The Welsh government has unveiled a plan to eliminate routine follow-up appointments after NHS treatment, aiming to redirect consultant time toward first-time specialist assessments and reduce waiting lists across Wales.
Under the new approach, patients will receive follow-up care only when clinically necessary. The strategy is designed to allow consultants to dedicate 70% of their time to seeing new patients, compared with the current 30%, and to increase surgical time from a 50:50 split with clinic work to 80% operating and 20% clinic time.
The Welsh government has allocated £145m in funding to support the reforms. This comprises £20m for maintenance and equipment, £25m for developing new surgical hubs, and £100m to increase day-to-day NHS activity. Crucially, health boards will receive payment only when they can demonstrate completed treatments, rather than on the basis of planned targets.
The plan reinforces that patients waiting longest should be treated first, unless a clear clinical reason justifies an exception. It will be overseen by clinicians rather than managers and officials, according to government statements.
Why are follow-up appointments being cut?
More than one million cases in Wales are currently waiting for follow-up appointments. By reducing these, the government hopes to redirect consultant capacity toward the backlog of people awaiting initial specialist assessment. The previous Labour administration had reduced waiting lists by funding additional procedures—such as 20,000 extra cataract operations—and contracting private providers, but the new government's strategy focuses on reshaping how existing NHS resources are deployed.
According to the Welsh Government's planned-care strategy, the target is for 35% of all new appointments and 50% of follow-up appointments to be delivered virtually in future, further optimising consultant time.
What else is in the plan?
The reforms include several complementary measures. Surgical capacity will be increased, including weekend working, in specialisms where waiting times are longest. GP referral reviews will be accelerated so patients learn sooner whether further treatment, tests, or investigations are needed. Diagnostic capacity will be expanded and digital tools deployed to shorten the interval between referral and diagnosis.
These changes will run alongside Plaid Cymru's manifesto commitment to establish up to 10 treatment hubs across Wales. Health boards are required to collaborate and share best practices to ensure consistent implementation.
Health Minister Mabon ap Gwynfor framed the plan as a departure from short-term fixes.
Waiting two years for planned care is not acceptable. This investment is tied to health boards changing how they work, permanently, so the progress I expect to see doesn't slip back as it has in the past. That's the difference between a short-term fix and lasting change.
He added:
Patients should receive timely advice, diagnosis and treatment through services that are designed around their needs, not around organisational boundaries. None of this is possible without the hard work and expertise of NHS staff. Their leadership sits at the heart of this approach, and every health board must now work together to deliver further improvements for patients.
What is the current state of waiting lists?
As of June 2026, more than 698,500 cases were on NHS waiting lists in Wales, a figure that has risen since the new government took office. Nearly 4,100 had been waiting two years or longer, up from just under 2,600 in March. However, Wales' waiting lists and longest waits were reported as down in January 2026, with the figure for people waiting more than 36 weeks at its lowest since April 2021, suggesting some recent volatility in the trend.
The government previously pledged to eliminate waits of two years or longer within a matter of months, but the new plan does not specify an exact date for achieving this milestone. Instead, it commits to reducing total waiting lists to pre-Covid-19 levels—approximately 460,000 cases—by the end of the current Senedd term. Further detail on timescales is expected later in 2026.
What do stakeholders say?
The Welsh NHS Confederation, which represents health boards, has endorsed the plan, welcoming
the emphasis on regional working, diagnostic capacity, surgical hubs and more sustainable planned care pathwaysas the right direction. However, the organisation's assistant director in Wales, Nesta Lloyd-Jones, cautioned that
waiting lists cannot be viewed in isolation from the wider pressures facing health and social care. This summer was proof that the system remains under unrelenting and escalating pressure, and there is no quick fix.
Opposition parties have been critical. James Evans, Reform's health, prevention and sport spokesperson, said:
It beggars belief that Plaid Cymru has waited so long before starting work on trying to cut waiting lists, but when the Welsh Gender Service paused referrals, they sprung into action. NHS waiting lists are still on the rise in Wales, and every time you ask a Plaid Minister how long it will take for them to eradicate two-year waits, you get a different answer. Meanwhile, Plaid's first 100 days was spent announcing reviews and committees.
Welsh Labour's health spokesperson, Ken Skates, said:
It is disappointing that Plaid are still unable to say when two-year waits will be eliminated. After 10 months of waiting lists falling, they've started to creep up in Wales—those on waiting lists need answers, vague timelines for the next four years do not help or inform the people suffering right now.
How does this compare to previous approaches?
The previous Labour government had succeeded in reducing waiting lists by using £120m to fund an extra 20,000 cataract operations and by paying private companies to reduce the number of people waiting for outpatient appointments and treatments. The new government's strategy, by contrast, aims to make more efficient use of existing NHS capacity at every stage of a patient's journey, rather than relying on additional external funding or private sector involvement.
According to government sources, the new plan does not introduce numerous novel ideas but instead consolidates reforms that have proven effective and rolls them out consistently across the country. This reflects a shift toward systemic change rather than one-off interventions.
What happens next?
The next official Welsh NHS waiting-list statistics update is expected on 17 September 2026. Health boards will be required to demonstrate progress in implementing the reforms and will be assessed on their ability to complete treatments rather than on planned activity. The government has indicated that more details about implementation timescales will be released later in 2026.
The plan's success will depend on health boards' capacity to reorganise workflows, increase surgical throughput, and expand diagnostic services while maintaining clinical standards. The emphasis on clinician-led oversight suggests the government intends to balance efficiency gains with patient safety considerations.
Key Facts
- Follow-up appointments will be offered only when clinically necessary, freeing consultant time for first-time specialist assessments.
- The plan is backed by £145m in funding, comprising £20m for maintenance and equipment, £25m for surgical hubs, and £100m for increased day-to-day NHS activity.
- Health boards will be paid only when they demonstrate completed treatments, not on the basis of promised targets.
- The government aims to reduce waiting lists to pre-Covid-19 levels (approximately 460,000 cases) by the end of the current Senedd term, though no exact date has been set for eliminating two-year waits.
- More than one million cases in Wales are currently waiting for follow-up appointments, and over 698,500 are on active waiting lists for initial treatment.
