Dear Mr Humpherson,
I am writing to ask the Office for Statistics Regulation to review the transparency and presentation of NHS elective waiting list statistics.
Since last autumn, Members across the House have repeatedly asked Ministers, through Written Parliamentary Questions and in the Commons, about waiting-list validation, removals without treatment, referral management and what happens to patients who leave the headline figures.
I enclose an annex setting out relevant Written Parliamentary Questions and Commons exchanges from Members across the House since autumn 2025. It shows a repeated pattern of incomplete, unavailable or non-substantive answers, including instances where the Department has said that information is not held centrally, has provided only aggregate figures, or has not answered before Prorogation. Ministers have still not provided a clear breakdown of why patients are removed without treatment, what happens to them afterwards, or how many are subsequently added back onto waiting lists.
This matters because Ministers regularly cite reductions in the waiting list as evidence of progress. Patients and the public need to know whether reductions reflect people receiving treatment, or whether they are being driven in part by administrative removals, validation exercises or changes in how patients are managed before joining the list.
I am not asking the Authority to make a political judgement about NHS performance. I am asking whether the current statistics give Parliament, patients and the public a sufficiently clear picture of what is happening.
I would be grateful if the OSR could consider whether published waiting list statistics clearly distinguish between patients treated and patients removed without treatment; whether patients added back onto waiting lists are clearly reported; and whether changes in referral pathways affect comparability over time.
Patients need shorter waits, not less transparent statistics. The public must be able to understand whether changes in waiting lists reflect genuine improvements in access to care.
With best wishes,
The Rt. Hon. Stuart Andrew MP
Shadow Secretary of State for Health and Social Care
Related links: Ed Humpherson to Rt Hon Stuart Andrew MP: NHS England Elective Waiting Time Statistics – Office for Statistics Regulation
Annex: Repeated parliamentary attempts to obtain information on NHS waiting-list validation and removals
Record identified from 4 September 2025 to 15 June 2026
What the record shows: 26 direct attempts by MPs from three parties: 21 Written Parliamentary Questions and five Commons exchanges. Eight received no substantive or direct answer by 15 June; 14 received only a partial or generic answer that omitted the requested data; and four answered the narrow point asked.
The same central information remains unavailable: the number removed through clinical and administrative validation; the requested breakdown of the headline reduction by completed treatment, cancellation or non-attendance, clinical validation and administrative validation; the reasons for individual unreported removals; whether patients were informed; what happened afterwards; and how many were subsequently restored to a waiting list.
Scope: Direct questions and Chamber interventions about elective waiting-list validation, removals without completed treatment, unreported removals, patient notification, financial incentives, and the contribution of removals to the published reduction. Broader material about general waiting times, GP contracts, Advice and Guidance and Single Point of Access is excluded.
Public data already available – and why it is insufficient Monthly referral-to-treatment statistics. NHS England publishes accredited official statistics showing the number of incomplete pathways, new RTT periods and admitted and non-admitted completed pathways, with national, commissioner, provider and specialty breakdowns. The figures are aggregate pathway counts rather than a patient-level account; a patient may appear on more than one pathway, and the non-admitted category includes both treatment and non-treatment clock stops. The publication therefore cannot show why each patient was removed, whether they still required treatment or whether they were later added back. Source: NHS England consultant-led RTT data 2025-26
Waiting List Minimum Data Set. NHS England publishes weekly management information on new, open and completed RTT pathways, with provider and treatment-function breakdowns. NHS England states that this dataset is subject to less validation than the monthly official statistics; the dashboard contains provider-submitted data without estimates for missing submissions or data-quality adjustments. It does not publish the individual reason for removal or link a removal to the patient’s later outcome or re-addition. Source: NHS England WLMDS information
Derived unreported removals. NHS England now publishes the number and percentage of unreported removals in its national time series. However, this is a residual balancing item calculated from the opening list, new clock starts, completed pathways and the closing list. It is not a direct record of why a pathway left the list. NHS England has said that an analytical deep dive into the reasons is planned for summer and autumn 2026. Source: NHS England RTT developments and unreported-removals explainer
What remains unavailable: a reproducible split of the headline reduction between completed treatment, patient cancellation or non-attendance, clinical validation and administrative validation; the reason for each unreported removal; whether the patient was informed; what happened afterwards; and whether the patient was subsequently restored to a waiting list. The Department has now confirmed £32.535 million of validation payments in 2025-26 while also stating that it does not centrally hold the number of pathways removed through validation.
