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The number of people in England waiting to start routine hospital treatment has hit a record high.

An estimated 7.68 million people were waiting to start treatment at the end of July, up from 7.57 million in June.

It is the highest number since records began in August 2007 and marks the eighth consecutive month of increases.

It comes as the government said the NHS will receive an extra £200m this winter.

Figures also showed a total of 389,952 people in England had been waiting more than a year – and around 7,289 people more than 18 months – to start routine hospital treatment at the end of July.

This is up from 383,083 – and 7,177 – at the end of June, respectively.

The government and NHS England set the ambition of eliminating all waits of more than 18 months by April this year, excluding exceptionally complex cases or patients who choose to wait longer – and all waits of more than a year by March 2025.

Cancer waiting times

Around 263,696 urgent cancer referrals were made by GPs in England in July, up 1% on 261,006 in June and up 10% year-on-year from 239,739 in July 2022.

The proportion of cancer patients who saw a specialist within two weeks of being referred fell from 80.5% in June to 77.5% in July – below the target of 93%, which is being dropped from October.

There was some improvement for cancer waiting times. In July, 37% of those starting treatment received their urgent referral more than two months prior, down from 41% in June and from 38% in July 2022.

That is down significantly from the worst-ever performance of 45% in January, though still significantly above pre-pandemic levels (21% in August 2019).

Meanwhile, 74.1% of patients urgently referred for suspected cancer were diagnosed or had cancer ruled out within 28 days, up from 73.5% the previous month. The target is 75%.

Ambulance response times

Further data revealed it took ambulances an average of 31.5 minutes to respond to Category 2 incidents – such as heart attacks and strokes – in August.

This was a slight improvement compared to July (31.8 minutes) and a big improvement compared to August 2022 (42.6 minutes).

However, it is still significantly worse than before the pandemic. In Aug 2019, the equivalent response time was just 21.3 minutes, and in Aug 2018 it was 20.6 minutes.

A&E performance

The number of people waiting more than 12 hours in A&E departments in England from a decision to admit to actually being admitted was 28,859 in August, up 21% from 23,934 in July.

The figure hit a record 54,573 in December 2022.

The number waiting at least four hours from the decision to admit to admission also went up, from 109,515 in July to 120,120 in August, an increase of 10%.

Analysis: Unless pay disputes are resolved – NHS waiting lists will keep rising

There are gains that will give much encouragement to health leaders: more urgent GP referrals (263,696) for cancer than any other July. And a slight improvement for ambulance waiting times in August when it took crews an average of 31.5 minutes to respond to Category 2 incidents (e.g. heart attacks and strokes).

That’s a slight improvement compared to July (31.8 minutes) and a big improvement compared to August 2022.

There has been a slight fall in the longest waiting times too. The number of people enduring waits of more than two years has fallen slightly, from 314 to 277.

And all of this against the backdrop of the busiest summer on record for the NHS in England with higher seasonal A&E attendances than ever before.

But it’s not all good news. The number on the list who have been waiting more than 18 months (72 weeks) has risen slightly, from 7,177 to 7,289. And the total number waiting more than 18 weeks is up from 3.09 million to 3.18 million.

And the headline figure that will dominate coverage is the record 7.68 million waiting for elective care. This figure has never been higher.

The prime minister will say his key pledge to bring down this waiting list is being undermined by strikes. And to some extent he is right.

More than 800,000 people have seen their routine care delayed because of eight months of strikes.

The nurses dispute has been resolved but junior doctors and their consultant colleagues will continue their strikes possibly long into winter. And for the first time they will strike together next week.

That will effectively bring the NHS to a grinding halt.

Unless this dispute is resolved the numbers will keep rising.

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Prime Minister Rishi Sunak has made cutting waiting lists one of his priorities for 2023, pledging in January that “lists will fall and people will get the care they need more quickly”.

Shadow health secretary Wes Streeting MP said: “Record numbers of patients are waiting for healthcare and they are left waiting unacceptably long, whether it’s for an operation, ambulance, or in A&E. For millions of patients across England, the NHS is no longer there for them when they need it.”

