Max Warner
@maxwarner.bsky.social
Economist at the IFS working on health and social care, public spending and public sector productivity https://ifs.org.uk/people/max-warner
Elective waiting times in the NHS have improved since Labour came to office, but relatively slowly. Improvements in 18 week performance will have to pick up speed considerably if the government are to hit their headline NHS target by the end of the parliament.
October 24, 2025 at 1:34 PM
Elective waiting times in the NHS have improved since Labour came to office, but relatively slowly. Improvements in 18 week performance will have to pick up speed considerably if the government are to hit their headline NHS target by the end of the parliament.
There are reports that the government is considering changing student loans or pensions for resident doctors. We've written a new @theifs.bsky.social comment on the potential merits of such changes. Here's a summary:
July 19, 2025 at 8:12 AM
There are reports that the government is considering changing student loans or pensions for resident doctors. We've written a new @theifs.bsky.social comment on the potential merits of such changes. Here's a summary:
After defence commitments and the Barnett formula, giving DHSC 2.5% per year in real-terms would leave no real-terms increases for other areas. 3.4% per year for DHSC (closer to the long-run average) would imply 1% cuts per year in real-terms for everything else. 9/12
June 2, 2025 at 9:57 AM
After defence commitments and the Barnett formula, giving DHSC 2.5% per year in real-terms would leave no real-terms increases for other areas. 3.4% per year for DHSC (closer to the long-run average) would imply 1% cuts per year in real-terms for everything else. 9/12
If we look at past Spending Reviews, health has long done well – between SR 1998 and SR 2015, on average, the day-to-day health budget was planned to grow at 3.5% per year, while the overall day-to-day budget was planned to grow at 1.5% per year. 4/12
June 2, 2025 at 9:57 AM
If we look at past Spending Reviews, health has long done well – between SR 1998 and SR 2015, on average, the day-to-day health budget was planned to grow at 3.5% per year, while the overall day-to-day budget was planned to grow at 1.5% per year. 4/12
Lots of discussion today about regional investment. You can use our @theifs.bsky.social public spending tool to explore how much the government currently spends in each region of the UK, what it spends it on, and how that has changed over time: ifs.org.uk/calculators/...
May 30, 2025 at 1:41 PM
Lots of discussion today about regional investment. You can use our @theifs.bsky.social public spending tool to explore how much the government currently spends in each region of the UK, what it spends it on, and how that has changed over time: ifs.org.uk/calculators/...
Finally, the tool allows you to break down many aspects of government spending. For example, here is how the government split capital spending across different areas in 2022–23. Health is much less capital intensive than many other areas of spending.
April 10, 2025 at 8:17 AM
Finally, the tool allows you to break down many aspects of government spending. For example, here is how the government split capital spending across different areas in 2022–23. Health is much less capital intensive than many other areas of spending.
But that isn’t the case for health capital spending, which has stayed a roughly constant share of capital spending over time
April 10, 2025 at 8:17 AM
But that isn’t the case for health capital spending, which has stayed a roughly constant share of capital spending over time
Third, the tool allows you to see how spending on different categories (in different countries/regions) has changed over time. Here, for example, you can see that health has become a larger part of what the government spends its money on (unlike defence – at least up to now!)
April 10, 2025 at 8:17 AM
Third, the tool allows you to see how spending on different categories (in different countries/regions) has changed over time. Here, for example, you can see that health has become a larger part of what the government spends its money on (unlike defence – at least up to now!)
Second, the tool allows you to make detailed spending comparisons between two areas of the UK. For example, Scotland spent more per person on health than England in 2022–23. But the gaps were much larger for education and benefits, pensions and social services.
April 10, 2025 at 8:17 AM
Second, the tool allows you to make detailed spending comparisons between two areas of the UK. For example, Scotland spent more per person on health than England in 2022–23. But the gaps were much larger for education and benefits, pensions and social services.
First, the tool allows you to map many types of government spending across the nations and regions of the UK. Here, for example, is how per person capital spending on healthcare – a key factor for NHS productivity – differed across the UK in 2023–24.
April 10, 2025 at 8:17 AM
First, the tool allows you to map many types of government spending across the nations and regions of the UK. Here, for example, is how per person capital spending on healthcare – a key factor for NHS productivity – differed across the UK in 2023–24.
Taking plausible scenarios for activity growth, changes to demand and changes to which patients are treated first, the table below shows what 18 week performance could be like by mid 2029 (or when the target is hit).
