Cambridgeshire and Peterborough NHS Foundation Trust has been ranked the worst in England for treatment waiting times, despite senior managers receiving six-figure pay packages, new research claims.
The trust placed last out of 149 NHS organisations for referral-to-treatment (RTT) performance in January 2026, marking the second consecutive year it has held the bottom spot.
The findings come from the TaxPayers’ Alliance “NHS Rich List”, which examines senior management pay alongside performance data. It shows the trust’s chief medical director, Catherine Walsh, received total remuneration of £322,500 in 2024–25 - more than the British Prime Minister.
The report raises wider questions about the link between NHS spending, management pay and patient outcomes.
Health spending has increased sharply over recent decades, rising more than five-fold in real terms from around £45 billion in 1974–75 to £242 billion in 2024–25. Department of Health and Social Care spending alone rose by five per cent in the last year.
Even after accounting for population growth and ageing, the NHS budget is forecast to be nearly a third higher by 2028–29 than it was in 2013–14.
However, performance has struggled to keep pace with funding increases. Nationally, only around 60% of patients attending major A&E departments were seen within four hours in late 2025, well below the NHS target of 95% and the Government’s interim target of 78%.
For planned care, waiting times also remain significantly off track. Just 62% of patients began treatment within 18 weeks in October 2025, far short of the 92% constitutional standard.
Against this backdrop, the Cambridgeshire and Peterborough trust’s ranking highlights the scale of the challenge locally, particularly in reducing long waits for non-urgent treatment.
The TaxPayers’ Alliance report also points to rising pay at senior levels across the NHS. In 2024–25, 1,758 managers received more than £100,000 in total remuneration, a 3.8 per cent increase on the previous year.
More than 570 earned more than the Prime Minister’s salary of £172,153, while the number receiving at least £300,000 more than doubled to 292.
The research argues that some managers in poorly performing trusts are continuing to receive high pay despite ongoing issues with waiting times and patient care.
Nationally, performance varies. While some trusts have improved A&E waiting times, others continue to struggle, with East Cheshire ranked the worst for emergency department performance for a second year running.
The government has already signalled a tougher approach to NHS leadership, with plans to link senior managers’ pay more closely to performance. Under the proposals, executives could receive bonuses for improving care, while those in failing trusts may see pay progression reduced.
A spokesperson for the TaxPayers’ Alliance said the findings highlight the need for stronger accountability, particularly where patients face long waits.
However, it should be noted the analysis is based on a combination of Freedom of Information data and the group’s own methodology, and comparisons between trusts can be influenced by differences in services, patient demand and local pressures.
For patients in Cambridgeshire and Peterborough, the figures underline ongoing concerns about access to treatment — even as overall NHS funding continues to rise.
A spokesperson for Cambridgeshire and Peterborough NHS Foundation Trust said: “There is a very clear framework set down by NHS England regarding the remuneration of directors.
*For further context, although the figures are for the financial year 2024-2025, we should point out that Dr Cathy Walsh retired in July 2026 after a long and distinguished NHS career."
The spokesperson also added: "I would like to offer some context around the claim that CPFT had the worst referral-to-treatment waiting time of 149 trusts.
"The TaxPayers’ Alliance research refers specifically to RTT median waiting times, which measure the period from GP referral to the start of consultant-led treatment and are primarily reported by acute hospital trusts.
CPFT provides a wide range of services, including mental health care, community physical health nursing, learning disability support and social care.
"Of our more than 150 teams and services, only three — podiatry, type one diabetes and community paediatrics — are required to submit RTT median data. As such, the published figure reflects a very limited subset of our work and is not representative of the Trust’s overall performance.”
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