NHS Activity Tracker: December 2025

On the second Thursday of the month, NHS England publish data relating to demand, activity, waiting times and national performance against constitutional standards and recovery targets across the secondary care sector. Each month, we'll take a more detailed look at national and trust level data across the acute, ambulance, community and mental health sectors. Over the winter months, we also take a detailed look at winter pressures in our Winter section. 

December’s data highlights record demand across urgent and emergency care, planned care, diagnostics, and mental health services. Trusts continue delivering activity at unprecedented levels, yet demand outpaces capacity, contributing to longer waits and missed targets across the system. Winter pressures are intensifying, with record flu bed occupancy, high bed occupancy, and persistent discharge delays, despite improvements in ambulance handover times. Maintaining patient flow and timely, high-quality care remains a critical challenge as the system heads deeper into winter. 

 

Key points 

• A&E: There were 2.35 million A&E attendances this month, the highest November figure on record. Overall performance against the 4-hour target improved from last year to 74.2% but was much lower for type one and two departments. 12-hour waits for admission rose are 11% higher than last year, underscoring current capacity concerns.  
• Ambulance: There were 802,530 ambulance incidents in November 2025, the third highest figure on record. Response times for both category 1 and category 2 were faster than last year but fell short of their respective targets.  
• Winter: Data from the winter sitrep up to the first week of December highlighted record levels of flu and growing pressure from other illnesses such as D&V, RSV and Covid are having a large impact on performance. Figures for urgent and emergency care suggest A&E capacity remains stretched and although ambulance performance is stronger than last year, there is still progress to be made on 45 minute waits. Bed occupancy remains high, with bed days lost to delayed discharges so far this winter even higher than last.  
• Cancer: October saw the second highest monthly activity on record across the 28-day faster diagnosis standard, 62-day pathway, and the 31-day pathway. Performance against standards dipped on the 28-day pathway and remained broadly stable on the 31-day and 62-day pathways.   
• Diagnostics: 2.62 million diagnostic tests were carried out this month, the highest figure on record. However, demand for diagnostics continues to outpace activity, with the diagnostic waiting list also rising to a record high 1.79m.  
• Elective waiting list: The size of the waiting list rose by 6,000 cases to 7.4 million in October, 145,900 fewer cases than last year. Planned care activity was the highest on record (1.68 million) but continues to be outpaced by new demand for services (1.93 million cases added to the list).  
• Community: The total reported community services waiting list was 1.15 million in October - 8% higher than the same time last year.1 in 4 children and young people wait over 52 weeks for community services, but this number has fallen slightly in recent months. 
• Mental health: Overall demand for services, represented by the number of open referrals, was the second highest on record at 2.35 million. Of these, 503,630 were new referrals, a record high. The number of people in contact with mental health services reached the highest level on record (2.17 million).