Introduction

This is the first quarterly update on independent sector NHS elective activity. All the data is taken from datasets collected and published by NHS England. We have extracted the information that relates to independent sector providers including hospitals and clinics across England.

The data largely covers hospital activity, including both inpatient and outpatient care, with a limited overview of diagnostic activity. This update does not yet include activity for community-based services. This is because activity data is not so easily accessible for these types of services. We intend to expand the range of data presented in future updates.

Overall Activity

Data from the Weekly Activity Returns show a steady increase in independent sector activity since publication of this dataset began in July 2021. Independent sector providers are on average delivering more than 102,000 patient care episodes per week so far in 2024 (an increase of, on average, more than 30,000 patients per week since the dataset began publication in 2021).

Overall, WAR data shows that the IS delivered more than 5 million total care episodes in 2023, with data from January and February 2024 indicating that this record figure is likely to be surpassed again this year.

Of this activity, some two-thirds of all activity is outpatient activity – with the remainder evenly split between inpatient treatment and diagnostics. At the present time, not all diagnostic providers submit data to WAR, and so the dataset only partially captures IS diagnostic activity. Among those providers that do submit data, diagnostic activity has almost doubled in the first two months of 2024 compared with the start of data collection in 2021.

So far in 2024, the sector is delivering an average of almost 17,000 inpatient appointments and more than 71,000 outpatient appointments every week.

Independent sector activity has increased and so has the share of overall activity

As a whole, the independent sector has continued to increase the amount of NHS activity it delivers. It surpassed its pre-pandemic total activity volume in 2022, and by the end of 2023 had increased NHS activity by more than 28% compared with a 2019 baseline. Early data for 2024 shows that this upwards trend is likely to continue – with RTT activity this February some 38% above comparable activity in February 2019.

In terms of activity share, the independent sector delivered 9.63% of all NHS-funded elective care in 2023 – up from 7.81% in 2019. That share has now been over 10% for five of the past six months, with 10.6% of all NHS elective care delivered by independent sector providers in February 2024. This proportion is higher still in the case of admitted elective activity, with the IS treating almost 1 in 5 admitted elective patients overall in the past 12 months.

In total, activity by IS providers removed more than 1.67 million people from the NHS waiting list in 2023.