Surgery: Waiting Lists

Validation is a routine part of providers’ waiting list management which ensures patient records are accurate, that patients are on the best pathway to meet their needs, and that they still need their appointments.

Over 85% of removals from the Referral to Treatment (RTT) waiting list are a result of direct care provided to patients. This can include patients starting treatment, a period of active monitoring, a clinical decision not to treat, or a patient declining a treatment. These are known as completed pathways.

Unreported removals, namely removals from the list not reported as completed pathways, have accounted for approximately 15% of patients who come off the waiting list for decades and are lower now than before the pandemic. It is the record levels of elective activity being delivered by National Health Service staff that is now getting the waiting list down.

Unreported removals happen for various reasons. For example, when a patient did not attend their first appointment, instances where the provider cannot accept the referral because it does not carry out the relevant procedure, and where patients are removed from the waiting list through validation because they no longer need to be treated.

The Department does not hold data centrally on the number of patient pathways removed from the elective waiting list from data validation. Full data for completed pathways is available at the following link:

https://www.england.nhs.uk/statistics/statistical-work-areas/rtt-waiting-times/.

From April 2025 to March 2026, NHS England paid NHS integrated care boards £32,535,000 to distribute to providers for waiting list validation exercises. From September 2025 to March 2026 that figure was £22,150,000.