Professor Julian Redhead, NHS England’s national clinical director for urgent and emergency care, said: “Today’s figures show that despite ongoing pressures across the NHS, including record demand for emergency care this summer, and an increase in COVID cases during July and August, NHS staff are continuing to deliver for patients.

“Category 2 ambulance response times are more than 10 minutes faster than a year ago, and significant progress continues to be made to bring down the longest waits for elective care despite months of disruption from industrial action.”

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US accuses UK of ‘significant human rights issues’ and restricting free speech

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US accuses UK of 'significant human rights issues' and restricting free speech

The US State Department has accused the UK of having “significant human rights issues”, including restrictions on free speech.

The unflattering assessment comes via a new version of an annual Human Rights Practices report, with its publication coinciding with Vice President JD Vance’s holiday in the Cotswolds.

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It says human rights in the UK “worsened” in 2024, with “credible reports of serious restrictions on freedom of expression”, as well as “crimes, violence, or threats of violence motivated by antisemitism” since the 7 October Hamas attack against Israel.

On free speech, while “generally provided” for, the report cites “specific areas of concern” around limits on “political speech deemed ‘hateful’ or ‘offensive'”.

Sir Keir Starmer has previously defended the UK’s record on free speech after concerns were raised by Mr Vance.

In response to the report, a UK government spokesperson said: “Free speech is vital for democracy around the world including here in the UK, and we are proud to uphold freedoms whilst keeping our citizens safe.”

Keir Starmer and JD Vance have clashed in the past over free speech in the UK. Pics: PA
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Keir Starmer and JD Vance have clashed in the past over free speech in the UK. Pics: PA

The US report highlights Britain’s public space protection orders, which allow councils to restrict certain activities in some public places to prevent antisocial behaviour.

It also references “safe access zones” around abortion clinics, which the Home Office says are designed to protect women from harassment or distress.

They have been criticised by Mr Vance before, notably back in February during a headline-grabbing speech at the Munich Security Conference.

The report also criticises the Online Safety Act and accuses ministers of intervening to “chill speech” about last summer’s murders in Southport, highlighting arrests made in the wake of the subsequent riots.

Ministers have said the Online Safety Act is about protecting children, and repeatedly gone so far as to suggest people who are opposed to it are on the side of predators.

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The report comes months after Sir Keir bit back at Mr Vance during a summit at the White House, cutting in when Donald Trump’s VP claimed there are “infringements on free speech” in the UK.

“We’ve had free speech for a very long time, it will last a long time, and we are very proud of that,” the PM said.

But Mr Vance again raised concerns during a meeting with Foreign Secretary David Lammy at his country estate in Kent last week, saying he didn’t want the UK to go down a “very dark path” of losing free speech.

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The US State Department’s report echoes similar accusations made by the likes of Nigel Farage and Elon Musk.

The Trump administration itself has been accused of trying to curtail free speech and stifle criticism, most notably by targeting universities – Harvard chief among them.

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US woman Aimee Betro found guilty of conspiracy to murder Birmingham shop owner

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US woman Aimee Betro found guilty of conspiracy to murder Birmingham shop owner

A would-be assassin who flew from the US to kill a Birmingham shop owner as part of a violent feud has been found guilty of conspiracy to murder.

Birmingham Crown Court heard how Aimee Betro, 45, flew from the US to murder shopkeeper Sikander Ali at point-blank range outside his home in the Yardley area of the city in September 2019.

Prosecutors alleged that Betro hid her identity using a niqab when she tried to shoot Mr Ali – but the gun jammed, allowing him to flee.

Betro – originally from Wisconsin – was part of a plot orchestrated by co-conspirators Mohammed Nabil Nazir, 31, and his father, Mohammed Aslam, 56, who were in a violent feud with Mr Ali’s family.

Mohammed Nabil Nazir and Mohammed Aslam were jailed in November 2024.
Pic: West Midlands Police/PA
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Mohammed Nabil Nazir and Mohammed Aslam were jailed in November 2024.
Pic: West Midlands Police/PA

During her trial, Betro said she had travelled to the UK on two previous occasions, having met Nazir on a dating app.

