The NHS backlog in England has reached a record high, with 7.77 million people waiting for non-emergency care by the end of September. What is more concerning is that about one million people are on multiple waiting lists for treatment, with some on up to five lists. The waiting list is now nearly 3.5 million higher than pre-pandemic levels. The Royal College of Nursing's chief nurse, Prof Nicola Ranger, attributes this to a shortage of nurses, and suggests the Government has lost control of waiting times. Although progress has been made in reducing waits of more than 18 months, ongoing strikes by healthcare workers have disrupted efforts. The strikes have cost the NHS an estimated £1 billion in premium rates and preparations. The Government's rejection of extra funding for strike-related costs has forced the NHS to use existing budgets, including those for IT and maintenance, to address the backlog. This has led to a relaxation of treatment targets, acknowledging the prolonged effort needed to address the backlog.