NHS waiting list was not falling before the pandemic

Actually the numbers [in the waiting list] were falling before the pandemic hit on many measures.

The Deputy Prime Minister, Oliver Dowden, claimed during a discussion about NHS waiting lists on Sky News that the numbers were falling before the pandemic “on many measures”.

Claims about rising or falling numbers are often ambiguous, because something can be both higher and lower than it used to be, depending on which moment in the past you compare it with.

We’re also not sure which measures Mr Dowden had in mind, or exactly which month he would consider the last before the pandemic. Full Fact has asked him about this, but not yet received a reply.

However, the number of cases still waiting for elective (i.e. non-emergency) NHS treatment in England (where the UK government controls the NHS) was the measure that Mr Dowden and his interviewer Trevor Phillips had been talking about. And this was not falling at the end of February 2020, by most reasonable ways of looking at it.

Indeed the number of cases on this waiting list at the end of February 2020, the last month before lockdown, was the second highest ever recorded, and higher than in 11 of the previous 12 months.

In a briefing last year, the Nuffield Trust, an independent health think tank, said: “The total waiting list for elective care was steadily increasing before Covid, from 2.5 million in April 2012 to 4.6 million in February 2020. At the beginning of the pandemic, the waiting list dropped to 4 million as GP appointments and referrals fell.”

This waiting list, known as the RTT or “referral to treatment” waiting list, represents the number of cases (known as “pathways”) where someone has been referred for non-emergency treatment under the care of a consultant, but that treatment hasn’t started yet. It doesn’t include every case of someone waiting for something in NHS England, but it is commonly referred to in the media as the “NHS waiting list”.

Another leading measure of performance in elective care is the percentage of cases treated within 18 weeks. This is a right all patients have under the NHS Constitution, but it was also not improving before the pandemic began.

Mr Dowden may have been referring to other ways of measuring waiting lists. As we’ve said before, there are several different kinds of waiting list, and many different ways of looking at them, so it is possible that some were falling before the pandemic, when looked at in some ways.

It’s also broadly true that the overall elective care waiting list for NHS England has grown more rapidly since the early months of the pandemic. 

However, Mr Dowden’s comments were made during a discussion of the specific figure of 7.71 million, which is the number of incomplete pathways at the end of October 2023. And this measure was not falling before the pandemic.

Mr Phillips called the 7.71 million figure a record, which strictly speaking is not quite right, as it is slightly lower than the previous month.

Politicians should describe official data fairly and accurately. If people are misled about what the data shows, it could distort their judgement when they vote.

Image courtesy of Richard Townshend