In July 2025, NHS England released an analysis of the NHS waiting list for the first time broken down by age, sex, ethnicity and deprivation levels as part of its Elective Care Reform Plan.

In brief, NHS England found:

• More than half of the overall waiting list is made up of people of working age (19 to 64).

• The largest specialty for those on the waiting list aged 18-64 is gynaecology. The largest specialty for those aged 65+ is ophthalmology.

• For pathways where sex is recorded, women make up a higher percentage of the waiting list compared to men. Women are more likely to be waiting over 18 and 52 weeks than men.

Gynaecology has held the largest number of patients on the waiting list for several years, with the problem worsening significantly since the Covid-19 pandemic.

Plan to help reduce waiting times

NHS England aim to reduce this backlog and improve outcomes through a number of different routes including:

• Ensuring care is delivered in the right place – a hospital outpatient appointment with a specialist is the typical route for elective care, but is not always the best approach in terms of resources.

• Empowering patients by giving them more choice and control – an increase in information in regard to treatment centre waiting times and ratings aim to enable the patient to make an informed choice in regard where their appointment will take place (whether that be remote or in person).

The impact on gynaecological patients

As a clinical negligence solicitor, I have seen how long waiting times can impact patients.

Those with gynaecological ‘red flag’ symptoms, including persistent abdominal or pelvic pain and abnormal bleeding, should be referred via a 2-week wait pathway as such symptoms may be indicative of cancer or other serious gynaecological conditions.

This means that patients experiencing ‘non-urgent’ gynaecological conditions, such as endometriosis or prolapse, may find themselves waiting much longer. This is concerning as these conditions can have a significant impact on day-to-day life. Endometriosis, for example, is often associated with pain, bleeding and fatigue, all of which can impact a patient’s mental health.

In addition, perimenopausal women may find that their symptoms of irregular bleeding and pelvic pain are dismissed as part of the aging process. Unfortunately, these symptoms are also, at times, indicative of something more serious.

Not only are those waiting to be seen by gynaecology experiencing prolonged pain and suffering, but they are also at risk of their condition progressing whilst waiting to be assessed by a specialist and undergo the appropriate investigations. By the time the patient is seen, they could find themselves facing more aggressive treatment or, in some cases, losing the chance to have any treatment at all. Sadly, this is something I see far too often.

Need for improvement

NHS England’s recent findings acknowledge the lived experience that some clients have described and is a step in the right direction for structural change which pushes for fair prioritisation. The overall waiting list has reduced by over 260,000 since July 2024. Although this is encouraging to see, it will take sustained effort and continued investment for health services to catch up with the needs of patients.