Asked why she had paid a third visit to the UK, arriving at Manchester Airport from Atlanta around two weeks before the shooting, Betro told jurors: “To celebrate my birthday, and I won tickets for another boat party in London.”

The court was shown CCTV of Betro waiting for 45 minutes outside Mr Ali’s house on the night of 7 September 2019.

As Mr Ali arrived home, Betro approached him with a firearm, but the gun failed to fire. Mr Ali is seen jumping back into his car and reversing away, clipping Betro’s driver’s side door in the process.

CCTV image said to show Aimee Betro in Birmingham following the attempted shooting of Sikander Ali in September 2019. Pic: PA
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CCTV image said to show Aimee Betro in Birmingham following the attempted shooting of Sikander Ali in September 2019. Pic: PA

The court heard Betro then goaded Mr Ali’s father, Aslat Mahumad, with whom her co-conspirators had a feud, through text messages including: “Where are you hiding?”, “Stop playing hide and seek, you are lucky it jammed,” and asking him to meet her at a nearby Asda.

Jurors were told co-conspirators Nazir and Aslam had been injured during disorder at Mr Mahumad’s clothing boutique in Birmingham in July 2018, leading them to conspire to have someone kill him or a member of his family.

In the early hours of the next morning and just hours after the failed shooting, Betro booked a taxi and returned to Mr Ali’s home, where she fired three shots at the property, which was empty at the time.

She then fled back to the US the next day before becoming involved in another of Nazir’s plots to get revenge on a rival.

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Prosecutors also said Betro sent three parcels full of ammunition and gun parts to the UK on 16 October 2019.

The court heard the parts, which were wrapped in foil and paper inside three cardboard boxes, were addressed to a man from Derby, with Nazir tipping off the police with the intent to frame him.

While the packages were intercepted and the man arrested as part of what the prosecution said was Nazir’s “devious scheme”, his involvement in the plan eventually came to light, and he was released without charge.

Betro, it said, was seen at a post office 100 miles away from her home address in the US posting the parcels under a fake name.

In the case of each of those three packages, Betro’s DNA has been found on the gun parts and ammunition inside them.

Betro had claimed it was all a coincidence, saying the woman on the CCTV was another American who looked, dressed and sounded like her.

It was alleged that Betro was in Armenia when Nazir and Aslam were jailed for 32 years and 10 years respectively in November 2024, but was extradited in January this year to face her own criminal proceedings.

Jurors deliberated for almost 21 hours before convicting Betro of conspiracy to murder, possessing a self-loading pistol with intent to cause fear of violence, and a charge of illegally importing ammunition.

She was found guilty by majority verdicts on the conspiracy to murder and firearm charges, and by a unanimous verdict on the ammunition charge.

Speaking to Sky News, Detective Chief Inspector Alastair Orencas, from West Midlands Police’s Major Crime Unit, called Betro’s crime “a brazen attempt,” adding that there “doesn’t seem to be a whole lot of effort to avoid detection”.

“I think she fell foul of a really slick, dynamic law enforcement operation over here,” he said.

“I don’t know whether that was her perspective from America, that that’s how we operate, but zero tolerance around firearms, criminality on these shores.”

Betro was remanded in custody and will be sentenced on 21 August.

Hannah Sidaway, specialist prosecutor from the Crown Prosecution Service in the West Midlands, said: “Only Betro knows what truly motivated her or what she sought to gain from becoming embroiled in a crime that meant she travelled hundreds of miles from Wisconsin to Birmingham to execute an attack on a man she did not know.”

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Thames Water crisis: Ministers line up administrator for utility giant

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Thames Water crisis: Ministers line up administrator for utility giant

Ministers have lined up insolvency practitioners to prepare for the potential collapse of Thames Water, Britain’s biggest water utility.

Sky News can exclusively reveal that Steve Reed, the environment secretary, has signed off the appointment of FTI Consulting to advise on contingency plans for Thames Water to be placed into a Special Administration regime (SAR).

