NHS under pressure - Wales

This page is an overview of the main pressure points in the NHS Wales.

 

NHS pressures waiting list

We also have analysis for NHS pressures in England, Scotland, and Northern Ireland. Note that available data is not always comparable across all nations.

 

NHS backlog

Waiting lists remain high

Waiting lists were already high before the pandemic but grew substantially after March 2020 and have still not recovered. In May 2025, there were more than 796,000 people waiting for NHS treatment in Wales. 
People are also waiting for longer: in the same month, the number of people waiting over 36 weeks for treatment was 22.2 times higher than it was pre-pandemic in May 2019. 

It used to be unheard of that a patient might wait over 2 years from referral to hospital for treatment or consultation, but this is now a regular occurrence.  

 

Cancer targets are not being met

The percentage of patients starting treatment within 62 days after first suspicion of cancer has been worsening over the past 3 years and stood at 61.3% in May 2025. Whilst this had been shown signs of improving over the past 2 years, but has consistently been below the 75% compliance target since records began in June 2019 – and even further below the 80% target set for 2026 in the Planned Care Recovery Plan

 

A&E attendances and waiting times

Waiting times at A&E are generally rising, with fewer people being seen within 4 hours and more people waiting over 12 hours.

The target for 95% of attendances to be seen in under 4 hours has never been met. In June 2015, 84.96% of people waited under 4 hours, whereas in June 2025 this figure was 66.3%. Over the same time, the proportion of people waiting over 12 hours increased from 1.91% to 10.5%. 

The mean time spent in an ED has increased by 89.9% over the last decade, to 5.28 hours in June 2025. Over the same time, the mean time spent in an ED has increased by 29.7%, to 2.75 hours in June 2025. This suggests the increasing average waiting time is caused by a smaller number of people waiting for a very long time. 

 

 

Diagnostics

Diagnostic waiting lists have been growing since before the pandemic and have increased ever more sharply since. In May 2025, there were 117,006 patients waiting for a diagnostic test.  

 

Waiting times for diagnostic tests also shot up dramatically after the start of the pandemic and remain high to the present. Median waiting time for a diagnostic service in May 2025 was 5.2 weeks, remain well-above pre-pandemic levels of 2.7 weeks in May 2019. 

 

 

Workforce

The secondary care workforce is growing, but so is the population

The secondary workforce in Wales has grown steadily over the past few years, both in terms of headcount and FTE (full-time equivalent). In March 2025, NHS Wales employed the full-time equivalent of 8,432.1 medical and dental staff. 

At the same time, however, the population of Wales is growing and ageing, resulting in a growing burden of disease. The ONS estimates that, between 2001 and 2021, the proportion of Wales residents over 75 increased from 8% to 10%. It expects this figure to increase to 15% by 2024.

Since older people tend to have higher needs for healthcare, doctors’ workload continues to rise due to an increasingly elderly population and an increasing prevalence of chronic diseases, such as type 2 diabetes. A growing secondary care workforce, therefore, does not mean demand is met.

 

Wales has fewer secondary care doctors per 1000 people than the OECD average

Compared to other OECD nations, the number of (headcount) secondary care doctors in Wales is below average: there are around 2.5 secondary care doctors per 1000 people in Wales, compared to the OECD average of 2.7 (most recent data from 2022). To meet this average, Wales would need an additional 647 secondary care doctors.

 

Vacancies remain high across NHS Wales medical and dental staff. There are currently 485 FTE vacant posts in Wales, nearly 10% of all medical and dental posts (excluding all trainees and GPs). 

 

 

Pressures in General Practice

The number of fully qualified, permanent GPs has seen little growth since 2016, with 2166 headcount or 1490.3 full-time equivalent GPs in March 2025. 

 

At the same time, the population continues to grow and age. This means that the workload of GPs continues to increase, and individual GPs are responsible for ever more patients. In March 2025, a fully qualified FTE GP was responsible for an average of 2, 239 patients. In 2013, this figure was 1719, representing an increase 30% in the number of patients per full time GP. 

 

More patients per GP means a significant workload increase for each individual practitioner, as appointments and referrals are consistently high. 

 

 

Wales also has fewer individual GPs per 1000 people than comparable nations. In 2022, there were 0.87 GPs per 1000 people in Wales, compared to an OECD average of 1.08. This means that Wales would need around 663 additional GPs to meet the OECD average.