Independent providers delivered 6.15 million NHS‑funded appointments, tests and operations between September 2024 and August 2025, almost 500,000 more than the previous year. According to the Department of Health and Social Care (DHSC), activity averaged around 19,000 surgical procedures and 100,000 outpatient appointments each week, helping to treat more than 1.1 million people, with all care free at the point of use.
Ministers link this contracted capacity to progress on referral‑to‑treatment (RTT) waits. DHSC reports the overall list has fallen by 206,000 year on year. Official August 2025 figures show 7.41 million open RTT pathways, with about 61% of patients within 18 weeks at that point.
NHS England’s Elective Reform Plan sets a clear trajectory: reach 65% within 18 weeks by March 2026 and restore the 92% constitutional standard by March 2029. Performance remains below these waypoints, which is why national policy now emphasises using all available capacity, including NHS‑contracted independent providers.
Sector data indicate the independent sector now carries roughly a tenth of all NHS elective activity and close to one in five operations, with the greatest volumes in orthopaedics and ophthalmology. That scale is a material component of throughput as systems work back towards the 18‑week standard.
Operational reforms are intended to stretch capacity further. DHSC says a national programme of monthly weekend High‑Intensity Theatre lists is being introduced across 50 hospitals, with trusts reporting that standardised case selection and dual‑theatre set‑ups support many more procedures in a day than typical weekday lists.
Diagnostics expansion is proceeding in parallel. Community Diagnostic Centres are moving to 12‑hour days, seven days a week, and DHSC cites more than 8.7 million tests delivered since July 2024. The department also points to new and expanded surgical hubs coming online through 2025.
Digital capacity is expected to shoulder part of elective demand. NHS England’s ‘NHS Online’ service-an online hospital accessed via the NHS App-is planned to begin from 2027 and deliver up to 8.5 million appointments and assessments in its first three years. Separately, the government reported in April that 87% of hospitals now offer services via the NHS App, contributing to 1.5 million avoided missed appointments.
Patient choice is central to delivery. Research from the Independent Healthcare Providers Network with the Patients Association and Arthritis UK indicates patients typically need to travel just under 13 miles-around 30 minutes by car-to cut waits by more than two and a half months, with larger gains for some procedures in the South East. DHSC is encouraging patients to consider switching to nearby providers with shorter queues.
For commissioners and integrated care boards, the near‑term tasks are practical: configure the NHS e‑Referral Service so independent options surface at booking; publish reliable wait times into the NHS App; and align pre‑assessment, imaging and follow‑up so patients can move between providers without delay. NHS England’s plan also scales ‘advice and guidance’ to keep avoidable referrals off lists, with management data indicating more than one million patients were diverted between July 2024 and March 2025.
Risks remain material. August data show the interim 65% RTT goal is still some distance away, while the Royal College of Surgeons highlights theatre time, estates and staffing as binding constraints. Independent analysis by the Institute for Fiscal Studies also questions whether restoring 92% by 2029 is achievable without faster growth in planned care than in recent years.
Policy intent is unchanged: a mixed‑economy model in which independent providers are contracted at NHS prices and treatment remains free at the point of use. Whether today’s figures translate into shorter waits will depend on execution at system level-consistent information on choice, help with travel where needed, and dependable data on provider waits over winter and beyond.