Mental Health Watch - Spotlight on briefing
This briefing turns the spotlight on to the newest indicator on Mental Health Watch – which has only been reported publicly since spring 2024. Performance against the proposed, but yet to be implemented, four week waiting time standard for children and young people’s mental health services is now featured on the site, along with the percentage of patients waiting more than 52 weeks and more than 104 weeks for what is defined as a ‘full clock stop.’ This is when the child or young person receives an intervention such as evidence-based treatment, the development of a care plan, consultation, advice or signposting.
The four week target was included as part of the Mental health clinically-led review of standards[i], which was published by NHS England in February 2022. Meanwhile, a commitment to ‘reduce longest waits for CYP community mental health services by improving productivity, and reducing local inequalities and unwarranted variation in access’ has been included in the Medium Term Planning Framework[ii] for the NHS covering the period from 2026/27 to 2028/29 inclusive.
This data remains experimental but nonetheless acts as a boost to transparency of performance and it is anticipated that regular publication will help to drive up quality.
What does the latest data show about performance and variation?
Across the period from October-December 2025 inclusive, 37.1% of CYP referrals (16,266 of 43,792) across England had the ‘full clock stop’ within four weeks. This is the highest percentage on record, which dates back to the February-April 2024 period and exceeds the previous peak of 30.9% in October-December 2024 (9,370 of 30,327). Chart 1 below shows performance across the full data series published to date.
Of the 40 ICB areas that reported data for October-December 2025, the percentages seen within four weeks varied very significantly from just 5% in Sussex to 72% in Somerset. The full range of performance at ICB level is illustrated below in Chart 2.
In relation to the long waits, the NHS Digital reports the number of open referral spells still waiting for a ‘full clock stop’ after more than 52 weeks, 78 weeks and 104 weeks. On Mental Health Watch, we are separating out the percentages waiting for more than 52 weeks but not more than 104 weeks and then keeping the percentage for more than 104 weeks as reported. This can help to illustrate the extent to which long waits are being managed over time.
At the end of December 2025, 53.5% of open CYP referral spells had been waiting for more than 52 weeks (308,581 of 576,255) or 30.6% had been waiting for more than 104 weeks (176,316). The latter percentage is the highest on record (slightly above the 30.5% at the end of August 2025) and the former percentage is the second highest (only below 54.1% also at the end of August 2025).
The variation in the proportions of long waits at ICB level is from 11% in NHS Mid and South Essex ICB to 69% in NHS Hampshire & Isle of Wight ICB for those referrals waiting more than 52 weeks and from 5% in NHS Mid and South Essex ICB to 48% in NHS Cornwall and Isles of Scilly ICB.
Chart 1 – Percentage of CYP receiving full clock stop within 4 weeks of referral, England
Chart 2 – ICB performance against the proposed 4 week standard, Oct-Dec 2025
What was the state of play the previous month and one year earlier?
Performance against the proposed four week waiting time standard for a ‘full clock stop’ had been at the previous peak in September-November 2025, at 33.0%. Four of the 38 ICBs that reported data for that quarter achieved performance of 53% or more (NHS Somerset ICB – 71%, NHS Leicester, Leicestershire and Rutland ICB – 69%, NHS Kent and Medway ICB – 60%, NHS Cheshire and Merseyside ICB – 53%). On the other hand, 5 ICBs reported performance of 9% or less.
When turning a spotlight on to October-December 2024, that was the only other period on record where more than 30% of referrals received the full clock stop within 4 weeks, at 30.9% (9,370 of 30,327).
While the overall reported waiting list has, based on the latest available date, declined slightly by 2.0% between December 2024 (587,785) and December 2025 (576,255), the number of long waits has risen year-on-year. Referrals waiting for more than 52 weeks has increased by 7.3% (from 287,469 to 308,581) and for those waiting for more than 104 weeks the rise has been 19.6% (from 147,410 to 176,316). Chart 3 below shows the full range of performance against the proposed standard in the three months to December 2024 at ICB level, to illustrate the comparison to the corresponding period in 2025.
Chart 3 – ICB performance against the planned 4 week standard, Oct-Dec 2024
While 12 of 42 ICBs have reduced the numbers of referrals waiting more than 104 weeks for a ‘full clock stop’ when comparing the position at the end of December 2025 with that of December 2024, the remaining 30 have had an increase including 11 by 40% or more. NHS Lincolnshire ICB has seen an increase in referrals waiting more than two years of 2,544.4% (from 135 to 3,570). The greatest percentage reduction – 50.2% – has been seen in NHS Birmingham and Solihull ICB (from 4,540 to 2,260). Chart 4 below shows the trends over the past year in the ICB areas with the largest increases in long waiters.
Chart 4 – ICBs with sharpest increase in CYP waiting two plus years
How is performance reported for CYP waiting times?
Monthly data is published by NHS Digital as part of its wider Mental Health Services Monthly Data series. The precise number of eligible cases and those receiving a ‘full clock stop’ intervention within the four-week window and those waiting for more than 52 and 104 weeks across England, however local numbers at ICB level are rounded to the nearest five to avoid the risk of patient identification. Percentages at ICB level are reported to the nearest whole number only without decimal places.
The Multiple Submission Window Model (MSWM) now in place allows local areas to resubmit data later in the year. This briefing is based on ‘End of Year’ updated data where available (up to and including March 2025 as of this publication).
What next?
RCPsych will continue to analyse and monitor performance against the measure in future updates of Mental Health Watch to determine how close the system is to meeting the proposed four week wait standard and addressing the numbers waiting for more than 104 weeks for a ‘full clock’ stop’.
Sources
All of the performance data has been extracted from NHS Digital’s Mental Health Services Monthly Statistics dataset.[iii]
[i] NHS England. Mental health clinically-led review of standards. 22 February 2022. Available online: https://www.england.nhs.uk/publication/mental-health-clinically-led-review-of-standards/ [Accessed on 19 February 2026].
[ii] NHS England. Medium Term Planning Framework – delivering change together 2026/27 to 2028/29. 24 October 2025. Available online: https://www.england.nhs.uk/publication/medium-term-planning-framework-delivering-change-together-2026-27-to-2028-29/ [Accessed on 19 February 2026].
[ii] NHS Digital. Mental Health Services Monthly Dataset. 2025-2026. Available from: Medium Term Planning Framework – delivering change together 2026/27 to 2028/29. 24 October 2025. Available online: https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-services-monthly-statistics [Accessed on 19 February 2026].
