NHS Activity Tracker: November 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. 

This month’s data release highlights record demand across the system including urgent and emergency care, planned care and mental health services and community services.

Trusts continue to deliver activity at an unprecedented rate, but it cannot keep pace, leading to longer waits and subdued performance against certain key targets. As we head into winter, concerns around patient flow remain and the challenge to maintain timely, high-quality care will be amplified across the system. 

Key points 

• A&E: There were 2.4 million A&E attendances this month, the highest October figure on record, performance against the 4-hour target improved from last year to 74%. 12-hour waits for admission rose by 21% since last month, underscoring current capacity concerns as we move into winter.  
• Ambulance: There were 806,440 ambulance incidents in October 2025, the 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. 
• Cancer: September saw the second highest monthly activity on record across the 28-day faster diagnosis standard, 62-day pathway, and the 31-day pathway. Despite this high activity, performance dipped on the 28-day pathway and remained broadly stable on the 31-day and 62-day pathways. 
• Diagnostics: 2.52 million diagnostic tests were carried out this month, the highest September figure on record. The waiting list rose to the third highest figure on record (1.72 million), up by nearly 130,000 since last year. 
• Elective waiting list: The size of the waiting list decreased slightly (by 16,000 cases) to 7.39 million in September. Planned care activity was the highest for any September (1.62 million) but continues to be outpaced by new demand for services (1.85 million cases added to the list).  
• Community: The total reported community services waiting list in England fell slightly for the second month running (by 26,300) to 1.15 million in September but remains 5% 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 third highest on record (2.34 million referrals). Of these, adult referrals were the highest ever recorded (1.8 million). Activity, measured by care contacts attended, was 10% higher than last year.