Waiting lists in 20 hospital trusts in England fell three times faster than the national average during the first year of the GIRFT Further Faster 20 programme.
The findings of a new internal FF20 evaluation show the trusts taking part in FF20 in the year from October 2024 to October 2025 saw a 4.2% reduction in waiting lists compared to 1.4% nationally. For working-age adults, waiting lists fell more than five times faster, helping to get people back into the workforce.
Launched by the Department of Health and Social Care, FF20 saw the GIRFT team working with 20 hospital trusts across England with the highest levels of economic inactivity, with the aim of reducing waiting lists. Trusts and their Integrated Care Systems (ICSs) were supported to go further and faster with their existing programmes, with regular meetings to share best practice and discuss challenges.
As well as opportunities for shared learning, trusts were able to test new models of delivery and partnerships, focusing on each trust’s challenges. For example, a project to implement and scale High Flow Theatre Lists (HFTL) across 12 of 20 trusts delivered 230 sessions and treated around 2,100 patients. This has subsequently led to the rapid expansion of super clinics for high-volume specialties (gynaecology, orthopaedics and general surgery), increasing short-term capacity.
Where required, GIRFT also offered hands on support from operational and clinical specialists.
The evaluation report concludes that the first year of FF20 demonstrated meaningful reductions in waiting lists, particularly for the working-age population, and substantial operational improvement across multiple trusts. GIRFT has since gone on to apply the FF methodology to reducing unnecessary outpatient follow-ups (FF-FU – working with 21 trusts to develop clear follow up protocols, with associated operational guidance and digitisation) and to urgent and emergency care (FF-UEC – providing hands-on on-site support to trusts from a multidisciplinary team of clinical and operational experts to implement GIRFT’s UEC guidance).
“We are very pleased to share this report, showing that the first year of FF20 has demonstrated meaningful reductions in waiting lists, particularly for the working-age population, and substantial operational improvement across multiple trusts. FF20 has delivered significant insights and progress within a short timeframe and remains a valuable model for targeted, data-driven, clinically led improvement, supported on the ground by highly skilled and effective teams in areas of highest need. The key elements of learning from this programme are now well embedded in the GIRFT support to trusts going forward, across both elective and urgent and emergency care.”
The findings of the FF20 report come as the government marks one year since the launch of the Elective Reform Plan, which set the NHS the target of ensuring 92% of patients wait no longer than 18 weeks for from referral to treatment by the end of the parliament. Since July 2024, the waiting list has reduced by more than 225,000 despite 28.4 million referrals.
“We said our Elective Reform Plan would get waiting lists down, and one year on that’s exactly what it’s delivering. Along with record investment, we’re doing things differently to get patients seen quicker, back to work and living their lives. It will be a long road, but together with NHS staff, we are fixing our health service and make it fit for the future and beyond.”
"NHS staff have been relentless in their efforts to bring waiting times down, and today’s figures show patients are starting to see the benefits – not only getting the care they need faster but also being supported back into the job market. The last year has seen the NHS take great strides to deliver more tests and scans closer to home, and cut unnecessary and time-consuming appointments and processes, so that people can get the surgery they need faster. The NHS will continue to deliver on the Elective Reform Plan and ensure people can get the treatment they need in a timely manner.”
“It is encouraging to see targeted support helping trusts run operating lists and outpatient clinics more efficiently. Long waits carry real human costs - prolonged pain, loss of independence, time away from work and disrupted lives. This initiative shows what’s possible with focused investment. Our surgical workforce census shows surgeons are ready to do more operations, and with the right theatres, staffing and bed capacity in place, the NHS can go further and faster in tackling waiting lists.”
“It’s great to see NHS trusts’ innovation and hard work to see patients quickly, cut waiting lists and boost productivity making such a huge contribution to the economy and growth. This is all the more impressive given the impact of record demand, resident doctor strikes and a relentless focus on delivering a financial ‘break even’ position for the NHS as a whole.”
