What does the pledge mean?

The government plans to raise the level of NHS activity, so that in England there are “an extra two million NHS operations, scans, and appointments every year”. It says this will help to “cut NHS waiting times”.

The Labour manifesto also describes this commitment as “40,000 more appointments each week, during evenings and weekends”.

The government’s “Plan for Change”, published on 5 December 2024, said: “To put us on track to reducing waiting times for elective care, the 2024 Autumn Budget provided funding to support the NHS to deliver the first step of an extra two million NHS operations, scans and appointments a year in England, equivalent to 40,000 additional appointments a week.”

We’ve asked the Department of Health and Social Care (DHSC) and NHS England about their specific plans for the pledge, and will update this page with any information we receive. In practice there are various kinds of NHS appointments, but it seems that the government is talking about elective hospital appointments specifically.

In its manifesto, Labour said it would achieve the pledge “by incentivising staff to carry out additional appointments out of hours” and that it will “pool resources across neighbouring hospitals to introduce shared waiting lists to allow patients to be treated quicker”.

Two million more appointments represents a relatively small rise in the context of the roughly 162 million hospital appointments that happened in the year to July 2024 (if we include all the appointments that were booked, whether or not they were attended). 

Indeed, in the period between Labour first making this pledge in October 2023 and coming to power in July 2024, the annual number of appointments had already risen by almost 10 million. 

We wrote an article about the scale of this pledge shortly before the election.

What progress has been made?

The extra out-of-hours appointments are not yet being offered to patients, as far as we can tell. But the chancellor, Rachel Reeves, did announce funding for them in the Budget on 30 October 2024.

What the government meant by “extra” is also a difficult question. If it simply meant that the annual number of appointments booked will eventually be two million higher than it was when Labour took office, then the pledge has already been met.

In the 12 months to July 2024, 161,122,613 elective hospital appointments were booked with NHS England (including those that were later cancelled or not attended), and in the 12 months to October 2024, the total had already reached 163,861,162 appointments. 

Alternatively, the government may have meant it would introduce a programme that would add two million appointments a year on top of what was happening anyway—in other words, that two million appointments would be delivered solely through its new out-of-hours appointments initiative. If so, we would need new data when a programme is launched, showing the number of appointments it is delivering. 

We asked the DHSC in November 2024 whether the pledge meant two million more appointments in total, or two million more appointments on top of what was happening anyway, and it told us that it had not yet set that out. We asked again in December 2024, after the government published its “Plan for Change”. We’ll update this page when we know more.

For the time being, we’ve rated this pledge as “In progress”, given the action that has been taken. Once the government has explained what the pledge actually meant, we’ll update that rating as needed.