New data reveals rise in NHS appointments hailed by government is smaller than last year’s increase

New data obtained by Full Fact reveals that a 3.6 million rise in the number of hospital appointments—celebrated by the government as a “massive increase”—is actually smaller than the increase achieved the year before.

We’ve been investigating the government’s pledge to deliver “an extra two million appointments” for our Government Tracker, which is monitoring more than 50 Labour promises so that voters can judge how the government is doing, by its own standards.

Previously unpublished NHS data going back to 2018, released to us under the Freedom of Information Act, shows that the specific appointments that were the focus of Labour’s pledge to deliver additional activity had already been increasing for several years. The rise hailed by Labour is actually less than in the equivalent period in 2023/24, and broadly similar to the one in 2022/23.

Questions over the pledge

The hospital appointments pledge was a key part of Labour’s 2024 election campaign. But it wasn’t clear until months after the party came into government what kinds of appointments were being counted, or what kind of baseline “extra” was being measured against.

We asked the government many times exactly how it would measure the pledge, but it repeatedly failed to explain how it was defined.

As we wrote before the election, two million more appointments “would be quite a small rise”, when put in the context of all hospital activity. And in June 2024, the Institute for Fiscal Studies (IFS) said: “Such an increase in hospital activity would be smaller than the annual growth in demand pressures forecast by the government’s Long-Term Workforce Plan (2.1% per year).” It would be a rise, in other words, but probably less than was needed.

Answers at last

When NHS England finally published the data behind the pledge in February, it answered some of our questions. It turned out that the government was measuring its performance by counting just certain types of hospital operation, test or appointment. We updated our Government Tracker page to explain what we knew.

But there was no published history of this data which would allow us to compare the recent rise to previous years—and as far as we can tell, there still isn’t. (While NHS England publishes a wide range of data, this doesn’t seem to include historic figures on the specific set of operations, scans and appointments that the government said was the focus of its pledge.) This meant it was still impossible to know whether a rise of over two million appointments in five months (now 3.6 million in eight months) was really a big deal.

After all, England’s population is growing, and ageing. Government health spending and the NHS workforce have been growing too. You’d expect people to need more appointments every year, and given the extra money being spent, you’d expect more to be provided to meet the demand.

So we submitted a Freedom of Information request to NHS England, and at the end of April we obtained the data going back to 2018. This at last reveals that the number of these appointments was rising for several years before Labour took office.

Indeed the rise of 3.6 million in the first eight months of the Labour government, which the health secretary Wes Streeting described this month as a “massive increase”, is actually smaller than the 4.2 million rise that happened in the equivalent period the year before. (This is after the figures have been standardised to account for the varying number of working days per month. Our calculations standardise the figures to the latest period, following a similar method to that used by NHS England in the published data.)

In percentage terms, the 3.6 million rise is 7.7% more than in the same eight-month period the year before, but it follows rises of 10.1% and 8% in the previous two years.

As for the figure of two million, we now know that it was a promise to deliver what would be by far the smallest rise in these appointments since the height of the pandemic. A Statistical Ambassador for the Royal Statistical Society, Nevil Hopley, reproduced our calculations and reached the same results.

We shared the data we obtained with the IFS, which told us: “As we said at the time it was announced, the target was never particularly ambitious: two million additional operations, scans and appointments is relatively small compared to the number of people the NHS treats each year. And in recent years, this measure of activity has grown by much more than two million a year."

None of this means that the government isn’t improving the NHS. That’s a much larger question, and Labour’s term in power still has years to run.

And while the rise in appointments may not seem remarkable compared with previous years, it does obviously still mean that hospitals have been doing more than before.

When we asked the Department of Health and Social Care about the figures, it told us: “On entering office last July, the Secretary of State was advised that the fiscal blackhole meant elective appointments would have to be cut by 20,000 every week. Instead, this government provided the extra investment needed to deliver more than three million additional appointments, significantly dwarfing our own pledge.”

This new data adds much-needed context to the government’s claims about the NHS, and it should not have required a Freedom of Information request for it to be released. If politicians are unwilling to be transparent about their promises, voters have every reason to wonder what is hidden in the small print they don’t share.

For more on the government’s performance in delivering its pledges, take a look at our Government Tracker.