Health Services: Waiting Lists

Integrated care boards (ICBs) have existing contractual powers to manage activity by providers, which were enhanced in 2025/26 with central support for setting and managing activity. The NHS Standard Contract includes the ability to set indicative activity plans (IAPs) to help providers and commissioners plan demand, capacity and expenditure. Activity management plans (AMPs) allow commissioners and providers to work together to manage elective activity within agreed performance and financial targets.

The setting of IAPs and AMPs must be appropriate, and the designated process needs to be followed. Commissioners’ use of IAPs and AMPs support systems to live within their means and deploy better financial discipline than previous years where systems have overspent.

The provision and use of IAPs and AMPs is designed to deliver the demand and activity levels modelled to achieve the goal of at least 65% of patients waiting no longer than 18 weeks for treatment by March 2026 whilst living within financial budgets set for 2025/26.

Any planning assumptions based on waiting times need to support commissioners’ overall duties to the populations they serve and our waiting time targets, including our commitment to return to the 18-week standard. NHS England have worked with commissioners to ensure services are not planned on the basis of waiting times above this standard.

While IAPs and AMPs are implemented to ensure this financial balance, all providers are expected to have their own safeguards to ensure that patients waiting for planned care are triaged, and that appointments take place according to clinical priority and the length of time patients have waited, avoiding risk of serious complications.