For someone waiting for a hip alternative, the NHS waiting list isn’t an abstract policy issue. It’s the difference between walking to the shops or staying indoors, sleeping through the night or waking up in pain, returning to work or putting life on hold.
Across Wales, there are signs that some long-awaited developments are finally beginning to move in the proper direction. More and more individuals are getting through the system for planned operations, tests and appointments. But that is only a part of the story. Parts of the NHS depend on people once they are scared, terminally ailing, or under severe stress while waiting for cancer treatment.
The recent election in Wales makes it a crucial moment to take stock of the NHS: what’s improving, what’s still struggling and what it means for patients. The latest official figures cover March and April 2026, when the previous government’s targets were still in place.
The latest Plaid Cymru Welsh Government has said it’s going to proceed to report against these targets until they’re modified or revised. Mabon ap Gwynfor, recently appointed Minister for Health and Care, inherits a service that’s recovering and still under real pressure.
The most blatant excellent news is in planned maintenance. In March, just 666,700 were waiting for appointments, tests or treatment. That was a decrease of about 21,300 from February and the tenth consecutive month of declines. These data don’t represent individual patients. An individual may wait for multiple appointment, test or treatment. Administrative information showed that roughly 529,100 people were on treatment waiting lists.
The longest wait can be over. Just under 2,600 treatments were waiting greater than two years, down 96.3% from the March 2022 peak. The proportion of those waiting lower than 26 weeks rose to 65.9%, the most effective figure since May 2020. The number of individuals waiting greater than 36 weeks fell to only 166,800, the bottom level for a media week since August 2050. Lowest since April 2020.
These improvements must be recognized as necessary to broader public health. For patients, planned care rehabilitation can mean less time spent in pain, less uncertainty, fewer canceled plans, and a greater likelihood to remain at work or look after family.
Why emergency care still feels broken.
Urgent care is where many individuals resolve whether the system is absolutely coping. This is the a part of the NHS that folks face in moments of fear: chest pains, a fall, difficulty respiratory, a serious infection or the sudden deterioration of an elderly relative.
In April, emergency department attendances in Wales were recorded at slightly below 95,100, a mean of three,168 per day. Only 66% of patients were admitted, transferred or discharged inside 4 hours, in comparison with a goal of 95%. More than 10,000 patients waited 12 hours or more.
The reasons should not the one ones that many individuals are going to the accident and emergency department (A&E). Emergency departments rely upon extensive hospital and out-of-hospital social care. Patients cannot leave A&E if wards are full. If ambulances cannot deliver patients, they can not get back on the road. If people who find themselves clinically well enough to go away the hospital can’t be safely discharged, beds remain occupied.
In April, slightly below 1,300 delayed discharges occurred on the day the info were collected. Together they calculated about 57,500 delayed days for adults who were ready to go away the hospital but couldn’t.
This explains why the general public can hear that waiting lists are improving and still feel that the NHS is stuck. A hip operation may finally be scheduled, while an elderly parent waits all day within the emergency department because there aren’t any beds or care packages available.
Matthew Horwood / Tragedy
Cancer care shows the stakes most clearly. The Welsh goal is for at the very least 75% of patients to start out their first definitive treatment inside 62 days of referral for an urgent suspicion of cancer. In March, performance improved, but only to 60.2 percent. Delay is vital because cancer is unusually sensitive. Later diagnosis and treatment means more advanced disease, more complex treatment and poorer outcomes.
Mental health services show one other type of stress. In March 2026, local support services received 7,568 referrals. Across all ages, 84.9% of diagnoses were accomplished inside 28 days and 92.7% of treatment was initiated inside 28 days of diagnosis. Secondary mental health services were supporting 17,498 patients at the tip of March.
These figures show that improvements in headline waiting lists, although significant, don’t tell the entire story. Demand is increasing in various parts of the system, and the pressure isn’t limited to planned operations.
Manpower
The NHS in Wales has more staff than ever. At the tip of 2025, 100,224 full-time equivalent staff were directly employed by NHS Wales, a 1.6% year-on-year increase and a 25.8% increase on 2018. But more staff doesn’t routinely mean enough capability.
The same release recorded 5,652 vacancies and a mean sickness absence rate of 6.4% in 2025. Anxiety, stress, depression and other mental illnesses accounted for 34.9% of sickness absence.
It refers to people working under constant pressure. Recruitment is vital, but so are retention, morale and dealing conditions. Recovery shall be difficult if the caregivers themselves are exhausted.
Then there may be the financial reality. Audit Wales reported that every one seven Welsh health boards breached their statutory duty again within the three years from 2024 and 2025. Money alone won’t solve every problem. But improving access, redesigning support staff and services is difficult when every health board is financially strapped.
The Welsh NHS is moving, but unevenly. It won’t be a test for people to see if a graph is healthier. It shall be if all the journey through care starts to feel safer, faster and more humane.