Community sector

Waiting lists

As of December 2024, the total community services waiting list in England was reported at 1.04 million, falling by 1.5% since November.

• Encouragingly, the total waiting list has been gradually dropping each month since it reached a high of 1.10 million in August 2024.
• Children and young people (CYP): There were 270,000 CYP waiting for community services in December, an increase of 1% from the previous month.
• Adults: The number of adults waiting for community services decreased by 18,100 in the latest month, falling to 775,000.
• Trusts reporting: 124 NHS trusts and foundation trusts reported waiting list information in December with a combined waiting list of 922,316. 25 trusts account for the top half of the total waiting list, with eight trusts reporting over 20,000 patients waiting for treatment. 

FIGURE 6 

Community health services total reported waiting list 

Waits over 52 weeks

As highlighted by the Darzi report, long waits for community services risk being normalised. The total number of waits over 52 weeks stood at 57,900 in December 2024 – the highest on record.

• In the latest month, there were 10,400 adults waiting more than 52 weeks for treatment, which is down by 2.1% from last month. Of these, 930 adults were waiting more than 104 weeks for treatment.
• However, the number of long waits for children and young people (CYP) reached a record high in December. There were 47,500 CYP waiting for 52 weeks or more, marking a 5.7% increase from the month before. Of these, 9,200 CYP were waiting for 104 weeks or more, which is nearly 10 times the number of adults.
• Since February 2024, when 13 new providers were added to the reporting scope, the number of children and young people waiting over 52 weeks has increased by nearly three quarters (73.2%).

Our report Forgotten generation: shaping better services for children and young people examines the challenges children and young people services are facing and highlights the growing concerns for those waiting to access services.

Demand and activity 

Referral requests for community services have fallen in the latest month: 

• Referral requests decreased in November, with 1.7 million referrals recorded, showing a 9.7% decrease from October. Despite the fall since last month, referrals remained 3.3% higher than the same period last year.  
• Compared to five years ago, before the pandemic, referrals are 59% higher. This indicates a sustained and significant rise in demand for community services.  
• Care contact activity levels also fell in the latest month, with 9 million care contacts recorded in November – a 4% decrease from October.  

FIGURE 7 

Total referrals received by community services

UCR services, virtual wards and intermediate care

Urgent community response (UCR) referrals

• As of November 2024, 83% of UCR referrals met the two-hour standard for delivering UCR services, with trusts exceeding the national objective for another month.
• The target was met by 81 out of 91 trusts in November. Of these, nine trusts delivered UCR services within the two-hour window to 95% of patients.

Intermediate care - delayed discharges

• For the month of January, there were an average of 2,300 patients who no longer met the requirements to remain in intermediate care each day. Of these, 87% remained in hospital at the end of the day, the same proportion as in December.
• This means that nearly six out of seven patients remained in intermediate care despite being medically fit for discharge. The proportion has never dropped below 87%.

Virtual wards 

• As of January 2025, virtual ward capacity was 12,600, reflecting a 1% decrease compared to the previous month.  
• There were 10,200 patients receiving care through virtual wards, meaning the occupancy rate was 80.5%, up from 75.4% in December.  
• The virtual ward capacity per 100,000 GP registered population aged 16 years and over stood at 20 – lower than last month and below the longer-term ambition of 40 to 50 virtual beds per 100,000 people, as outlined in the Delivery Plan for Recovering Urgent and Emergency Care. 

FIGURE 8 

Virtual ward occupancy rate (%)