Backlogs, Breakdowns and Progress - NHS Scotland's Struggle to Cut Waiting Times

19th January 2026

Long waits for NHS care have become one of the most pressing health‑service issues in Scotland. Patients across the country from busy urban centres to rural and remote communities are facing delays not just for major operations but for outpatient appointments and specialist services such as audiology (hearing tests and hearing aid fittings).

Understanding the scale of this challenge and the plans to address it is key to grasping the pressures NHS Scotland is under in 2025-26.

The Waiting List Picture - Growing Backlogs and Targets Missed

Public Health Scotland's official data shows that hundreds of thousands of patients are waiting for NHS care. At the end of March 2025, there were over 550,000 ongoing waits for new outpatient appointments, and a substantial number of these waits had exceeded one year — with thousands even waiting more than two years. This was the highest recorded total for very long waits and reflects the continuing backlog from pandemic disruption and rising demand.

Although the Scottish Government sets clear waiting time standards — such as seeing 95 % of new outpatients within 12 weeks — performance has remained well below targets, with around 60 % of new outpatient waits completed within this standard in early‑to‑mid 2025.

This broad outpatient backlog includes services like audiology, meaning many people referred for hearing tests or hearing aid care experience long waits for initial assessment or follow‑up appointments.

Rural and Specialist Pressures

In places like NHS Highland — which covers a vast rural area including Caithness — these waiting lists translate into practical hardship for patients needing specialist care. Travel distances, limited clinic capacity, and workforce shortages all contribute to extended waits.

While audiology isn’t broken out separately in national statistics, its inclusion in the wider outpatient delays helps explain reports of people waiting up to or over a year for hearing services. Anecdotal reports in local media have highlighted these extremely long waits, underscoring the real‑world impact of the backlog on communities in the Highlands.

Glimmers of Progress - Falling Waiting Lists

Despite the scale of the challenge, there has been measurable progress in cutting long waits. By late 2025, the number of patients waiting over 52 weeks for new outpatient appointments had fallen for several consecutive months, driven by increased NHS activity and additional funding targeted at the longest waits. For example, from April to November 2025, the number of long outpatient waits fell by around 13 %, and the overall outpatient waiting list also dropped modestly.

Health officials have pointed to sustained investment and month‑by‑month improvements as evidence that the system is beginning to catch up, with more patients being seen and treated compared with the previous year.

Government Plans and Investment to Reduce Backlogs

Scottish Government plans to tackle waiting times are laid out in official Operational Improvement Plans aimed at increasing capacity and reducing delays across the NHS. Central to these plans are several key strategies:

Expanded capacity: Additional investment — including more than £135 million targeted at services with the longest waits — is being used to generate extra appointments and procedures. This includes both routine care and diagnostics, helping to reduce pressure on outpatient services.

Clear targets: The government has reiterated a commitment that nobody should be waiting more than 52 weeks for a new outpatient appointment or planned treatment by March 2026. Achieving this would mark a major improvement over recent years.

Regional working and workforce planning: Efforts to optimise NHS capacity across health board boundaries aim to balance workload and make better use of staff and facilities, while workforce recruitment and retention are part of longer‑term reforms.

Shift toward community care: Plans emphasise shifting some services out of acute hospitals and into primary and community settings where possible, which can help shorten waits and improve access.

Challenges and the Road Ahead

Despite progress, official figures and independent analysis suggest the pace of improvement must accelerate to meet targets. Recent reporting has indicated that, even with falling long waits, the Scottish Government may not fully eliminate waits over one year by the 2026 deadline — leaving a significant number of patients still in lengthy queues.

In specialist areas like audiology, where resource constraints and rural delivery challenges are acute, progress may lag behind more mainstream services unless targeted efforts are made. There is also broader recognition that workforce shortages and growing demand will require sustained investment and reform over the long term.

Progress Amid Ongoing Strain

NHS Scotland’s waiting times situation reflects both deep post‑pandemic backlogs and genuine recent progress. While hundreds of thousands of patients still wait beyond national standards for outpatient care — affecting services from general clinics to specialist audiology appointments — the government’s plans to expand capacity, target funding, and press down long waits are beginning to show results.

Whether these efforts will fully meet ambitious targets in the coming year remains uncertain. Success will depend on sustained investment, effective workforce strategies, and continued operational improvements, particularly in rural and specialist areas where waits like those seen in audiology have hit families hardest.