NHS Activity and Performance Summary: September and October 2025
Report summarising data on activity and performance in the Welsh NHS for September and October 2025.
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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 University NHS Trust (WAST). Data for each topic area are also available in more detail on StatsWales.
Main points
Emergency services (October)
In October there were 865 purple calls to the ambulance service, around 2.4% of all calls, and 4,529 red calls, around 12.7% of all calls.
For patients in cardiac arrest for whom resuscitation was attempted, 20.4% had a return of spontaneous circulation (ROSC) at the time of arrival to hospital, a fall compared with the previous month.
The median response times for purple and red calls were 7 minutes 29 seconds and 8 minutes 49 seconds respectively, both longer than in the previous month.
In October there were just under 96,800 attendances to all emergency departments, an average of 3,121 attendances per day; this was 17 attendances more per day on average than in the previous month.
Performance against both the four-hour and twelve-hour targets worsened compared with the previous month.
The average time spent in emergency departments was less than the previous month at 2 hours and 48 minutes.
Treatment waiting lists (September)
Figures are currently not available due to issues with Betsi Cadwaladr University health board data. Data will be published when the issues are resolved.
Diagnostics and therapies (September)
Diagnostics patient pathways waiting increased to just over 129,200 in September, the highest figure on record. The number waiting longer than eight weeks (the target maximum wait) increased to just over 47,800.
For therapies, pathways waiting decreased to just over 58,000 and the number waiting longer than fourteen weeks (the target maximum wait) decreased to just over 4,600.
Cancer services (September)
2,178 people started their first definitive treatment in September, 350 more than the previous month. The number of patients informed they did not have cancer increased to 15,120. Performance worsened against the 62 day target in September, decreasing to 58.8%.
Ambulance calls
Until July 2025, 999 ambulance calls were categorised as red (immediately life-threatening), amber (serious but not life-threatening) or green (non-urgent).
On 1 July a new response model was implemented, and two new response categories were introduced to replace the previous red category. The new categories are purple: Arrest, for cardiac and respiratory arrests, and red: Emergency, for major trauma and other incidents where patients are at significant risk of cardiac or respiratory arrest if they do not receive a rapid response.
Non purple or red calls are currently still managed as amber or green, however work is ongoing to establish new categories reflecting the different types of less urgent calls. These will be added to the performance framework later.
Data up to June 2025 based on the previous response model will remain available on StatsWales, however they are not comparable with the new measures. A wider range of quality indicators will be published by the NHS Wales Joint Commissioning Committee. This Chief Statistician’s update provides more information on the background to the new ambulance performance measures.
Activity
Figure 1: number of purple and red emergency ambulance calls, by month [Note 1]
Description of figure 1: a line chart showing numbers of purple and red calls have been relatively stable since July 2025.
Source: Welsh Ambulance Services University NHS Trust
[Note 1]: Detailed definitions for the measures are provided in the accompanying quality report.
Ambulance activity and performance measures, on StatsWales
In October, 865 purple calls were received by the Welsh ambulance service (around 2.4% of all calls) and 4,529 red calls were received (around 12.7% of all calls). These were both increases compared with September.
Performance
Targets
- For purple and red calls the median and 90th percentile response time targets are 6-8 minutes and under 20 minutes respectively.
Figure 2: return of spontaneous circulation (ROSC) rate, by month [Note 1]
Description of figure 2: a line chart showing return of spontaneous circulation rates have fallen in recent months.
Source: Welsh Ambulance Services University NHS Trust
[Note 1]: Detailed definitions for the measures are provided in the accompanying quality report.
Ambulance activity and performance measures, on StatsWales
For patients in cardiac arrest for whom resuscitation was attempted, 20.4% had a return of spontaneous circulation (ROSC) at the time of arrival to hospital, a fall compared with the previous month.
Figure 3: median and 90th percentile response times for purple and red emergency ambulance calls (minutes and seconds), by month [Note 1]
Description of figure 3: a line chart showing median and 90th percentile response times are shorter for purple calls than red calls, and all are relatively stable recently.
Source: Welsh Ambulance Services University NHS Trust
[Note 1]: Detailed definitions for the measures are provided in the accompanying quality report.
Ambulance activity and performance measures, on StatsWales
The median response time for purple calls was 7 minutes 29 seconds and the 90th percentile (the point at which 90% of responses were quicker and 10% were slower) was 16 minutes 50 seconds. These were both longer than in September.
For red calls, the median increased to 8 minutes 49 seconds and the 90th percentile fell to 21 minutes 34 seconds.
For both purple and red calls the median and 90th percentile response time targets are 6-8 minutes and 20 minutes respectively.
Figure 4: median time for defibrillator arrival, to commence CPR instruction, and to identify cardiac arrest (mm:ss), by month [Note 1]
Description of figure 4: a line chart showing median times to identify cardiac arrest and commence CPR instruction have fallen slightly recently, while the median time for defibrillator arrival has increased.
Source: Welsh Ambulance Services University NHS Trust
[Note 1]: Detailed definitions for the measures are provided in the accompanying quality report.
Ambulance activity and performance measures, on StatsWales
The median time for defibrillator arrival was 6 minutes and 2 seconds, the median time to commence CPR instruction was 4 minutes exactly, and the median time to identify cardiac arrest was 1 minute and 59 seconds.