Sources said on Tuesday that the advisory role established FTI Consulting as the frontrunner to act as the company’s administrator if it fails to secure a private sector bailout – although approval of such an appointment would be decided in court.

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Thames Water, its largest group of creditors and Ofwat, the industry regulator, have been locked in talks for months about a deal that would see its lenders injecting about £5bn of new capital and writing off roughly £12bn of value across its capital structure.

The discussions are said to be progressing constructively, although they appear to rely in part on the prospect of the company being granted forbearance on hundreds of millions of pounds of regulatory fines.

Responding to an enquiry from Sky News on Tuesday, a government spokesperson said: “The government will always act in the national interest on these issues.

More on Thames Water

“The company remains financially stable, but we have stepped up our preparations and stand ready for all eventualities, including applying for a Special Administration Regime if that were to become necessary.”

Insiders stressed that FTI Consulting’s engagement by the Department for the Environment, Food and Rural Affairs (DEFRA) did not signal that Thames Water was about to collapse into insolvency proceedings.

A SAR would ensure that customers would continue to receive water and sewage services if Thames Water collapsed, while putting taxpayers on the hook for billions of pounds in bailout costs – a scenario the chancellor, Rachel Reeves, is keen to avoid at a time when the public finances are already severely constrained.

The SAR process can only be instigated in the event that a company becomes insolvent, can no longer fulfil its statutory duties or breaches an enforcement order, according to insiders.

Mr Reed has repeatedly stressed the government’s desire to avoid taking Thames Water into temporary public ownership, but that it was ready to deal with “all eventualities”.

“Thames Water must meet its statutory and regulatory obligations to its customers and to the environment–it is only right that the company is subject to the same consequences as any other water company.

The company remains financially stable, but we have stepped up our preparations and stand ready for all eventualities,” he told the House of Commons in June.

Thames Water, which has about 16m customers, serves about a quarter of the UK’s population.

It is drowning under close to £20bn of debt, and was previously owned by Macquarie, the Australian infrastructure and banking behemoth.

Its most recent consortium of shareholders, which included the Universities Superannuation Scheme and an Abu Dhabi sovereign wealth fund, have written off the value of their investments in the company.

The government’s SAR process has only been tested once before, when the energy retailer Bulb failed in 2021.

Bulb was ultimately sold to Octopus Energy with the taxpayer funding used to save and run the company since having been repaid.

Thames Water is racing to secure a rescue plan involving funds such as Elliott Management and Silver Point Capital, with a deadline of late October to appeal to the Competition and Markets Authority against Ofwat’s final determination on its next five-year spending plan.

Ofwat has ruled that Thames Water can spend £20.5bn during the period from 2026, with the company arguing that it requires a further sum of approximately £4bn.

Mike McTighe, a veteran corporate troubleshooter who chairs BT Group’s Openreach division, has been parachuted in to work with the funds.

The company said in its accounts last month that there was “material uncertainty” over whether it could be solvently recapitalised.

Earlier this year, Thames Water was fined a record £123m over sewage leaks and the payment of dividends, with Ofwat lambasting the company over its performance and governance.

In recent weeks, Thames Water has been engulfed in a row over the legitimacy of bonuses paid to chief executive Chris Weston and other bosses, even as it attempts to secure its survival.

Under new laws, Thames Water is among half a dozen water companies which have been barred from paying bonuses this year because of their poor environmental records.

The creditor group was effectively left as the sole bidder for Thames Water after the private equity firm KKR withdrew from the process, citing political and reputational risks.

The Hong Kong-based investor CK Infrastructure Holdings (CKI), which already owns Northumbrian Water, has sought to re-engage in talks about a rescue deal but has gained little traction in doing so.

News of FTI Consulting’s appointment also comes on the same day as a “nationally significant” water shortfall was declared across swathes of the country.

Last week, Sky News revealed that David Black, the Ofwat chief executive, was to step down following the publication of a government-commissioned review which recommended the regulator’s abolition.

He has been replaced by Chris Walters, another Ofwat executive, on an interim basis.

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