At four NHS trusts serving central London, 206 open trauma and orthopaedic pathways had been waiting more than a year at the end of September 2026. That was up from 186 in August and down from 315 a year earlier. The combined waiting list reached 17,303 open pathways, up 69 from August and 1,198 from September 2025.
Three of the four trusts were above England on the 18-week measure
Across the four trusts, 63.3% of open pathways had been waiting 18 weeks or less, compared with 61.4% across England. University College London Hospitals (UCLH) had the highest share among the four at 76.9%, followed by Imperial College Healthcare at 63.1% and Guy’s and St Thomas’ at 61.9%. Chelsea and Westminster Hospital was at 56.3%.
The combined list grew 0.4% from August and 7.4% year on year. England’s list fell 1.6% over the month and 3.6% over the year. In September, 1.2% of open pathways across the four trusts had been waiting more than a year, compared with 2.4% across England.
How the longest waits changed at each trust
- Chelsea and Westminster Hospital recorded 159 pathways waiting more than a year, up from 153 in August and down from 180 a year earlier. It accounted for 159 of the 206 across the four trusts.
- Imperial College Healthcare recorded one pathway waiting more than a year, down from two in August and 79 in September 2025. Its total list was 353 pathways larger than a year earlier.
- Guy’s and St Thomas’ recorded 43 pathways waiting more than a year, up from 30 in August and down from 49 a year earlier.
- UCLH recorded three pathways waiting more than a year, up from one in August and down from seven a year earlier.
Monthly, annual and England comparisons
| Trust or area | Month | Open pathways | Within 18 weeks | Over 52 weeks |
|---|---|---|---|---|
| University College London Hospitals | September 2026 | 3,423 | 76.9% | 3 |
| University College London Hospitals | August 2026 | 3,434 | 73.7% | 1 |
| University College London Hospitals | September 2025 | 3,464 | 72.3% | 7 |
| Imperial College Healthcare | September 2026 | 3,253 | 63.1% | 1 |
| Imperial College Healthcare | August 2026 | 3,213 | 64.5% | 2 |
| Imperial College Healthcare | September 2025 | 2,900 | 52.1% | 79 |
| Guy’s and St Thomas’ | September 2026 | 5,057 | 61.9% | 43 |
| Guy’s and St Thomas’ | August 2026 | 5,131 | 61.4% | 30 |
| Guy’s and St Thomas’ | September 2025 | 4,352 | 66.5% | 49 |
| Chelsea and Westminster Hospital | September 2026 | 5,570 | 56.3% | 159 |
| Chelsea and Westminster Hospital | August 2026 | 5,456 | 55.7% | 153 |
| Chelsea and Westminster Hospital | September 2025 | 5,389 | 50.7% | 180 |
| Four trusts combined | September 2026 | 17,303 | 63.3% | 206 |
| Four trusts combined | August 2026 | 17,234 | 62.6% | 186 |
| Four trusts combined | September 2025 | 16,105 | 59.9% | 315 |
| England | September 2026 | 830,089 | 61.4% | 19,769 |
| England | August 2026 | 843,419 | 61.1% | 19,741 |
| England | September 2025 | 860,865 | 59.7% | 26,590 |
What the figures cover
Transform Medical used NHS England’s incomplete referral-to-treatment tables for trauma and orthopaedics (C_110). We selected four trusts with orthopaedic services in or near central London: UCLH (RRV), Imperial College Healthcare (RYJ), Guy’s and St Thomas’ (RJ1), and Chelsea and Westminster Hospital (RQM). The combined percentage uses the sum of pathways within 18 weeks divided by the sum of all open pathways at those four trusts. The England figures use the national row in the commissioner tables. We used NHS England’s revised September 2025 release.
Each figure covers the trust as a whole, including sites outside central London where applicable. The combined figures represent these four trusts. The tables count pathways still open at month-end, and a person can have more than one pathway. Trauma and orthopaedics covers a range of conditions and treatments. Individual waits for hip or knee replacement can vary.
NHS England sources — September 2026 provider table, September 2026 England table, August 2026 tables and revised September 2025 tables.
Trust services — UCLH, Imperial College Healthcare, Guy’s and St Thomas’ and Chelsea and Westminster Hospital.