Emergency departments
Activity
Figure 5: 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 5: a line chart showing a generally increasing trend in attendances to emergency departments.
Source: Emergency department data set, DHCW
Emergency departments: attendances by age and sex, April 2016 onwards, 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 October there were just under 96,800 attendances to all emergency departments, an average of 3,121 attendances per day; this was 17 attendances more per day on average than in the previous month.
Just under 15,300 patients were admitted to hospital following attendance at major emergency departments. This was 3.3% 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 6: percentage of patients admitted, transferred or discharged within 4 hours at emergency departments, by month
Description of figure 6: 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, between 60 and 70%.
Source: Emergency department data set, DHCW
In October, 66.0% 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 48 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 7: patients waiting more than 12 hours to be admitted, transferred or discharged at NHS emergency departments, by month
Description of figure 7: 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, at around 10,000 patients.
Source: Emergency department data set, DHCW
In October, 10,499 patients waited 12 hours or more. This was 414 (4.1%) more than in the previous month.
Outpatient appointments
Activity
Figure 8: average daily referrals for first outpatient appointment, by month
Description of figure 8: a line chart showing outpatient referrals, which has been fluctuating with an upwards trend.
Source: Outpatient Referral Dataset, DHCW
Outpatient referrals, April 2012 onwards, on StatsWales
An average of 4,851 referrals for first outpatient appointments were made per day in September. This is an increase of 15.6% (655 more referrals per day on average) compared to August.
Diagnostics and therapies
Activity
Figure 10: patient pathways waiting for diagnostic and therapy services, by month [Note 1]
Description of figure 10: a line chart showing generally upward trends in pathways waiting for diagnostic and therapy services.
Source: Diagnostic and therapy services waiting times, DHCW
Therapy services: pathway waiting times, grouped weeks waiting, October 2009 onwards, on StatsWales
[Note 1]: From April 2024 audiology and weight management pathways were no longer reported in the therapies data.
In September there were just over 129,200 patient pathways waiting for diagnostics, an increase of 4.7% compared with the previous month and the highest figure on record.
In September there were just over 58,000 patient pathways waiting for therapies, a decrease of 0.1% 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 11: patient pathways waiting over the target time for diagnostic and therapy services, by month [Note 1]
Description of figure 11: 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
Therapy services: pathway waiting times, grouped weeks waiting, October 2009 onwards, 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 September, just over 47,800 pathways were waiting longer than the target time for diagnostics, an increase of 2.4% compared to August, and the highest figure since January 2024.
There were just over 4,600 therapies pathways waiting longer than the target time, a decrease of 4.4%.
The median waiting time for diagnostic tests was 5.0 weeks, 0.7 weeks shorter than in August, and for therapy services it was 4.2 weeks, 0.6 weeks shorter than in August.
Referral to treatment waiting times
Figures are currently not available due to issues with Betsi Cadwaladr University health board data. Data will be published when the issues are resolved.
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. Figures are available for the number of individual delays and the corresponding total number of days delayed experienced by those patients.
Figure 16: pathway of care delays, by month
Description of figure 16: line charts showing the number of delays and the total days delayed.
Source: Pathway of Care Delays, DHCW
Delayed hospital discharges: total pathway of care delays and total days delayed, on StatsWales
In October there were just under 1,500 pathway of care delays on the day the data were collected, an increase compared to the figure in September. The total cumulative days delayed for those patients was just over 64,100, an increase compared to the figure in September.
Cancer services
Activity
Figure 17: closed suspected cancer pathways in the month, by month and outcome
Description of figure 17: 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
In September, 2,178 pathways started cancer treatment, 350 more than in August. 15,120 pathways were closed after patients were informed they did not have cancer, an increase of 11.8%. There were 17,279 new suspected cancer pathways, an increase of 1,833 (11.9%) from August. 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 18: percentage of pathways where the patient started their first definitive treatment within the target time, by month
Description of figure 18: 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, with a slight upward trend.
Source: Suspected Cancer Pathway, DHCW
In September, 58.8% of pathways started their first definitive treatment within 62 days of first being suspected of cancer. This was 3 percentage points lower 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.
A range of new ambulance performance metrics were introduced in July 2025. Health board figures are published on StatsWales. However, it is not possible to summarise these in the format of the key measures for the other topics as below.
In emergency departments, Aneurin Bevan had the best 4-hour performance (76.9%) and Betsi Cadwaladr had the worst (55.9%). Aneurin Bevan had the best 12-hour performance (7.0%) and Betsi Cadwaladr had the worst (19.0%).
Cardiff and Vale has the highest proportion of diagnostic breaches over 8 weeks (56.4%) and Aneurin Bevan has the lowest (9.5%).
For therapies, Hywel Dda has the highest proportion over 14 weeks (25.3%), while Swansea Bay and Cwm Taf Morgannwg have the lowest (less than 1%).
For cancer services, Cwm Taf Morgannwg had the highest proportion of patients starting treatment within 62 days (64.6%), and Betsi Cadwaladr the lowest (52.6%).
More detailed data is available on StatsWales: Health and Social Care.
Figure 19: local health board performance summary, September and October 2025 [Note 1]
Description of figure 19: 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 University 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 (UK Statistics Authority).
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
18 December 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.
