The number of patients in Wales escaping to seek treatment in England has increased by 40% in two years
Health secretary Steve Barclay told delegates at the Conservative Party conference last week that the number of patients “escaping” Wales for treatment in England has risen by 40% in two years.
This claim appears to be based on unpublished data. When we contacted Mr Barclay and the Conservative party to ask where the figures came from, neither responded. NHS England collects this data but it is not routinely published. The Department of Health and Social Care and the Welsh Government both told us they do not publish such figures, and we’ve not been able to find the data elsewhere.
A similar statistic to that used by Mr Barclay has been reported by the media based on “internal NHS figures” for 2020/21 and 2022/23, however. If the statistic is accurate, Mr Barclay’s claim may be missing context, because patients from England also cross the border into Wales for treatment, and the number of non-Welsh patients treated in Wales rose by 55% from 2020/21 to 2021/22 according to the Welsh Government. Both sets of figures may also have been affected by the pandemic.
When Government departments and ministers make unevidenced claims and don’t publish data to support these claims, the public don’t have the ability to scrutinise and challenge claims made by those in power. Ministers must provide evidence for what they say, and ensure that any statistics and data they rely on to back up their claims are provided publicly in accordance with the Code of Practice for Statistics or relevant guidance.
Selective or misleading use of official information without appropriate context and caveats can also damage public trust in public bodies and officials.
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How many people are crossing the border for treatment?
Mr Barclay did not say in his speech what the 40% figure was based on.
But it appears to be very similar to a front page report in the Daily Mail in August which said 39,485 patients from Wales sought elective treatment, such as hip and knee operations, in England in 2022/23–up 39% from 28,405 in 2020/21.
The article does not say where the figures have come from, but describes them as “internal NHS figures”–and the Mail was unable to elaborate when we asked it for more information. NHS England collects this data but it is not routinely published and we have been unable to find anywhere else these figures have been published. We have asked NHS England if the figures reported are correct, but have not heard back.
If the figures are accurate, on their own they only tell us part of the story.
The Welsh Government told Full Fact that patients also cross the border from England into Wales for treatment and that the number of non-Welsh patients treated in Wales fell during the first year of the pandemic, before increasing again.
Data from Digital Health and Care Wales shows that in 2019/20 there were 11,127 non-Welsh residents admitted for treatment in Wales. This fell by 46% to 6,015 in 2020/21—the first year of the pandemic—before increasing by around 55% to 9,298 in 2021/22. Figures for 2022/23 are not available yet.
This shows there was a significant drop in patients travelling to Wales for treatment during the first year of the pandemic, and a significant increase the following year.
We do not have figures for Welsh patients travelling to England in 2019/20 (the year leading up to the pandemic) so can’t say for certain if the same trend was observed in the other direction. However it is possible that the 40% rise cited by Mr Barclay was driven at least in part by the impact of the pandemic and the ending of lockdowns and other Covid restrictions.
Other figures show there was a significant drop in waiting lists and elective care activity following the first lockdown in March 2020, and waiting lists, new referrals and completed pathway numbers have all since risen again.
Image courtesy of the House of Commons