NHS Activity Tracker: October 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 the ongoing strain on capacity across the system: progress on waiting lists falter as demand for services continues to outpace activity being delivered, even if at record levels in some areas. As we head into winter, the current challenge to maintain timely, high-quality care will be amplified across the system.

Key points

• A&E: attendances were highest on record for any September at 2.31 million. Performance improved from last year to 75%. 12-hour waits rose by 25% since last month, underscoring current capacity concerns as we move into winter. 
• Ambulance: response times for both category 1 and category 2 fell short of their respective targets and were the slowest since February 2025. However, each response time was faster than last year.
• Cancer: for August, performance across the 28-day faster diagnosis standard and the 62-day standard was slightly weaker than last year. However, across the summer months (June, July, August) cancer activity and performance across all pathways reached record summer levels.
• Diagnostics: 2.37 million diagnostic tests were carried out in the latest month, the highest August figure on record. This contributed to the highest diagnostic activity for any summer period on record. Despite this, the diagnostic waiting list remains 6% higher than last year.
• Elective waiting list: the size of the waiting list increased slightly for the third month in a row to 7.41 million cases in August. The number of cases waiting more than 52 weeks for treatment continue to fall, but further progress will be needed for them to account for 1% of all waits as set out in planning guidance. 
• Community: the community health services waiting list fell slightly to 1.18 million in August 2025 but remains 7.1% higher than last year. Long waits of over 52 weeks for CYP fell for the first time in two and a half years (February 2023) but continue to account for 25% of all CYP waits. Highest number of referrals to community services on record in July (1.89m in July).
• Mental health: new referrals to services fell from last month’s peak but are still elevated compared to other August periods. Overall demand for services, represented by the number of open referrals, is also high for August (2.16 million open referrals). CYP open referrals are up 8.3% compared to last year.

Case study

Extending access and transforming MRI delivery through remote scanning

In response to growing demand and increasing MRI backlogs, a pioneering Very Extended Scanning Pilot (VESP) was launched by Imperial College Healthcare NHS Trust at a Community Diagnostic Centre (CDC) in Wembley to extend MRI services beyond conventional hours.

By introducing late-night appointments between 8pm and midnight, supported by remote scanning technology, the project has delivered faster access, improved patient experience, and established a more flexible, sustainable workforce model.

Addressing diagnostic backlogs and workforce pressures

Before the pilot, scanner use was limited to standard working hours due to workforce constraints, leaving valuable equipment idle outside core hours. The VESP model introduced an additional four hours of scanning per day, five days per week. This initiative directly addressed local diagnostic pressures while helping realise greater potential for the newly established CDC.

The project used secure remote scanning technology to enable experienced MRI radiographers to operate scanners from home or off-site locations. This approach increased flexibility, expanded the pool of staff willing to support out-of-hours services, and allowed senior radiographers to oversee two scanners simultaneously.

This model not only improved productivity but also supported the upskilling of junior radiographers, who delivered patient-facing care under remote clinical supervision.

Collaborative and safe implementation

Radiographers, radiologists, operational managers, and IT teams were involved from the outset of the project through workshops and planning forums. Together, they co-developed workflows, safety protocols, training programmes and digital safeguards to ensure clinical safety, data security, and staff wellbeing.

The service was delivered in partnership with a specialist imaging technology supplier, who provided secure connectivity, configuration, and continuous technical support.

Extensive impact assessments confirmed the model’s robustness, with no patient safety incidents reported throughout the pilot. Staff surveys demonstrated high levels of confidence in maintaining patient safety, validating the model’s safety and acceptability.

Outcomes for patients and staff

During a six-month period, 1,350 patients were scanned using the late-night model, with scanner utilisation averaging 86%. The Did Not Attend (DNA) rate was only 1.1%, compared to 7.4% during standard hours, reflecting greater patient convenience and engagement. 90% of patients received their MRI scan within three weeks of referral, accelerating diagnosis and clinical decision-making.

Patients expressed strong satisfaction, with 80% stating they would choose an evening appointment again. Many cited the convenience of late-night slots, particularly those balancing work or caregiving responsibilities. Analysis also showed that patients using the service came from more deprived areas (average IMD 4.51 vs 5.07 in standard hours), demonstrating progress in tackling health inequalities in the area.

Staff feedback has been equally positive. Radiographers valued the opportunity for remote and flexible working, reduced travel, and enhanced career development through mentoring and supervisory roles. On-site staff appreciated the upskilling opportunities and closer collaboration with senior colleagues, leading to the creation of a stronger, future-ready workforce.

Future impact

Looking ahead, the model’s scalability is being explored across a range of clinical contexts, including complex MRI. The Trust is now transitioning the late-night remote MRI service from pilot to business-as-usual, recognising its tangible impact on access, efficiency, and staff experience.

The Very Extended Scanning Pilot has demonstrated that remote MRI technology can safely and effectively transform service delivery, expanding access, improving equity, and strengthening workforce resilience. It stands as a replicable model for innovation across the NHS, proving that by embracing digital solutions, the health service can deliver faster, fairer, and more sustainable diagnostics for all.

“The Very Extended Scanning Pilot has shown how digital innovation can reshape the way we deliver diagnostics. By extending access and enabling flexible, remote working, we’ve improved patient experience, reduced waiting times, and created a more sustainable workforce model.

"This project embodies our commitment to using technology not just to increase capacity, but to deliver care that’s more equitable, responsive, and ready for the future.” - Dr Amrish Mehta, Consultant radiologist and director of women’s, cardiac, clinical support and sexual health services

“VESP has been a real team effort, bringing together radiographers, operational leads, and IT colleagues to make out-of-hours MRI scanning both safe and effective.

"The flexibility of remote scanning has empowered staff, supported professional development, and helped us deliver a service that better fits around our patients’ lives. It’s been inspiring to see what’s possible when we work collaboratively and think differently.” - David Tao, Clinical Services Manager