Healthcare delivery
PAC report criticises NHS recovery plans
Billions have been spent to tackle NHS waiting lists, but recovery targets continue to be missed, the Public Accounts Committee (PAC) has found. In a new report, MPs likened Government plans for NHS reform to “poor practices seen on HS2”.
In a new report on reducing NHS waiting times for planned (or elective) care, the Public Accounts Committee (PAC) has found that despite NHS England (NHSE) spending £3.24bn on transforming diagnostic and surgical services, it has now missed its recovery targets by significant margins, with too many people still waiting too long for tests and treatment. At January 2025, over 6 million people were waiting for elective care, and progress in reducing waiting times appears to have stalled: l Nearly 192k patients were waiting over a year for care by July 2025 – a length of wait which should have been eliminated by March.
l For diagnostic tests, 22% of patients were on a waiting list for more than six weeks - against a target of 5% by March 2025, and an operational standard of 1%.
l When it comes to treatment, only 59% of patients were treated within the statutory standard of 18 weeks, against a target of 92%.
l Plans to reduce follow-up outpatient appointments by 25% (compared to ’19-’20) by March ’23 saw NHSE achieve only 0.1% fewer appointments between June ’22 and July ’23.
The PAC’s report states that these failures were driven in part by NHSE’s and the government’s flawed approach to improving its own services. Billions of pounds in spending were approved by government without sufficient focus on what exactly its funding would deliver and without any focus on outcomes for patients. Diagnostic transformation received £2.2bn, and £1.04bn went to surgical transformation, at a time of scarcity for capital funding. A shortfall of 3.6m tests led to the missed diagnostics target; for new surgical hubs, only the number of newly delivered hubs was tracked, with NHSE
unable to say what contribution they actually made to total elective activity. Plans to free up more outpatient appointments could have made the most difference as the vast majority (80%) of elective care pathways end through an outpatients appointment; but NHSE had no credible plan to achieve this, failing to secure meaningful engagement from clinicians to do so. The report recommends NHSE and
government should focus reporting on patient outcomes to ensure that funding delivers its intended outcomes, set out plans to reach the 1% operational standard for six week waits for diagnostic tests, and learn the lessons from the failure of the outpatients programme. The PAC said that it is further concerned that major reforms announced by the Department
Structural changes are being made to the healthcare system without secured funding in place to pay for the changes, or impact assessments carried out.
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www.clinicalservicesjournal.com I January 2026
for Health and Social Care (DHSC) and NHSE are replicating poor practices seen on the HS2 and New Hospital Programmes, and will lead to wasted effort. Structural changes are being made to the healthcare system without secured funding in place to pay for the changes, or impact assessments carried out. The PAC is warning these changes, especially the planned cuts to local health boards, could have a significant negative impact on patients and on the workforce through the level of uncertainty they create. The report seeks confirmation from DHSC that it will not announce unfunded commitments, and set out the likely costs of planned redundancies and the absorption of NHSE into DHSC. The PAC added that it is not confident that DHSC is being realistic about the immense effort needed to bring down waiting times, with digital solutions risking being treated as a ‘cure-all’. Digital integration is a key weakness for the NHS, and the report seeks DHSC and NHSE’s plans to address legacy IT. The PAC remains sceptical that digital change can
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