Referral to treatment (RTT) waiting list statistics: October 2025 (revised)

Due to data quality concerns, referral to treatment (RTT) data for Betsi Cadwaladr University Health Board (BCUHB) were temporarily suspended in November 2025. This followed concerns about anomalies in reported waiting list sizes and inconsistencies with operational activity levels. Following a review of BCUHB processes, revised and updated data are now available. In line with the Code of Practice for Statistics (UK Statistics Authority), which requires statistics to be published as soon as they are ready and revisions released promptly, updated figures for Wales and BCUHB are published here, ahead of the next scheduled NHS performance and activity update on 22 January 2026.

This report presents headline figures for Wales for October, provisional figures for November, and summarises the impact of the BCUHB data revisions on previously published statistics.

Full data are available on StatsWales.

An independent review of BCUHB’s data processes was conducted in December, involving NHS Wales Performance and Improvement, Digital Health and Care Wales, Welsh Government statisticians and a peer health board. The review examined data collection, quality assurance, and governance arrangements.

The review established that the underlying cause of the issue was a failure to report a specific cohort of patient pathways, primarily those that had been allocated to independent providers. The code that captured this group of patients had inadvertently not been included in the health board’s aggregate data submission. These pathways have now been identified and included in revised data for April to August 2025 and subsequent months’ data.

Weaknesses in local quality assurance and oversight were found to be contributory factors in the failure to detect the issue. These have been addressed by the health board in response to the review. More broadly, and aside from the known data issue, the health board has demonstrated compliance with mandated data standards on completeness and accuracy of RTT reporting. Together with confirmation that the missing pathways are now included, this provides the assurances necessary to reinstate full RTT reporting for Wales.

Final quality assurance by Welsh Government statisticians will assess coherence of official data with relevant operational information, helping to reduce the risk of similar issues arising in future.

The review focused on data for the current financial year. Further revisions to historic BCUHB data prior to April 2025 may be required, but any changes are expected to be smaller than those presented here.

We are reassured the BCUHB data issue does not impact other heath boards because the inconsistencies between reported data and operational information only applied in BCUHB and the coding process that led to the problem is specific to this health board.

Official statistics must meet the highest standards of trustworthiness, quality, and value. The actions taken have focused on restoring accurate and reliable reporting as quickly as possible to ensure these statistics meet user needs.

Analysis of the impact of the data revisions for Wales and BCUHB is provided below.

In October there were just over 781,200 referral to treatment (RTT) patient pathways waiting to start treatment, a decrease of around 9,200 from September. 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 599,800 individual patients on treatment waiting lists.

The proportion of pathways waiting less than 26 weeks increased to 58.1% in October. The number of pathways waiting longer than 36 weeks decreased to just under 241,200.

Just over 7,300 pathways were waiting more than two years, 89.6% lower than the peak but an increase of 655 (9.8%) from the previous month. The average time patients had been waiting for treatment at the end of October was 0.6 weeks shorter than the previous month at 19.9 weeks.

Provisional data for November indicate a decrease in total pathways waiting and those waiting more than two years.

There were just under 49,300 pathways waiting longer than one year for their first outpatient appointment in October, a decrease of around 10,400 (17.4%) from the previous month, and 52.0% less than the peak in August 2022. 

There were just under 138,900 pathways closed in October, an increase of around 9,800 from September and the highest figure on record.

Following the review of data processes at BCUHB, revisions have been applied to figures for BCUHB and Wales covering April to August 2025. For August 2025, total pathways waiting in Wales (795,400) have increased by around 4,800 compared to the original published figure (790,600). This includes an increase of 2,600 pathways waiting more than one year and 145 pathways waiting more than two years.

The scale of revisions reduces for earlier months because there was less independent provider activity. For example, for April 2025 there is an increase of 1,150 pathways in total, of which 194 were waiting more than one year and 25 were waiting more than two years. From August, funds were made available to health boards to ‘insource’ more consultations from independent providers.

Figure 1: Pathways waiting to start treatment, November 2020 to November 2025 [Note 1]

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Description of figure 1: a line chart showing a recent fall in pathways waiting. The number waiting longer than one year is changeable and two year waits have fallen over the last few years.

Source: Referral to treatment times, DHCW 

NHS waiting lists: referral to treatment: pathways waiting to start treatment, summary table, September 2011 onwards, on StatsWales

[Note 1]: Figures in the shaded area for the most recent month in this chart are provisional and are subject to change. The official data series ends in the previous month.

In October there were just over 781,200 patient pathways waiting to start treatment, a decrease from September (790,400). Just over 142,200 pathways were waiting more than one year in October, a fall of around 5,800 from the previous month. Just over 7,300 were waiting more than two years, 9.8% higher than September but nearly 90% lower than the peak in March 2022.

These official statistics are published with a lag of around seven weeks from the end of the reference period. However, given the interest in referral to treatment (RTT) waiting lists and the Welsh Government’s commitment to reducing the longest waits, there is public value in making data on this topic available earlier. We are therefore providing provisional estimates for the month ahead. 

