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Whole-System Pressure

A view of wider hospital and emergency-system strain, using A&E performance and 12-hour admission waits.

Latest pillar reading
40.4
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Data month: July 2026

Weight in headline index: 20%

What this pillar is showing

This pillar shows whether system-wide pressure is likely to be making access harder everywhere else. When A&E and flow are strained, treatment access often feels more fragile overall.

Primary chart

Pillar score history

This is the main trend line for the pillar itself. It shows how pressure in this area has moved over recent scored months. Higher scores mean more access pressure.

Range
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Whole-System Pressure fell by 2.1 points to 40.4 in July 2026. Higher scores mean more access pressure.

Status bands are shown as background ranges. The latest point is highlighted; hover or tap points for month, score, change and comparison values.

View chart data table
Month Pillar score 3-month average Headline index
April 2021 0.0 0.0 31.0
May 2021 0.0 0.0 31.1
June 2021 0.0 0.0 34.3
July 2021 3.8 1.3 35.7
August 2021 5.0 2.9 39.6
January 2022 18.3 9.0 61.9
February 2022 20.0 14.4 50.8
March 2022 27.4 21.9 55.0
April 2022 27.7 25.0 58.4
May 2022 23.2 26.1 57.9
June 2022 26.3 25.7 61.2
July 2022 33.4 27.6 63.0
August 2022 32.1 30.6 65.0
September 2022 36.3 33.9 68.8
October 2022 47.3 38.6 69.9
November 2022 43.6 42.4 68.1
December 2022 62.8 51.2 73.3
January 2023 41.5 49.3 72.2
February 2023 37.2 47.2 64.0
March 2023 40.8 39.8 63.6
April 2023 25.5 34.5 63.6
May 2023 30.4 32.2 64.8
June 2023 27.6 27.8 63.2
July 2023 24.1 27.4 61.9
August 2023 29.1 26.9 65.1
September 2023 34.8 29.3 67.8
October 2023 45.8 36.6 68.6
November 2023 45.8 42.1 66.1
December 2023 47.4 46.3 66.6
January 2024 54.0 49.1 70.3
February 2024 45.3 48.9 61.6
March 2024 38.6 46.0 59.7
April 2024 37.7 40.5 62.0
May 2024 39.0 38.4 60.9
June 2024 34.5 37.1 59.5
July 2024 32.4 35.3 58.8
August 2024 24.2 30.4 58.2
September 2024 35.7 30.8 59.9
October 2024 45.8 35.2 60.4
November 2024 44.4 42.0 57.0
December 2024 52.6 47.6 58.3
January 2025 55.1 50.7 61.5
February 2025 43.7 50.5 54.6
March 2025 40.5 46.4 53.3
April 2025 39.2 41.1 55.9
May 2025 36.8 38.8 56.3
June 2025 33.3 36.4 54.7
July 2025 29.4 33.2 54.1
August 2025 30.6 31.1 55.5
September 2025 38.8 32.9 57.2
October 2025 47.7 39.0 57.6
November 2025 44.8 43.8 56.5
December 2025 45.5 46.0 56.3
January 2026 62.6 51.0 62.8
February 2026 48.1 52.1 55.3
March 2026 36.9 49.2 54.7
April 2026 38.1 41.0 57.6
May 2026 42.0 39.0 54.0
June 2026 42.5 40.9 53.8
July 2026 40.4 41.6 52.8

Latest context

Latest pillar score
40.4
Raw score for July 2026.
Weighted contribution
9.0
Contribution into the headline Treatment Access Index.
Headline index same month
52.8
Useful for comparing this pillar against the overall access environment.

Secondary charts

A&E within 4 hours

4-hour performance
75.4%

Percentage of patients seen within four hours in A&E.

