Surgery: Waiting Lists

Integrated care boards 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 Action Plans (IAPs) to help providers and commissioners plan demand, capacity, and expenditure. While not binding, if activity exceeds the agreed plan, and therefore the funding agreed, an Activity Management Plan (AMP) can be agreed to bring activity back in line.

The provision and use of IAPs and AMPs is designed to deliver the activity levels required to achieve the goal of at least 65% of patients waiting no longer than 18 weeks for treatment by March 2026 whilst also 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. AMPs allow commissioners and providers to work together to manage elective activity within agreed performance and financial targets, all whilst working towards improving patient waiting times overall.