1. 4 September 2025 – Dr Caroline Johnson MP (Conservative) – Written Parliamentary Question, UIN 75244
Information sought: Whether the Department had estimated the value for money of paying NHS trusts to validate their waiting-list data.
Government response: The Government said that no estimate had been made of the return on investment of the validation sprint. It described validation guidance and said around 250,000 additional removals had occurred during the April-to-June sprint compared with the same period a year earlier.
Status: Answered.
Still unanswered: No assessment of value for money had been carried out.
Official parliamentary record
2. 4 September 2025 – Dr Caroline Johnson MP (Conservative) – Written Parliamentary Question, UIN 75251
Information sought: The number of incomplete pathways removed through the validation sprint in each month since April 2025.
Government response: The Government said that the Department did not hold monthly data centrally. It gave only an estimate of around 250,000 additional removals across the whole period from the week ending 13 April to the week ending 22 June 2025.
Status: Partial answer – requested monthly data not held.
Still unanswered: The monthly number of pathways removed through validation.
Official parliamentary record
3. 4 September 2025 – Dr Caroline Johnson MP (Conservative) – Written Parliamentary Question, UIN 75252
Information sought: What guidance had been issued to NHS England and NHS trusts on validation of waiting-list data.
Government response: The Government set out the relevant guidance, including requirements for clinical agreement before a patient is returned to the referrer and for removed patients and their GPs to receive a letter.
Status: Answered.
Still unanswered: The answer did not provide evidence about compliance with the guidance.
Official parliamentary record
4. 15 October 2025 – Steve Barclay MP (Conservative) – Written Parliamentary Question, UIN 82312
Information sought: How many patients had been removed from waiting lists for reasons other than completed treatment, by month since July 2024.
Government response: The Government eventually answered on 29 April 2026. It supplied monthly totals but said the breakdown of reasons was not available in the aggregate official statistics. A less-validated weekly management dataset existed but did not match the official monthly totals.
Status: Partial answer – reasons not supplied.
Still unanswered: A reliable monthly breakdown of removals by reason.
Official parliamentary record
5. 17 October 2025 – Stuart Andrew MP (Conservative) – Written Parliamentary Question, UIN 82954
Information sought: How many elective waiting-list removals had resulted from data-validation exercises in 2025-26 and the cost of those exercises.
Government response: Answered on 15 January 2026. The Government said the Department did not hold centrally the number of pathways removed through validation. It confirmed payments of £18,818,566 from April to September 2025.
Status: Partial answer – removal number not held.
Still unanswered: The number of pathways removed despite the Department funding the validation exercise.
Official parliamentary record
6. 25 November 2025 – Dr Caroline Johnson MP (Conservative) – Health and Social Care Questions, Commons Chamber
Information sought: Whether a patient who had waited a year, undergone repeated validation and was then confirmed still to need treatment would be shown as having waited for the full year or a much shorter period.
Government response: The Secretary of State said that a clock stop would apply from the consultant appointment, then criticised the previous Government. Dr Johnson asked him to write with a clear answer.
Status: No direct answer.
Still unanswered: How that patient’s full wait would appear in the published figures.
Official parliamentary record
7. 21 January 2026 – Stuart Andrew MP (Conservative) – Written Parliamentary Question, UIN 107367
Information sought: What the £18.8 million validation payments funded and whether payment was made per patient, pathway, RTT clock stop or another unit.
Government response: The Government confirmed that providers received £33 for each additional RTT clock stop per patient pathway above an agreed baseline.
Status: Answered.
Still unanswered: The answer did not disclose how many pathways were removed or the total patient outcomes associated with the payments.
Official parliamentary record
8. 5 February 2026 – Joe Robertson MP (Conservative) – Written Parliamentary Question, UIN 111344
Information sought: Whether full raw NHS waiting-list data, including removals and treatment activity, would be published weekly and monthly.
Government response: The Government referred to existing weekly management information and monthly RTT statistics. It acknowledged that the specific reasons for unreported removals and the stage at which they occurred were not published.
Status: Partial answer – detailed data not published.
Still unanswered: The raw data needed to distinguish treatment activity from different categories of removal.
Official parliamentary record
9. 5 February 2026 – Joe Robertson MP (Conservative) – Written Parliamentary Question, UIN 111345
Information sought: The number of patients removed from waiting-list data and the reasons for those removals.
Government response: The Government gave aggregate totals: 14,460,885 removals between April and November 2025, including 2,069,189 unreported removals. It said the specific reason for each unreported removal was not published.
Status: Partial answer – reasons not supplied.
Still unanswered: A breakdown showing why more than two million pathways were removed without being reported as completed treatment.
