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Generally, I’d caution against using weekly data on NHS performance but comparing how A&E copes on special weeks such as the one around Christmas is suggestive of meaningful change.
Above, the percentage seen within 4 hrs in NHS Scotland Type 1 A&E departments suggests a significant improvement in that high pressure week around Christmas Day, of around 18%.
The monthly averages, also, confirm improvement. Remember that 3.5% increase is 3.5% of tens of thousands of patients.
You may be thinking, what if end December 2025 was milder, less icy, than end December 2022?
Both years are likely to have ice and slippery conditions, but 2025’s warnings suggest more widespread ice hazards with falling temperatures and snow showers.
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Talking-up Scotland 
A record number of hip and knee replacements were carried out in 2024 than in 2019 (pre-Covid).
I expect the number of replacements carried out in 2025 will be even higher.
From 5 August 2025 –
https://www.gov.scot/news/record-numbers-of-hip-and-knee-operations-performed-last-year/
“There has been an increase in planned operations across NHS Scotland, as recent statistics reveal that the number of hip and knee arthroplasty operations reached an all-time high in 2024.
The statistics from The Scottish Arthroplasty Project reported that 17,399 first (primary) hip or knee replacements performed in NHS Scotland hospitals in 2024 compared to 15,908 in 2019.
The annual report also showed that over the last 10 years the mean length of hospital stays, for both primary hip and primary knee procedures, has decreased from 5 days to 2.6 days.”
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There is a looming problem affecting the supply of the bone cement required for these types of operations and this may affect the stats for this year.
The main supplier of this type of cement for the NHS is a company in Germany. They are having problems which are affecting supply and may take up to 2 months to get production up and running again. The NHS has about 2 weeks supply left which will have to be rationed in some way but won’t last for 2 months. This situation is likely to significantly impact the number of these operations that can be carried out.
https://www.theguardian.com/society/2026/feb/18/nhs-hip-and-knee-operations-threatened-by-bone-cement-supply-shortage
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‘A&E performance around Christmas peak pressure suggests major improvements’ – not in NHS England it seems when it comes to the important ‘over 12 hour waits’ metric!
The Royal College of Emergency Medicine (RCEM) had this headline for a press release on February 12: ‘The wheels have come off’: predictably busy January exposes ‘fragile’ NHS system as A&Es swamped with patients needing beds’. That was its view following the publication of NHS England’s Emergency Department performance statistics for January 2026, and its ‘situation report’ for the week ending 8 February.
The RCEM states: ‘Today’s data showed that more than one in seven patients who attended a major ED in England last month were subject to a wait of more than 12 hours to be discharged, admitted or transferred: a total of 192,168 people.’ This we’re told is the second-worst month for 12-hour waits in Emergency Departments on record.
It adds: ‘The proportion of patients waiting less than four hours remained about the same as the previous January, from 57.7% to 57.3%.’ And: ‘A total of 71,517 of the sickest patients – those who were waiting for admission into a hospital bed – waited on trolleys in an ED for more than 12 hours after a decision to admit was made – the worst of any month on record.’ (My emphasis)
It also reports: ‘… the average number of beds occupied by patients who were medically fit to be discharged stood at 13,823 across England, the second-highest of any month on record.‘
By my reckoning, that’s two second worst months and one worst of any month on record achieved by an A&E system for which Labour in Westminster is responsible! Imagine this was happening in Scotland!
The official NHS England data release states:
‘Of the total attendances at Type 1 and Type 2 A&E Departments in January 2026, 192,168 spent over 12 hours in department from arrival to admission, discharge or transfer (13.1%), an average of 6,199 per day.’
‘Of the total attendances at Type 1 and Type 2 A&E Departments in December 2025, 154,018 spent over 12 hours in department from arrival to admission, discharge or transfer (10.5%), an average of 4,968 per day.’
Source https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2026/02/ECDS_Supplementary_Analysis_Statistical_Commentary_February_2026_QRT5FW.pdf
That’s a remarkable deterioration in the over 12 hour metric between December and January! Imagine this had happened in Scotland!
When reporting on NHS England’s performance data released on February 12, the BBC News website opted for this headline: ‘NHS waiting list at lowest level in three years’. We’re told: ‘At the end of December 2025 there were 7.29 million patients waiting for treatments such as knee and hip operations. That is the lowest number since February 2023.’
On 20 January, 2026, the BBC News website had this headline’: ‘The hospitals where waiting times are getting worse. Is yours one of them?’. It reported that the waiting list in England had fallen to 7.31 million, the lowest level since February 2023. So some but slow progress in cutting this waiting list has been achieved over c. 2 years.
However, this positively framed headline for the February 12 article may seem a bit too positive when later in the piece one reads: ‘But while the waiting list did drop, performance against the 18-week target declined slightly. Some 61.5% of patients were waiting less than 18 weeks – compared to 61.8% in November. The target is 92%, which the government has promised to meet again by 2029.’
The BBC February 12 article does make reference to the same A&E performance data referred to in the RCEM press release , noting: ‘.. a record number of 12-hour trolley waits’ and ‘More than 71,500 patients spent longer than 12 hours in January 2026 waiting for a bed …. – the highest figure since it started being tracked in 2010.’
Anyone prepared to speculate which statistic the BBC would have chosen to headline if this had been happening in NHS Scotland – the slightly smaller waiting list or the worsening 12 hour metric for A&E?
The BBC article omits any mention of the 2.6 percentage point deterioration in the 12 hour waits statistic from December 2025 to January 2026. It omits to mention the difference in the average number of patients spending over 12 hours during December 2025 compared to January 2026 – a difference of over 1,200 patients each day!
These damning facts are not worthy of a BBC headline, unlike a marginal improvement in elective waiting list metric. Experience tells us the article would have been headlined and written quite differently if this had been happening in Scotland! And for the record, no opposition politician in Westminster was quoted making a critical comment and no Labour government minister was challenged in the BBC piece.
For perspective, in its report on performance of Scotland’s Type 1 emergency departments during the week ending February 8, 2026, Public Health Scotland had this: ‘2,095 (7.9%) patients spent more than 12 hours in a type 1 Department (compared to 2,088 (7.9%) the previous week, and 1,445 (5.3%) weekly average for 2025).’
Let’s hope that NHS Scotland can continue to improve its performance: let’s hope that through higher productivity and some way of accessing additional funding for staff and capital equipment it can do so substantially and soon. Let’s hope NHS England can do likewise.
The big difference is that the government responsible for NHS England has unfettered access to additional funds for investment in health and social care (and in every other devolved public service). Whatever Westminster decides England’s voters need and want in terms of health and social care provision impacts what Scotland, NI and Wales can afford to do.
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