Provisional data indicate there were around 757,900 total pathways waiting at the end of November, of which 133,700 were waiting more than one year and 6,900 were waiting more than two years. These provisional estimates are subject to change before the official figures for November are released on 22 January.

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 701,200 open pathways on consultant-led pathways in Wales, equivalent to 22 pathways for every 100 people. For England, the figure in October was 13 pathways for every 100 people. These comparisons are explored further in this Chief Statistician’s blog. 

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 599,800 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 in the NHS waiting lists: estimate of unique patients dataset on StatsWales.

Figure 2: percentage of patient pathways waiting less than 26 weeks, by month

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Description of figure 2: 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

NHS waiting lists: referral to treatment: pathways waiting to start treatment, summary table, September 2011 onwards, on StatsWales

Of the just over 781,200 patient pathways waiting to start treatment in October, 58.1% had been waiting less than 26 weeks. This was higher than September (56.9%).

Figure 3: patient pathways waiting more than 36 weeks, by month

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Description of figure 3: a line chart showing the number of pathways waiting more than 36 weeks has fluctuated in recent years.

Source: Referral to treatment times, DHCW

NHS waiting lists: referral to treatment: pathways waiting to start treatment, summary table, September 2011 onwards, on StatsWales

In October, just under 241,200 patient pathways had been waiting more than 36 weeks. This was around 8,600 lower than in the previous month and represents 30.9% of all pathways waiting to start treatment. 

The median time waiting to start treatment in October was 19.9 weeks, 0.6 weeks shorter than the previous month.

Figure 4: closed patient pathways, by month

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Description of figure 4: a line chart showing an upward trend in the number of patient pathways closed.

Source: Referral to treatment times, DHCW

NHS waiting lists: closed referral to treatment pathways, September 2011 onwards, on StatsWales

The number of patient pathways closed in October was just under 138,900, an average of 5,869 per working day and the highest figure on record. This was an increase of 169 patient pathways (or 2.9%) closed per working day from the previous month.

Following the review of Betsi Cadwaladr University Health Board (BCUHB) data processes, the health board has provided revised data from April to August 2025. The underlying cause of the issue was a failure to report a specific cohort of patient pathways, primarily those that had been allocated to independent providers. The impact of these revisions on important measures for Wales and BCUHB is presented below.

Description of figure 5: a table showing the original and revised published figures for Wales for total pathways waiting.

Source: Referral to treatment times, DHCW 

NHS waiting lists: referral to treatment: pathways waiting to start treatment, summary table, September 2011 onwards, on StatsWales

Description of figure 6: a table showing the original and revised published figures for Wales for pathways waiting one year.

Source: Referral to treatment times, DHCW 

NHS waiting lists: referral to treatment: pathways waiting to start treatment, summary table, September 2011 onwards, on StatsWales

Description of figure 7: a table showing the original and revised published figures for Wales for pathways waiting two years.

Source: Referral to treatment times, DHCW 

NHS waiting lists: referral to treatment: pathways waiting to start treatment, summary table, September 2011 onwards, on StatsWales

For August 2025, total pathways waiting in Wales have increased by around 4,784 (0.6%) compared to the original published figure. This includes around 2,560 pathways waiting more than one year (an increase of 1.6%) and 145 pathways waiting more than two years (an increase of 1.7%). The scale of revisions reduces for earlier months because there was less independent provider activity. For example, for April there is an increase of 1,148 pathways in total (0.1%), of which 194 were waiting more than one year and 25 were waiting more than two years. From August, funds were made available to health boards to ‘insource’ more consultations from independent providers.

Description of figure 8: a table showing the original and revised published figures for Betsi Cadwaladr University health board for total pathways waiting.

Source: Referral to treatment times, DHCW 

NHS waiting lists: referral to treatment: pathways waiting to start treatment, summary table, September 2011 onwards, on StatsWales

Description of figure 9: a table showing the original and revised published figures for Betsi Cadwaladr University health board for pathways waiting one year

Source: Referral to treatment times, DHCW 

NHS waiting lists: referral to treatment: pathways waiting to start treatment, summary table, September 2011 onwards, on StatsWales

Description of figure 10: a table showing the original and revised published figures for Betsi Cadwaladr University health board for pathways waiting two years

Source: Referral to treatment times, DHCW 

NHS waiting lists: referral to treatment: pathways waiting to start treatment, summary table, September 2011 onwards, on StatsWales

For BCUHB the revisions are greater than for Wales as a proportion of the original published figures. For August the revised figures increased by 2.4%, 4.9% and 2.7% for total pathways waiting, one year waits and two year waits respectively. The scale of revisions reduces for earlier months. For April 2025, the increases are 0.6%, 0.4% and 0.4% respectively for total pathways, one year waits and two year waits.

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 administrative data systems in use across the NHS in Wales. Data 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 to monitor their own performance.

Reliable statistics on the volume of activity undertaken in the NHS and the size of waiting lists 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.

We welcome any feedback on any aspect of these statistics which can be provided by email to stats.healthinfo@gov.wales.

Hospital Statistics
Email: stats.healthinfo@gov.wales

Media: 0300 025 8099

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