Widespread confusion over number of ‘people’ on NHS waiting lists

Several politicians, newspapers and social media users have mixed up the number of people and the number of cases currently on NHS England’s elective care waiting list.

In the most recently published data, which describes the situation at the end of September 2023, there were about 7.8 million cases, known as “pathways”, where someone was awaiting treatment.

However some people are waiting to be treated for more than one condition, which means they are on more than one pathway. This in turn means that the number of people on the waiting list is smaller—and in the most recent data, this number was published for the first time.

At the end of September, there were in fact about 6.5 million people waiting for at least one form of elective treatment from the NHS in England.

Waiting list claims

Last week we wrote about several Labour politicians—party leader Sir Keir Starmer, shadow chancellor Rachel Reeves and MP Dame Angela Eagle—claiming that there are “7.8 million people” on NHS waiting lists.

We’ve since also identified the same claim on a Labour web page, and being made in Parliament by shadow Treasury minister Tulip Siddiq, the Labour MPs Rachael Maskell, Andrew Western and Dame Angela Eagle again, and the Liberal Democrat MP Sarah Olney.

It has also appeared in a Times article and an Independent article (both now corrected), a Guardian column by Polly Toynbee, a headline in a Facebook post from the i newspaper and a press release from the Royal College of Surgeons. Several people have also made the same mistake on social media.

Waiting lists are complicated

Figures from the NHS England elective care waiting list are very often quoted in public, but it doesn’t include everyone waiting for any kind of NHS treatment. Waits for several selected diagnostic tests are recorded separately, for example, as are waits for organ transplants.

Health policy for Scotland, Wales and Northern Ireland is devolved, with the UK government responsible for NHS England. As a result, claims about waiting lists in context of the UK government’s record usually refer to English waiting lists specifically.

The examples listed above all appear to refer to the waiting list in England, because the 7.8 million figure is recorded in the most recent NHS England data—albeit in relation to pathways rather than patients. We’ve not seen NHS data for the total number of patients on waiting lists across the UK.

The other UK nations report data on their waiting lists separately, which means it may not be directly comparable to England’s. (We’ve written before about the different ways that waiting lists in England and Wales are recorded.)

The latest data for Scotland at the time these claims were made showed that there were about 518,000 cases where someone was still waiting for outpatient treatment at the end of June, and about 150,000 inpatient or day cases. (These rose to about 526,000 and 151,000 at the end of September in more recent data.) 

Data in Wales shows about 761,000 cases waiting at the end of September.

In Northern Ireland at the end of June, about 119,000 patients were waiting for inpatient or day-case admission, and about 416,000 were waiting for a first consultant-led outpatient appointment.

However, there doesn’t appear to be a reliable way to combine these figures into a UK total.

Before NHS England recently began publishing the number of unique patients waiting, it was common to see organisations or media outlets referring to figures for outstanding treatment pathways as “people on the waiting list”, even though this wasn’t accurate.

Claims corrected

Politicians and the media must take care to use the best evidence available and describe it accurately, so people are not misled about the state of public services.

Following contact from Full Fact, Ms Siddiq’s office said it would ask Parliament to correct the record. Ms Maskell said she was happy to talk about episodes of care in future. As we’ve mentioned above, the Independent and the Times also corrected their articles.

The Royal College of Surgeons told us: “[NHS England] published the multiple pathways data for the first time in November, showing that the number of unique patients is estimated to be around 6.5 million. We did include this information in notes to editors in our press release and will be including the breakdown in future communications.

“The waiting lists show that there is a huge demand on services, one person may be on multiple pathways for treatment, possibly for several conditions at the same time. This does not lessen the pressure on the system, particularly as winter pressures have already started to take effect.”

We have approached everyone else named in this article for comment.

Image courtesy of Sasun Bughdaryan