stewartb
As has been highlighted before on TuS, one needs to look closely and critically at performance statistics for NHS England. They are not always what they seem – cf. 12 hour A&E waits. The Nuffield Trust is now exposing yet more dodgy data.
Source: Nuffield Trust (August 13 2025) Why is the planned care waiting list coming down and what does the data really tell us?
Context: ‘When Wes Streeting celebrated the improvement in the waiting list – saying “thanks to our interventions and the hard work of NHS staff, the overall waiting list has now fallen in April for the first time in 17 years” – the most straightforward assumption was that the NHS is delivering more operations and appointments that reduce the overall list of people waiting. But is this really the case?’ (my emphasis)
But: ‘In any given month, we expect the size of the waiting list to equal the incomplete pathways from the month before, plus new referrals in the given month, minus the reported completed pathways in the given month. But when we compared our calculated expected waiting list figures to the reported waiting list in the publicly available data, the size of the reported waiting list has been consistently smaller than the expected waiting list.
‘This shortfall between the expected and reported waiting list represents pathways that are not reported as completed pathways, but removed from the list anyway, and can be described as “unreported removals”. Over the two previous complete financial years (from April 2023 to March this year), there have been on average 244,578 unreported removals a month (unadjusted for working days), and 7,566,344 incomplete pathways (making up the reported waiting list) a month. This means that, on average, unreported removals equate to around 3% of the size of the waiting list. For context, the waiting list dropped by 29,814 between April and May this year, or by 0.4%.’
It adds: ‘.. across several months, there were more pathways being removed from the waiting list without being marked as complete than pathways joining the list.’
The Nuffield Trust concludes: ‘The information available in the public domain is insufficient for independent scrutiny of the elective waiting list, and consequently for holding government to account. Removals from the waiting list should be described in publicly available data in a meaningful way; the current process is unduly obscure. Until more transparent reporting is provided, accountability around unreported removals remains impossible and the planned care waiting list will continue to be a misleading indicator of how the NHS is dealing with demand.’
The above would have been headline news from BBC Scotland, The Herald and the rest – with “shameful” and similar in quotes from opposition politicians and ‘leading’ doctors from the BMA and royal colleges – IF the Nuffield Trust had been referring to NHS Scotland!
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Why is the planned care waiting list coming down and what does the data really tell us?
Do not does – Mr Robertson P7
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Straightforward answer. Whatever English party is in charge at Westminster cheats at all kinds of figures in a vain attempt at making England look like they are better than the devolved nations and are rightfully in charge of the whole UK.
Whether it’s PISA scores by only counting the best performing schools in an attempt to cover up the abject failure overall in education to NHS waiting lists at A&E where they only start the clock once a patient has been seen by someone to find out their problem.
Also you have to ask the question why there isn’t a GERE like GERS or GERW or GERNI. That’s because almost every local council in England is failing to the point where they are facing bankruptcy and the humiliation would be too much bear that England is worse than all the devolved nations at managing the funds.
As I’ve said before “We can’t have mother England looking bad now could we”.
There used to be one union that showed England how to do things properly and fairly but England decided that they didn’t like being told how to do things so they left that union and dragged us out with them against our will.
The people of Scotland need to wake up to the fact that we are not a part of a union of equals, we were within the EU, but certainly not in an autocratic UK which is fast heading towards fascism.Look at how much money Scotland got from the EU for infrastructure projects versus how much we have received from the laughable ‘Levelling up’ scheme.
Scotland, Wales and NI get what England votes for by sheer weight of numbers. All of the MP’s from the devolved nations put together are outnumbered almost 5 to 1 and in 2029 there is a strong chance that Farage will be PM with coalition from the Tories.
Next year we absolutely need to ensure we vote in an ‘Independence’ orientated government.
The alternative doesn’t bear thinking about.
Jim.
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MP Chris Murray claims that Scots are 800 times more likely to wait over two years for treatment than England.
England’s NHS data is notoriously unreliable. In 2014 NAO found half of 650 waiting time records surveyed were unreliable, either lacking documentation or being inaccurate.
Because of antiquated IT systems problems still exist. Of the 400,000 GP referrals each month an estimated 21% vanish. Patients may have to start again with their GPs. The necessary data to track patients is scattered across different IT systems that do not talk to each other. Hospitals are meant to return patients facing such unnecessary delays to the waiting lists. Of 30 hospitals contacted by the BBC in 2024 to ask how regularly this happened only 3 could provide figures. Unrecorded referrals.?
The system can be gamed.Trusts get £33 for every patient who comes off the waiting lists. Some Trusts stop the clock or pause it on waiting times if a patient misses an appointment or there are unecessary delays. Around 8 million outpatient appointments are missed every year.
Mr Murray claims that England’s NHS is cutting waiting times. This may be a result of unreported removal of patients from the waiting lists, says the Nuffield Trust.The waiting lists have gone down while unreported removals have gone up.
Unreported removals, around 245,000 per month, are estimates, They are cases where treatment is not completed. Possible reasons for removal are patients have moved to private treatment; patients have died waiting for treatment; software faults; cleaning because of faulty data collection or recording.
It is impossible to know if waiting lists are falling because of effective treatment or an increase in unreported removals and unrecorded referrals. There is often no reliable data. But data does suggest that more people are being added to the waiting lists than treatment pathways completed. Of 100 referrals only 86 are recorded as completed pathways.
Mr Murray, like all of England’s NHS data, can’t be trusted.
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