NHS Activity Tracker: January 2026

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. 

January’s data shows positive steps, particularly in the elective care waiting list. However, high levels of demand are still evident, with 846,263 ambulance incidents in December 2025, the highest December on record, and 2.26 million open referrals for mental health services, the highest November on record. Winter pressures are continuing, with high bed occupancy, concerning increases in virus levels and persistent discharge delays. 

Please note that these are national averages and there is considerable regional variation in these metrics. 

Key points

• A&E: There were 2.33 million A&E attendances this month. Overall performance against the 4-hour target was 73.8% but was much lower for type one and two departments (60.3%). 12-hour waits between decision to admit and admission are 6.3% lower than last year, but capacity concerns remain.
  
  
• Ambulance: There were 846,263 ambulance incidents in December 2025, the highest December 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 January shows high of flu and growing pressure from other illnesses such as D&V, RSV and Covid-19 are having a large impact on performance. Bed occupancy remains high, exceeding both NICE and NHS planning guidance targets, although it is slightly lower than last year. Patient flow remains a challenge: more patients have arrived at hospital by ambulance so far this year than last year, and there are significant discharge delays. 
  
  
• Cancer: Performance against standards dipped on the 28-day pathway compared with last year, but improved slightly on the 31-day and 62-day pathways.
  
  
• Diagnostics: 2.45 million diagnostic tests were carried out this month. The diagnostic waiting list reached 1.76 million, which is 66% higher than in November 2019. 
  
  
• Elective waiting list: The size of the waiting list decreased by more than 86,500 cases to 7.31 million in November. This is far lower than the 7.48 million in November 2024. 1.54 million cases were managed on the waiting list this month, but 1.71 million new cases were added and thus demand continues to outpace activity. 
  
  
• Community: The total reported community services waiting list fell to 1.12 million in November, but remains 6.5% higher than the same time last year. One1 in four4 children and young people wait over 52 weeks for community services, and 9.0% wait over 104 weeks. 
  
  
• Mental health: Overall demand for services, represented by the number of open referrals, was the highest November on record at 2.26 million. Of these, 461,625 were new referrals. 2.09 million people were contact with mental health services in November.