MBI-supported trusts achieve average 8% improvement in RTT performance through national validation programme
NHS trusts supported by MBI Health during NHS England’s RTT validation sprint programme achieved an average 8% improvement in 18-week RTT performance over the course of 12 months, demonstrating the critical role trusted waiting list data plays in elective recovery.
Over the course of the programme, MBI supported 18 NHS trusts with RTT PTL validation and waiting list assurance activity. Analysis focused on the 12 trusts where MBI maintained sustained engagement across most or all phases of the programme and where work was primarily aligned to sprint-related validation activity.
Using publicly available NHS England RTT submissions between April 2025 and March 2026, the analysis showed substantial improvements in both operational performance and waiting list position across those organisations.
Across the 12 participating trusts, MBI helped to achieve:
- more than 80,000 pathway removals
- an average 9% reduction in RTT PTL size
- reduction of more than 10,000 pathways waiting longer than 52 weeks
- an average reduction in waiting times of approximately 3 weeks
- and, most significantly, an average 8% improvement in 18-week RTT performance
The findings are particularly notable in the context of NHS England’s 2025/26 operational planning guidance, which asked trusts to deliver a minimum 5% point improvement in RTT performance by March 2026.
While no single intervention alone drives elective recovery, the programme reinforced a pattern MBI has consistently observed across the NHS: organisations improve performance faster when they regain confidence in the accuracy and reliability of their waiting list data.
Validation as a performance enabler
The validation sprint programme was designed to help trusts rapidly review and validate elective waiting lists, identifying pathways that no longer required care, correcting inaccurate pathway states, and reducing the risk of patients being lost within operational processes. The work delivered through the programme was primarily manual RTT pathway validation, undertaken by specialist validation teams working directly with trusts to review patient pathways at scale.
However, the impact extended well beyond waiting list reduction alone. By improving the accuracy of RTT data and reducing operational noise within PTLs, trusts were able to strengthen patient tracking, improve prioritisation of long waiters, deploy capacity more effectively, and make more confident operational decisions.
The programme reinforced a wider operational reality increasingly recognised across the NHS: sustainable elective recovery depends on having confidence in the underlying waiting list data. Where pathways are duplicated, incomplete, incorrectly categorised, or no longer clinically active, organisations can struggle to accurately understand demand, prioritise risk, or target capacity where it is most needed.
The scale of RTT improvement observed across the sprints demonstrates that validation is not simply an administrative exercise, but an important operational enabler that supports performance improvement, reporting confidence, and patient safety.
Recognition for improvement
Several organisations involved in the programme demonstrated significant elective recovery progress over the course of the year, including University Hospitals of North Midlands NHS Trust, which achieved both its year-end RTT performance target and stretch ambition, and London North West University Healthcare NHS Trust, which was recognised nationally for its elective improvement performance.
Sue Perks, Head of Elective Access at University Hospitals of North Midlands NHS Trust, said:
“Achieving our RTT improvement target, and ultimately exceeding our stretch ambition, required a combination of sustained operational focus, clinical engagement, and trusted waiting list data.
Working with MBI through the validation programme helped us improve visibility of our patient pathways, strengthen operational control of the PTL, and reduce data quality issues that were affecting reporting confidence and pathway management. That clarity helped support our elective recovery programme and played an important role in helping us achieve our year-end RTT performance goals.”
The progress seen across participating trusts highlighted the value of combining focused operational improvement with robust waiting list validation processes to support sustainable elective recovery beyond short-term interventions.
Building on the programme
Although the validation sprint programme may not continue in its original form, the operational need for waiting list validation and assurance remains. NHS England’s latest planning guidance continues to emphasise the importance of regular RTT validation and improved waiting list governance as part of elective recovery.
For many organisations involved in the programme, the focus has now shifted from large-scale validation exercises towards establishing more sustainable, continuous approaches to PTL assurance. The sprints reinforced that while manual validation can rapidly improve visibility and performance, maintaining confidence in waiting list data over time requires ongoing assurance processes and operational oversight.
As a result, a growing number of trusts are now implementing, or exploring, longer-term approaches to sustainable validation and waiting list management supported by MBI’s LUNA° and ROVA° platforms. LUNA° and ROVA° support trusts to move beyond periodic validation exercises by combining structured EPR data with information extracted from unstructured clinical documents to identify pathway risks, missing outcomes, duplicate pathways, and emerging data quality issues earlier and more consistently.
Emilios Evangeli, Operations Director at MBI Health, said:
“What the validation sprints made very clear is that validation is not simply a one-off data quality exercise. It is a critical operational discipline that underpins sustainable elective recovery.
Across the trusts we worked with, improving confidence in RTT data helped teams reduce operational noise, strengthen pathway management, and focus effort on the patients who genuinely required action.
The programme also reinforced that maintaining those improvements over time requires ongoing assurance, not periodic clean-up exercises alone. The scale of improvement in 18-week RTT performance across these organisations shows the impact trusted operational data can have when combined with sustained clinical and operational focus.”