Official parliamentary record
10. 5 February 2026 – Joe Robertson MP (Conservative) – Written Parliamentary Question, UIN 111346
Information sought: What proportion of the reduction in NHS waiting lists since April 2025 was attributable to patient removals and a breakdown of waiting-list change by treatment status.
Government response: The Government said 14.3% of all removals between April and November were unreported removals. It did not provide the requested breakdown of the net reduction by treatment status.
Status: Partial answer – central question not answered.
Still unanswered: How much of the headline fall was due to treatment and how much was due to each non-treatment removal category.
Official parliamentary record
11. 5 February 2026 – Joe Robertson MP (Conservative) – Written Parliamentary Question, UIN 111347
Information sought: What steps were being taken to ensure patients were not wrongly removed from the official waiting list because of administrative issues.
Government response: The Government referred to national policy, clinical oversight and two-way communication with patients. It did not supply figures showing how many patients had been wrongly removed or later restored.
Status: Partial answer – safeguards described, outcomes absent.
Still unanswered: The incidence of wrongful removal and the number of patients returned to a list.
Official parliamentary record
12. 9 February 2026 – Matt Vickers MP (Conservative) – Written Parliamentary Question, UIN 111880
Information sought: Whether patients removed from NHS waiting lists were informed of the removal and told the reason.
Government response: The Government said patients should be kept informed and that a patient and referrer were expected to be notified when a clinical decision was taken to discharge them.
Status: Partial answer – policy given, compliance unknown.
Still unanswered: How often patients were actually notified and how many were removed without their knowledge.
Official parliamentary record
13. 12 February 2026 – Joe Robertson MP (Conservative) – Written Parliamentary Question, UIN 113151
Information sought: The criteria used to determine payments for pathways removed through validation and the safeguards against perverse incentives and data manipulation.
Government response: The Government described validation as routine and referred to clinical oversight and guidance. It did not answer the question about payment criteria. The £33-per-additional-clock-stop arrangement was disclosed separately in the later answer to Stuart Andrew.
Status: Partial answer – payment criteria omitted.
Still unanswered: The requested explanation of the financial incentive and how it was controlled.
Official parliamentary record
14. 25 February 2026 – Stuart Andrew MP (Conservative) – Written Parliamentary Question, UIN 115807
Information sought: What payments NHS England had made for validation exercises since 1 September 2025 and in 2025-26 to date.
Government response: On 29 April the Government said it had not proved possible to respond before Prorogation.
Status: No substantive answer.
Still unanswered: The updated cost of validation payments.
Official parliamentary record
15. 25 February 2026 – Stuart Andrew MP (Conservative) – Written Parliamentary Question, UIN 115808
Information sought: The number of pathways removed from RTT waiting lists following validation exercises in each year since 2020.
Government response: On 29 April the Government said it had not proved possible to respond before Prorogation.
Status: No substantive answer.
Still unanswered: The annual number of pathways removed through validation.
Official parliamentary record
16. 25 February 2026 – Stuart Andrew MP (Conservative) – Written Parliamentary Question, UIN 115809
Information sought: How many pathways in the reported net reduction since 1 September 2025 were removed because treatment was completed and how many through data validation.
Government response: On 29 April the Government said it had not proved possible to respond before Prorogation.
Status: No substantive answer.
Still unanswered: The central breakdown between treatment and validation.
Official parliamentary record
17. 15 April 2026 – Claire Young MP (Liberal Democrat) – Written Parliamentary Question, UIN 127649
Information sought: Whether payments or incentives were made to GPs in respect of removing patients who failed to respond to validation communications.
Government response: The Government discussed a Quality and Outcomes Framework adjustment and said it did not create an incentive to remove patients for QOF purposes. It then described waiting-list validation as routine.
Status: Partial answer – wider incentive question unresolved.
Still unanswered: Whether any payment or incentive elsewhere in the system was linked to removal following non-response.
Official parliamentary record
18. 15 May 2026 – Helen Morgan MP (Liberal Democrat) – Written Parliamentary Question, UIN 1746
Information sought: Monthly numbers removed through unreported removals, administrative methods and other validation during the previous two years.
Government response: A holding answer on 21 May said an answer was being prepared. No substantive answer had been published by 10 June 2026.
Status: No substantive answer by 10 June.
Still unanswered: The monthly breakdown for the previous two years.
Official parliamentary record
19. 18 May 2026 – Stuart Andrew MP (Conservative) – Written Parliamentary Question, UIN 1941
Information sought: With reference to the earlier answer on validation payments, what payments NHS England and the Department had made for waiting-list data validation exercises since 1 September 2025 and during the 2025-26 financial year.