Range
View data
MonthA&E within 4 hours
Nov 10 97.2%
Dec 10 94.8%
Jan 11 95.8%
Feb 11 97.1%
Mar 11 96.8%
Apr 11 96.9%
May 11 97.1%
Jun 11 97.1%
Jul 11 97.6%
Aug 11 97.4%
Sep 11 96.9%
Oct 11 96.6%
Nov 11 96.6%
Dec 11 95.8%
Jan 12 95.8%
Feb 12 95.0%
Mar 12 96.5%
Apr 12 96.4%
May 12 96.8%
Jun 12 96.7%
Jul 12 97.1%
Aug 12 97.0%
Sep 12 96.7%
Oct 12 96.2%
Nov 12 96.0%
Dec 12 94.7%
Jan 13 94.5%
Feb 13 94.3%
Mar 13 93.5%
Apr 13 93.4%
May 13 96.6%
Jun 13 96.9%
Jul 13 96.7%
Aug 13 96.3%
Sep 13 95.8%
Oct 13 95.7%
Nov 13 95.9%
Dec 13 95.3%
Jan 14 95.2%
Feb 14 94.6%
Mar 14 95.6%
Apr 14 95.3%
May 14 94.8%
Jun 14 95.2%
Jul 14 95.2%
Aug 14 95.1%
Sep 14 94.6%
Oct 14 93.7%
Nov 14 93.5%
Dec 14 89.9%
Jan 15 91.2%
Feb 15 92.0%
Mar 15 92.7%
Apr 15 93.3%
May 15 94.3%
Jun 15 94.8%
Jul 15 95.0%
Aug 15 94.3%
Sep 15 93.4%
Oct 15 92.3%
Nov 15 91.3%
Dec 15 91.0%
Jan 16 88.7%
Feb 16 87.8%
Mar 16 87.3%
Apr 16 90.0%
May 16 90.3%
Jun 16 90.6%
Jul 16 90.3%
Aug 16 91.0%
Sep 16 90.6%
Oct 16 89.1%
Nov 16 88.4%
Dec 16 86.2%
Jan 17 85.1%
Feb 17 87.5%
Mar 17 90.0%
Apr 17 90.5%
May 17 89.7%
Jun 17 90.7%
Jul 17 90.3%
Aug 17 90.3%
Sep 17 89.7%
Oct 17 89.9%
Nov 17 88.8%
Dec 17 85.0%
Jan 18 85.3%
Feb 18 85.0%
Mar 18 84.6%
Apr 18 88.6%
May 18 90.4%
Jun 18 90.8%
Jul 18 89.3%
Aug 18 89.7%
Sep 18 88.9%
Oct 18 89.0%
Nov 18 87.6%
Dec 18 86.4%
Jan 19 84.4%
Feb 19 84.2%
Mar 19 86.6%
Apr 19 85.1%
May 19 86.6%
Jun 19 86.4%
Jul 19 86.5%
Aug 19 86.3%
Sep 19 85.2%
Oct 19 83.6%
Nov 19 81.4%
Dec 19 79.8%
Jan 20 81.7%
Feb 20 82.8%
Mar 20 84.3%
Apr 20 90.4%
May 20 93.5%
Jun 20 92.8%
Jul 20 92.0%
Aug 20 89.2%
Sep 20 87.3%
Oct 20 84.4%
Nov 20 83.8%
Dec 20 80.3%
Jan 21 78.5%
Feb 21 83.9%
Mar 21 86.1%
Apr 21 85.4%
May 21 83.7%
Jun 21 81.3%
Jul 21 77.7%
Aug 21 77.0%
Sep 21 75.2%
Oct 21 73.9%
Nov 21 74.1%
Dec 21 73.4%
Jan 22 74.3%
Feb 22 73.3%
Mar 22 71.6%
Apr 22 72.2%
May 22 72.8%
Jun 22 72.1%
Jul 22 71.1%
Aug 22 71.7%
Sep 22 71.1%
Oct 22 69.5%
Nov 22 69.0%
Dec 22 65.2%
Jan 23 72.5%
Feb 23 71.5%
Mar 23 71.5%
Apr 23 74.6%
May 23 74.0%
Jun 23 73.4%
Jul 23 74.0%
Aug 23 73.0%
Sep 23 71.7%
Oct 23 70.3%
Nov 23 69.8%
Dec 23 69.5%
Jan 24 70.4%
Feb 24 71.0%
Mar 24 74.3%
Apr 24 74.5%
May 24 74.0%
Jun 24 74.6%
Jul 24 75.2%
Aug 24 76.3%
Sep 24 74.2%
Oct 24 73.1%
Nov 24 72.2%
Dec 24 71.1%
Jan 25 73.0%
Feb 25 73.5%
Mar 25 75.0%
Apr 25 74.8%
May 25 75.4%
Jun 25 75.6%
Jul 25 76.4%
Aug 25 75.9%
Sep 25 75.1%
Oct 25 74.1%
Nov 25 74.2%
Dec 25 73.8%
Jan 26 72.5%
Feb 26 74.1%
Mar 26 77.1%
Apr 26 76.9%
May 26 75.7%
Jun 26 75.0%
Jul 26 75.4%
Aug 26 75.0%

12-hour waits

12-hour waits
47,438

Number of patients spending more than 12 hours from decision to admit to admission.

