicators (“national indicators”) that must be applied for the purpose of measuring progress towards the achievement of the wellbeing goals, and (b) lay a copy of the national indicators before Senedd Cymru. Under section 10(8) of the Well-being of Future Generations Act, where the Welsh Ministers revise the national indicators, they must as soon as reasonably practicable (a) publish the indicators as revised and (b) lay a copy of them before the Senedd. These national indicators were laid before the Senedd in 2021. The indicators laid on 14 December 2021 replace the set laid on 16 March 2016.
Information on the indicators, along with narratives for each of the well-being goals and associated technical information is available in the Wellbeing of Wales report.
Further information on the Well-being of Future Generations (Wales) Act 2015.
The statistics included in this release could also provide supporting narrative to the national indicators and be used by public services boards in relation to their local well-being assessments and local well-being plans.
Next update
21 August 2025
We want your feedback
We welcome any feedback on any aspect of these statistics which can be provided by email to stats.healthinfo@gov.wales.
