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Acute hospital trusts in England are organisational units within the NHS, providing services such as emergency departments and short-term treatments. As of 2022, there are 215 NHS trusts across the UK, with 124 acute trusts in England. The number of trusts has changed over time, with mergers and the establishment of chains of hospitals occurring since their introduction in 1991. Acute hospital trusts have faced challenges in recent years, with all trusts in England failing to meet the target of treating 92% of patients within 18 weeks.
| Characteristics | Values |
|---|---|
| Number of acute hospital trusts in England | 124 |
| Total number of NHS trusts in the UK | 215 |
| Number of doctors in the NHS | 132,900 |
| Number of nursing staff in the NHS | 350,600 |
| Number of managers in the NHS | 36,600 |
| Number of hospital beds in the NHS | 141,960 |
| Number of people on the waiting list | 7.54 million |
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What You'll Learn
Acute hospital trusts in England provide emergency departments
As of 2022, there are 215 NHS trusts across the UK. However, this number is subject to change as new trusts are often created, or existing trusts sometimes merge. For example, the University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) was, before 2020, two separate trusts. As of April 2020, 217 extant trusts employed about 800,000 of the NHS's 1.2 million staff. The number of hospitals managed by NHS trusts varies across the UK. Some trusts, like Manchester University NHS Foundation Trust, manage as many as 10, while others are far smaller.
There is a growing number of hospitals, and therefore a growing number of hospitals for NHS trusts to manage. The government recently committed to building 40 more by 2030. However, most analysts say that the number of hospital beds is a more useful and insightful measure. This number, at the most recent count, stands at 141,960. That number has halved in the last 30 years, while demand has increased dramatically.
In 2025, every acute hospital trust in England failed to hit Keir Starmer's target to treat 92% of patients within 18 weeks. Acute hospital trusts where more than half of patients were waiting more than 18 weeks for treatment in October 2024 include Manchester University NHS Foundation Trust, Milton Keynes University Hospital NHS Foundation Trust, and University Hospitals Sussex NHS Foundation Trust.
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Acute hospital trusts in England provide short-term treatments
As of 2022, there are 215 NHS trusts across the UK, employing about 800,000 staff. The number of trusts has changed over time due to mergers and acquisitions. For example, in 2021, the Salford Royal NHS Foundation Trust and the Pennine Acute Hospitals NHS Trust merged to form the Northern Care Alliance NHS Group. The number of hospitals managed by each trust varies, with some managing as many as 10 hospitals, while others manage fewer.
The long-term trend shows a growing number of hospitals, with the government committing to building 40 more by 2030. However, analysts argue that the number of hospital beds is a more useful metric, as demand has increased dramatically over the years. As of the most recent count, there are 141,960 hospital beds, which is half the number from 30 years ago.
Acute hospital trusts in north-west London, such as Chelsea and Westminster Hospital NHS Foundation Trust and Imperial College Healthcare NHS Trust, have strengthened their partnership working to improve patient care. They have formed a new board in common to make strategic decisions, share best practices, and develop high-quality services. These partnerships have helped reduce waiting times and allowed patients to be seen more swiftly.
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Acute hospital trusts in England are missing Labour's 18-week target
Analysis of the figures shows that out of 124 acute trusts, none are hitting the target. In some trusts, more than half of the patients are waiting longer than 18 weeks. The NHS Confederation reported that by 2028/29, the NHS must undertake 50% more elective activity than it currently is to clear the backlog. The government has promised to meet the target by March 2029, with individual performance targets set for each hospital trust by March 2026.
Some trusts have shown improvement, such as The Princess Alexandra Hospital Trust in Harlow, which saw a rise from 41.8% to 48.8% of patients waiting less than 18 weeks. However, some trusts have seen a dip in their figures since November. The long waiting times are due to poor patient flow, increased demand, the backlog of care, and workforce shortages.
The Department of Health and Social Care has set an ambitious plan to tackle the NHS backlog, aiming to deliver two million extra appointments in the first year and sending crack teams of clinicians to hospitals to improve productivity. The NHS overall in England is expected to ensure 65% of patients do not wait longer than 18 weeks, with the majority of trusts making progress.
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There are 124 acute hospital trusts in England
Acute hospital trusts in England provide services such as emergency departments and a wide range of typically short-term treatments. As of 2025, there are 124 acute hospital trusts in England, employing around 800,000 of the NHS's 1.2 million staff. However, the number of trusts has changed over time, with mergers and acquisitions leading to fluctuations in the total count. For instance, in April 2020, there were 217 trusts, while as of 2022, there were 215 trusts across the UK.
The number of hospitals managed by each NHS trust varies, with some trusts managing as many as ten hospitals, while others manage far fewer. As of 2015, there were about 2,200 non-executives across 470 organisations within the NHS in England. The trust system was first established in 1991, with 57 trusts, and the number has grown over time.
The long-term trend indicates a growing number of hospitals, and by extension, a growing number of hospitals for NHS trusts to manage. The government has committed to building 40 new hospitals by 2030, although analysts have questioned the feasibility of this pledge. The definition of 'new hospitals' has also evolved, now encompassing new buildings or wings within existing hospitals or major refurbishments.
Despite these efforts, the NHS faces challenges, with a significant increase in demand over the last 30 years. The number of hospital beds has halved during this period, contributing to long waiting times. Acute hospital trusts in England are struggling to meet targets, with none out of 124 trusts achieving the goal of treating 92% of patients within 18 weeks. This target was last met in September 2015, and the waiting list has since grown substantially, with approximately 6.34 million individual patients waiting as of October 2024.
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Acute hospital trusts in England employ around 800,000 staff
The number of hospitals managed by each trust varies, with some managing as many as 10, while others are much smaller. Trusts are generally divided by geographical area or function, with some specialising in mental health or community health services. As of 2022, there were 215 NHS trusts across the UK, with the government pledging to build 40 more hospitals by 2030.
The long-term trend indicates a growing number of hospitals, which has resulted in a growing number of hospitals for NHS trusts to manage. However, the number of hospital beds has halved in the last 30 years, and demand has increased dramatically over the same period. This has contributed to the challenges faced by the NHS, including long waiting times. As of January 2025, all acute hospital trusts in England were failing to meet the target of treating 92% of patients within 18 weeks.
To address these challenges, the NHS has implemented initiatives such as sending specialist teams to hospitals to improve productivity and securing additional funding for new surgical hubs, scanners, and beds. Despite these efforts, there is still a significant shortage of staff within the NHS, with well over 100,000 vacancies.
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Frequently asked questions
As of 2025, there are 124 acute hospital trusts in England.
As of 2022, there are 215 NHS trusts across the UK.
As of April 2020, there were 217 NHS trusts employing about 800,000 of the NHS's 1.2 million staff.
An NHS trust is an organisational unit within the National Health Services of England and Wales, serving either a geographical area or a specialised function.
