Half of NHS waiting list patients in England have never had a single appointment or test since referral

Nearly three million people in England are languishing on NHS waiting lists without having received so much as a first appointment or diagnostic test, newly revealed figures show.

Of the 6.23 million people awaiting treatment, a staggering 2.99 million — almost half — have seen no further action at all since their GP referred them. The scale of this neglect has prompted health leaders to describe it as an “invisible waiting list crisis,” where patients are left in limbo, conditions worsening while no care arrives.

The previously unpublished data was obtained and analysed by MBI Health, a data consultancy that supports dozens of NHS trusts. It lays bare a vast shortfall in care that is now threatening the credibility of Prime Minister Keir Starmer’s flagship NHS pledge: that by 2029, 92% of patients will begin treatment within 18 weeks of referral.

As of May, only 61% were treated within that target window — and this new data suggests the situation is even more dire than official figures have so far indicated.

Rachel Power, chief executive of the Patients Association, called the revelation “staggering.”
“If accurate, 3 million people are trapped in an invisible waiting list crisis, stuck without basic diagnostic tests or first appointments while their conditions worsen,” she said. “That’s not a healthcare service; that’s a breakdown.”

One-third of those 3 million unseen patients — over one million people — have already been waiting more than 18 weeks. Their care is not simply delayed. It hasn’t even begun.

MBI founder Barry Mulholland, a former NHS manager, warned that the system cannot be fixed unless the issue of “unseen patients” is urgently addressed.
“The government talks about backlogs, but this is actually a frontlog,” he said. “These patients are trapped at the starting gate, never having received their first clinical contact. Unless that’s dealt with, we’ll never meet the 18-week target.”

According to MBI, specialities worst affected include ear, nose and throat care, orthopaedics, eye care, gastroenterology, and gynaecology — all with 67–75% of their waiting lists comprising unseen patients.

NHS England confirmed the data, stating that of the 7.3 million treatments patients are waiting for, 4.7 million — nearly two-thirds — belong to those yet to have a consultation or diagnostic procedure. And 1.6 million of them have waited beyond the 18-week maximum.

Liberal Democrat health spokesperson Alison Bennett called the figures “harrowing.”
“Behind every number is a person in pain, anxious about their health, waiting for care that may never come,” she said. “This is the result of years of mismanagement under the Conservatives. Millions of people are stuck in limbo.”

Despite the damning data, the Department of Health and Social Care declined to comment on the specific issue of the 3 million unseen patients. A spokesperson simply noted:
“Thanks to this government’s record investment, reforms and the hard work of NHS staff, we’ve cut the waiting list by over 260,000 since July 2024. This also fell for the first time in 17 years in April and May outside the pandemic.”

Yet critics argue these reductions are misleading if nearly half of all patients have received no contact whatsoever.

Mulholland added, “We must refocus efforts on ensuring that patients entering the system are seen swiftly. Without early clinical contact and accurate data, we’ll never turn the tide.”