NHS England report on waiting lists confuses patients and cases

An interactive report published by NHS England incorrectly claims that its figures count the number of “patients” receiving or waiting for treatment.

The figures in the report actually count the number of “pathways” or cases where somebody is waiting for treatment, or has just started to receive it. 

As we have said many times before, the number of patients is different, because some patients need treatment for more than one thing, meaning they will be involved in more than one case. There are currently about 84 unique patients for every 100 ongoing waits.

The latest data actually shows there are about 6.4 million patients waiting for treatment, rather than about 7.6 million, as in the NHS spreadsheet for August 2024. 

An NHS England spokesperson told Full Fact: “This report was designed to present the waiting list figures in an easy-to-understand way for patients, but we welcome any feedback and will review the wording ahead of next month’s release.”

In recent months we’ve repeatedly seen politicians from different parties and the media seem to confuse the number of cases on the NHS waiting list with the number of patients. Our AI tools have counted more than 50 such claims since last November. 

We think government agencies and other public bodies should try to be as accurate as possible when producing statistics, so that the public can clearly understand what they mean. 

What the NHS England report says

At the time of writing, the report is available from a link marked “Download Waiting Times by Hospital Trust” on the Referral to Treatment (RTT) Waiting Times section of the NHS England website.

Clicking the link automatically downloads an Excel spreadsheet that allows users to read the latest month’s data on a range of measures, including “What proportion of patients were waiting within 18 weeks?” and “How many patients were waiting to start treatment?”

In fact, all of these figures refer to pathways rather than patients. For instance, the spreadsheet says there are 7,643,214 “patients … waiting to start treatment” in England as a whole, but the same figure appears as the number of “Incomplete RTT pathways” in the “RTT Overview Timeseries” download that is available on the same webpage.

The report includes a notes section, but it contains no warnings that the numbers refer to pathways rather than patients.

This report has been published regularly since the early 2010s, and it has always referred to “patients”, except in the version published on 9 November 2023, when NHS England first began to report an estimate for the number of patients on the RTT list. 

In that month’s report, the figures were described as “patient pathways”, but this was changed back to “patients” in subsequent editions.

NHS England’s RTT data only counts cases where someone is awaiting consultant-led non-emergency treatment, so it doesn’t include every instance of someone waiting for something from the NHS. 

In a survey conducted between last October and March this year, the Office for National Statistics estimated that around a quarter of adults in Great Britain were “currently waiting for a hospital appointment, test, or to start receiving medical treatment through the NHS”. This would amount to about 13 million people.