Welsh NHS first outpatient referrals reach annual record

Wales recorded just over 1.7 million referrals for first outpatient appointments in 2025/26, the highest annual total on record and 37% above 2019/20. The Welsh Government report, published on 10 September, covers activity up to March. Its annual figures follow financial years. The referral record sits alongside a fall in waiting pathways from mid-2025 to 667,000 in March, mainly among those awaiting their first outpatient appointment. Those figures describe different things: referrals arriving over a year and pathways still open at a particular month-end.

A referral is not a person

One person can have several referrals and treatment pathways, so the annual total does not mean 1.7 million different people needed an appointment. Nor can subtracting the waiting-list total from annual referrals show how many people were treated. The chief statistician explains that the waiting list shrinks when monthly pathway closures exceed additions. A pathway may close because treatment starts or a consultation establishes that hospital treatment is unnecessary. A closure does not necessarily mean an operation.

The March fall did not continue

The later monthly release puts the official June total at just under 698,400 pathways, around 8,700 above May and the third consecutive monthly increase. The provisional July estimate was higher again, at around 709,700. July remains subject to revision and is not a final count. The annual report therefore cannot be read as evidence that the waiting list is still falling.

What comes next

Welsh Government sets the performance standards in the monthly release. Results are assessed against the health board providing care, including for patients living outside its area. The next monthly NHS activity and performance release is scheduled for 17 September at 9.30am.