Range
View data
Month12-hour waits
Nov 10 2
Dec 10 15
Jan 11 17
Feb 11 3
Mar 11 1
Apr 11 6
May 11 3
Jun 11 10
Jul 11 6
Aug 11 1
Sep 11 9
Oct 11 42
Nov 11 28
Dec 11 4
Jan 12 8
Feb 12 6
Mar 12 1
Apr 12 0
May 12 0
Jun 12 2
Jul 12 1
Aug 12 2
Sep 12 2
Oct 12 0
Nov 12 1
Dec 12 14
Jan 13 50
Feb 13 17
Mar 13 81
Apr 13 43
May 13 0
Jun 13 7
Jul 13 3
Aug 13 2
Sep 13 9
Oct 13 21
Nov 13 7
Dec 13 21
Jan 14 42
Feb 14 77
Mar 14 10
Apr 14 23
May 14 10
Jun 14 8
Jul 14 5
Aug 14 8
Sep 14 28
Oct 14 55
Nov 14 35
Dec 14 186
Jan 15 650
Feb 15 184
Mar 15 54
Apr 15 58
May 15 46
Jun 15 25
Jul 15 22
Aug 15 28
Sep 15 23
Oct 15 58
Nov 15 29
Dec 15 29
Jan 16 158
Feb 16 188
Mar 16 349
Apr 16 196
May 16 107
Jun 16 84
Jul 16 113
Aug 16 57
Sep 16 86
Oct 16 252
Nov 16 457
Dec 16 553
Jan 17 989
Feb 17 338
Mar 17 270
Apr 17 143
May 17 115
Jun 17 55
Jul 17 74
Aug 17 50
Sep 17 77
Oct 17 57
Nov 17 107
Dec 17 517
Jan 18 1054
Feb 18 369
Mar 18 853
Apr 18 356
May 18 106
Jun 18 99
Jul 18 149
Aug 18 162
Sep 18 154
Oct 18 214
Nov 18 259
Dec 18 284
Jan 19 627
Feb 19 521
Mar 19 331
Apr 19 442
May 19 416
Jun 19 462
Jul 19 452
Aug 19 371
Sep 19 458
Oct 19 725
Nov 19 1111
Dec 19 2356
Jan 20 2847
Feb 20 1621
Mar 20 1174
Apr 20 251
May 20 93
Jun 20 159
Jul 20 271
Aug 20 335
Sep 20 346
Oct 20 1268
Nov 20 2148
Dec 20 3745
Jan 21 3825
Feb 21 1021
Mar 21 688
Apr 21 526
May 21 695
Jun 21 1289
Jul 21 2208
Aug 21 2787
Sep 21 5024
Oct 21 7058
Nov 21 10646
Dec 21 12859
Jan 22 16564
Feb 22 16402
Mar 22 22506
Apr 22 24179
May 22 19657
Jun 22 22017
Jul 22 29139
Aug 22 28690
Sep 22 32762
Oct 22 43793
Nov 22 37853
Dec 22 54573
Jan 23 42767
Feb 23 34975
Mar 23 39687
Apr 23 26492
May 23 31498
Jun 23 26488
Jul 23 23396
Aug 23 27710
Sep 23 32228
Oct 23 43534
Nov 23 42503
Dec 23 43858
Jan 24 54312
Feb 24 44420
Mar 24 42972
Apr 24 42078
May 24 42555
Jun 24 38106
Jul 24 36806
Aug 24 28494
Sep 24 38880
Oct 24 49616
Nov 24 45791
Dec 24 54207
Jan 25 61529
Feb 25 47623
Mar 25 46766
Apr 25 44648
May 25 42891
Jun 25 38683
Jul 25 35467
Aug 25 35909
Sep 25 44765
Oct 25 54314
Nov 25 50648
Dec 25 50775
Jan 26 71517
Feb 26 54649
Mar 26 46665
Apr 26 47,750
May 26 50,212
Jun 26 49,466
Jul 26 47,438
Aug 26 44,951

What to watch

  • A&E within 4 hours: Percentage of patients seen within four hours in A&E.
  • 12-hour waits: Number of patients spending more than 12 hours from decision to admit to admission.
Private treatment context

Putting system pressure into private-treatment context

Whole-system pressure can make people think more seriously about private options, but PMI works best when expectations are clear. It usually supports eligible planned private diagnosis and treatment rather than replacing A&E, ambulance services, emergency NHS care or long-term NHS treatment.

Important note

The Treatment Access Index is general information only. It is not medical advice, insurance advice, or a recommendation to buy private medical insurance. You should consider your own needs and speak to a suitable specialist before making decisions about cover.