Latest UK PAC reports on NHS performance and government health figures and Scotland very similar

2nd February 2026

The NHS and Department of Health and Social Care have failed to take meaningful action on persistent medical negligence problems, despite repeated warnings over decades.

Total government liability for clinical negligence has soared to around £58-60 billion, the second-largest liability across the whole UK government.

Annual compensation costs now exceed £3.6 billion and are rising rapidly.

A significant share of awards (around 19 %) goes to legal fees rather than patients.

The Public Accounts Committee described the situation as showing a system struggling to protect patients from avoidable harm and criticised the lack of effective patient-safety strategies.

Why it matters:
This highlights major financial and safety issues in the NHS, with huge costs diverting money from frontline care and unresolved underlying drivers of harm.

NHS Waiting Times and Backlogs

Key points from the PAC's report on waiting lists:

Billions have been spent on NHS "transformation" programmes aimed at reducing waiting lists, but recovery targets are still being missed.

As of mid-2025:

Nearly 192,000 patients were waiting more than a year for elective (non-emergency) care.

22 % of patients waited more than six weeks for diagnostic tests, against a target of 5 %.

Only 59 % of patients began treatment within the statutory 18-week standard, far short of the 92 % goal.

PAC said funding plans lacked clear focus on patient outcomes and measurable results.

Why this matters:
Persistent long waits indicate ongoing performance issues, and the PAC warned that the government's current strategies are insufficiently effective.

Broader NHS Financial & Performance Context

While not all are brand-new reports, other PAC inquiries highlight long-standing structural health issues, including:

Financial unsustainability: Local NHS systems overspent by around £1.4 billion in 2023-24, with rising demand and workforce pressures worsening the budget outlook.

Variation in emergency care: Prior PAC reports have shown a "postcode lottery" in emergency and urgent care access across regions, linked to workforce and system flow problems.

PAC's Overall Messages on Health

Across multiple reports, the Public Accounts Committee has stressed:

Government performance gaps

Repeated goals (e.g., reducing waiting times, improving patient safety) are consistently missed or fall short of targets.

Despite large public spending increases, outcomes for patients have not improved in line with expectations.

Financial and value-for-money concerns

Enormous liabilities such as clinical negligence costs reflect a failure to reduce harm and contain spending.

PAC frequently calls for clearer strategy, better planning, and proper evaluation of programmes before they are funded.

Persistent structural problems

Long waiting lists, regional inequalities in care, and workforce pressures point to deeply rooted challenges in how the NHS is organised and managed.

Finally

The latest PAC reports on health figures show that:
The NHS is under financial stress and performance pressure

Government spending has not closed gaps in waiting times or patient safety

Billions in liabilities (especially clinical negligence) are a growing concern

The PAC is urging stronger action, clearer plans, and better accountability

Read more HERE

The situation in Scotland is broadly similar to that reported for NHS England, but with some important differences in detail, context and performance measures. Here's a clear summary of how Scotland's health figures compare with the rest of the UK:

Just like in England, NHS Scotland is under pressure from rising demand, long waits, budget constraints, workforce shortages and productivity challenges:

Financial sustainability concerns: Audit Scotland has reported that NHS Scotland remains financially unsustainable overall, with many health boards needing government loans to balance their books. Staffing and demand continue to outstrip resources.

Implementation gap: Despite increased spending and reform plans, the gap between policy ambitions and actual performance on the ground remains large. Targets to reduce waiting times and improve access haven’t been fully achieved.

This mirrors issues in England where PAC reports have found significant backlogs and missed recovery targets despite large public spending.

Waiting Times & Backlogs

Scotland faces high waiting lists and long waits for treatment, much like England:

Most NHS Scotland waiting-time standards are not being met, and performance has declined from pre-pandemic levels.

Outpatient and inpatient waits of over a year have been significant, although recent data shows some reduction in the longest waits.

Emergency department (A&E) waits remain well below the 95 % standard, with around 70 % of patients seen within four hours — also showing persistent pressure.

Delayed discharges from hospital contribute to blocked capacity and extra costs (an estimated £440 million lost because patients remain in beds longer than medically necessary).

These patterns are broadly similar to NHS England, where long waits — especially for electives and diagnostics — contributed to PAC critique of performance and value for money.

Comparisons With England

There are some nuanced differences:

Waiting Time Measures

Scotland uses slightly different targets (e.g., 95 % within 12 weeks for first outpatient appointment) compared with England’s 18-week referral-to-treatment target. Direct comparisons are tricky because of these different standards.

Performance Relative to England

Some data suggest A&E waits in Scotland are marginally better than in England for the 4-hour standard — though both systems perform well below targets.

On elective care and waiting lists, both countries have seen worse outcomes since the pandemic, but England’s elective waiting list has grown less steeply and some measures have begun improving, while Scotland’s performance has shown less consistent recent improvement.

Staffing growth in England has been faster than in Scotland, helping activity recover more quickly south of the border.

So, while neither NHS system is performing well compared with pre-pandemic years, and both are under intense pressure, there are differences in performance trends and targets between Scotland and England.

Workforce and Service Pressures

Like in England, Scotland’s NHS workforce is stretched:

Consultant, GP and other medical vacancies remain high.

Demand from an ageing population continues to grow.

Recruitment and retention challenges persist.

This amplifies waits and pressures on patient care, much as PAC has highlighted for NHS England.

Finally

Both NHS Scotland and NHS England are under strain from long waiting lists, workforce shortages, financial pressure, and challenges recovering from the pandemic.

Performance benchmarks in Scotland differ from England’s, making direct comparison imperfect — but the overall picture of pressure and unmet targets is similar.

Scotland has some areas of relative strength (e.g., A&E waits) but still faces significant capability and sustainability challenges.

Audit and parliamentary oversight bodies in both countries have criticised performance gaps and the implementation of reforms.