The state of health care and adult social care in England 2025/26

Key points

• Urgent and emergency care services are under sustained pressure. In 2025/26, there were just under 27.9 million calls to NHS 111 or online completions, nearly 14 million 999 ambulance calls, and 28 million attendances to urgent and emergency care services – over 608,000 more attendances than in 2024/25.
• In line with the ambitions of the NHS 10-year plan, more people are using community-based initiatives such as Pharmacy First, hear and treat, as well as see and treat ambulance services. While there are some signs of improvement, urgent and emergency care services are continuing to struggle to meet national response standards in the face of high demand.
• In 2025/26, there was slight improvement in the number of people waiting 4 hours to be either admitted, transferred or discharged from type 1 emergency services, with 60.9% of attendances (10.4 million) seen in under 4 hours. There was also a marginal reduction in the number of people waiting more than 12 hours from arrival to being either admitted, transferred or discharged across type 1 and type 2 emergency services.
• But more people who need to be admitted to hospital are facing long waits. In 2025/26, 571,000 – more than 1,500 people a day on average – waited more than 12 hours from the decision to admit them to being admitted. Our urgent and emergency care inspections show how this is creating significant operational challenges for emergency departments, with some patients having to wait in departments or corridor escalation areas for prolonged periods.
• The average number of general and acute hospital beds available has remained broadly level in 2025/26, but has not kept pace with the size of the population. In 2025/26, the number of beds per 100,000 people decreased by 0.9% from 174 per 100,000 in 2024/25 to 172 per 100,000. This, together with challenges in the wider system and hospital processes, can affect patient flow through the hospital.
• There are still ongoing challenges and delays in discharging patients. In 2025/26, on average 13,000 people who were ready to be discharged on any given day remained in hospital, up from 12,700 in 2024/25. Data from NHS England shows how system pressures, including a lack of capacity or delays in onward care and treatment, are the most common reasons for delays for longer stay patients
• People are waiting a shorter time for elective care treatment. Over the last year, the average number of incomplete pathways for planned care has fallen from 7.5 million in 2024/25 to 7.3 million in 2025/26. Performance against the interim standard has also improved, with 61.7% of waits for care of 18 weeks or less on average in 2025/26 compared with 58.9% in 2024/25.
• More people are also receiving a diagnosis or having cancer ruled out within 28 days. However, we continue to be concerned that people are having to wait too long with a diagnosis of cancer before starting treatment. In 2025/26, 69.4% of people with an urgent referral started treatment within 62 days, below the target of 85%.
• We reiterate the need for a faster pace of improvement nationally in maternity services, particularly around the safety of services and the inequalities for groups of people with protected characteristics. Our analysis of the rates of maternal readmissions this year highlights variation in readmission within 6 weeks of birth, with the highest rates for women from Black groups.
• Despite signs of ongoing improvement, inequalities in recruitment, career progression and staff experience remain widespread across the NHS. In 2025, the proportion of staff from ethnic minority groups in senior roles remained over 17% lower than the overall workforce at 30.7%, with staff from White groups continuing to report better opportunities for career progression or promotion than staff from ethnic minority groups.