Government response: Answered on 15 June 2026 as part of a grouped response to Questions 1941, 1942 and 1943. The Government confirmed that NHS England paid integrated care boards £32,535,000 for waiting-list validation exercises from April 2025 to March 2026, including £22,150,000 from September 2025 to March 2026.
Status: Answered.
Still unanswered: The payment figure does not show how many pathways were removed through the funded validation exercises or what happened to the patients concerned.
Official parliamentary record
20. 18 May 2026 – Stuart Andrew MP (Conservative) – Written Parliamentary Question, UIN 1942
Information sought: The number of pathways removed from RTT waiting lists following validation exercises in each year since 2020, re-tabling the unanswered February question.
Government response: Answered on 15 June 2026 as part of the grouped response to Questions 1941, 1942 and 1943. The Government said that more than 85% of removals were completed pathways and approximately 15% were unreported removals. It said unreported removals could include non-attendance, referrals a provider could not accept and removals through validation where a patient was considered no longer to require treatment. The Department said it did not hold centrally the number of pathways removed through validation.
Status: Partial answer – the requested annual validation-removal figures are not held centrally.
Still unanswered: The number of pathways removed through validation in each year since 2020.
Official parliamentary record
21. 18 May 2026 – Stuart Andrew MP (Conservative) – Written Parliamentary Question, UIN 1943
Information sought: How many pathways in the net reduction since 1 September 2025 were removed through completed treatment, patient cancellation or non-attendance, clinical validation and administrative validation.
Government response: Answered on 15 June 2026 as part of the grouped response. The Government gave the broad assurance that more than 85% of removals were completed pathways and approximately 15% were unreported removals, and listed examples of why unreported removals occur. It did not provide the requested breakdown of the net reduction between completed treatment, patient cancellation or non-attendance, clinical validation and administrative validation.
Status: Partial answer – the central breakdown was not supplied.
Still unanswered: The detailed breakdown needed to establish what actually drove the headline reduction.
Official parliamentary record
22. 18 May 2026 – Rachael Maskell MP (Labour) – Written Parliamentary Question, UIN 2077
Information sought: How many people had been removed from NHS waiting lists in total, because of duplicate appointments, because the patient had died, or for any reason other than receiving a consultation.
Government response: The question remained awaiting an answer on 10 June 2026, despite being due for answer on 20 May.
Status: No substantive answer by 10 June.
Still unanswered: The requested breakdown of non-treatment removals.
Official parliamentary record
23. 1 June 2026 – Stuart Andrew MP (Conservative) – Health Bill Second Reading, Commons Chamber
Information sought: Raised reports of patients being removed despite still needing treatment, sometimes without their knowledge, and challenged whether the falling headline figure reflected treatment or list management.
Government response: The Minister’s closing speech did not address the point or provide a breakdown of removals, patient outcomes or subsequent re-additions.
Status: No direct answer.
Still unanswered: Whether the headline reduction reflected completed care and what happened to patients removed without treatment.
Official parliamentary record
24. 1 June 2026 – Dr Caroline Johnson MP (Conservative) – Health Bill Second Reading, Commons Chamber
Information sought: Raised removals without treatment following cancellations, missed appointments, forms and repeated validation contact, and questioned whether falling figures represented treatment or statistical presentation.
Government response: The Minister’s closing speech did not respond to the removal point or provide transparency on reasons and patient outcomes.
Status: No direct answer.
Still unanswered: A breakdown of removals and evidence of what happened to affected patients.
Official parliamentary record
25. 9 June 2026 – Graham Stuart MP (Conservative) – Health and Social Care Questions, Commons Chamber
Information sought: An assessment of trends in unreported removals and reassurance that reported improvements reflected genuine care rather than manipulation or cleansing of lists.
Government response: The Minister said more than 85% of removals resulted from patient care and validation accounted for roughly 15%. She did not provide a detailed breakdown of the remaining removals or their outcomes.
Status: Partial answer – aggregate assurance only.
Still unanswered: The detailed trend and outcome data needed to test the reassurance.
Official parliamentary record
26. 9 June 2026 – Dr Luke Evans MP (Conservative) – Health and Social Care Questions, Commons Chamber
Information sought: How many patients were removed in March without treatment, what happened to them, whether they still needed treatment and whether the Government would review the cases.
Government response: The Minister said she did not have the exact March figure to hand. She did not explain what had happened to the patients or commit to a review.
Status: Partial answer – figure and outcomes not supplied.
Still unanswered: The March number, the patients’ subsequent outcomes and a review of whether treatment was still required.
Official parliamentary record