13/17
13/17
March 20, 2025 at 9:06 AM
Taking plausible scenarios for activity growth, changes to demand and changes to which patients are treated first, the table below shows what 18 week performance could be like by mid 2029 (or when the target is hit).
13/17
13/17
We estimate it would take 4.9% annual activity growth to hit the target without other changes. For comparison, treatment volumes grew by 3.8% in 2024, and by an average of 2.4% each year from 2016 to 2019. So 4.9% would be very hard to achieve.
9/17
9/17
March 20, 2025 at 9:06 AM
We estimate it would take 4.9% annual activity growth to hit the target without other changes. For comparison, treatment volumes grew by 3.8% in 2024, and by an average of 2.4% each year from 2016 to 2019. So 4.9% would be very hard to achieve.
9/17
9/17
There is no simple relationship between the size of the waiting list and waiting times, as the chart below shows. For example, 18-week performance was 59% in Sept-07, 71% in Apr-20 and 90% in Jul-17. But in these three months, the waiting list was 4 million.
4/17
4/17
March 20, 2025 at 9:06 AM
There is no simple relationship between the size of the waiting list and waiting times, as the chart below shows. For example, 18-week performance was 59% in Sept-07, 71% in Apr-20 and 90% in Jul-17. But in these three months, the waiting list was 4 million.
4/17
4/17
It’s therefore very striking that the ONS estimates outputs to have only increased by 2.2%, whereas NHSE think all acute outputs have grown by much more, with a total 6.3% growth rate.
February 10, 2025 at 12:38 PM
It’s therefore very striking that the ONS estimates outputs to have only increased by 2.2%, whereas NHSE think all acute outputs have grown by much more, with a total 6.3% growth rate.
Let’s start by comparing the differences in the two measures as best as we can. Productivity growth is the difference between the growth in inputs (e.g. staffing) and outputs (e.g. patients treated). The table below is the closest we can compare
February 10, 2025 at 12:38 PM
Let’s start by comparing the differences in the two measures as best as we can. Productivity growth is the difference between the growth in inputs (e.g. staffing) and outputs (e.g. patients treated). The table below is the closest we can compare
The NHS planning guidance today sets out some new elective targets. It's not just all about 18 weeks anymore - there's now a long waiter target (again). But unlike the 2022 plan to eliminate 52+ week waits by March 25, the target is to now to get them to 1% of the list size by March 26.
January 30, 2025 at 4:35 PM
The NHS planning guidance today sets out some new elective targets. It's not just all about 18 weeks anymore - there's now a long waiter target (again). But unlike the 2022 plan to eliminate 52+ week waits by March 25, the target is to now to get them to 1% of the list size by March 26.
More broadly hospital bed occupancy remains very high. Higher than this point last year, though slightly lower than the year before when flu occupancy was close to this year.
January 16, 2025 at 10:38 AM
More broadly hospital bed occupancy remains very high. Higher than this point last year, though slightly lower than the year before when flu occupancy was close to this year.
Interestingly the number of patients with flu in critical care beds is quite a lot lower this winter than in 2022-23, when total flu levels were similar. In other words, there are a similar number of flu patients but far fewer are in critical care beds this time round.
January 16, 2025 at 10:38 AM
Interestingly the number of patients with flu in critical care beds is quite a lot lower this winter than in 2022-23, when total flu levels were similar. In other words, there are a similar number of flu patients but far fewer are in critical care beds this time round.
Latest data suggests the number of patients in NHS hospitals in England with flu is coming consistently down now (as was the case last week too). Still higher than at the same time in the last couple of years.
January 16, 2025 at 10:38 AM
Latest data suggests the number of patients in NHS hospitals in England with flu is coming consistently down now (as was the case last week too). Still higher than at the same time in the last couple of years.
Over the last year, most measures of waiting times have worsened in Scotland, while most measures have improved in England.
6/11
6/11
November 27, 2024 at 10:45 AM
Over the last year, most measures of waiting times have worsened in Scotland, while most measures have improved in England.
6/11
6/11
Hospital activity in Scotland increased over the last year, but most types of hospital activity are still below their pre-pandemic levels. That’s despite the Scottish Govt’s target to increase inpatient and day case activity to 15% above pre-pandemic levels this year.
2/11
2/11
November 27, 2024 at 10:45 AM
Hospital activity in Scotland increased over the last year, but most types of hospital activity are still below their pre-pandemic levels. That’s despite the Scottish Govt’s target to increase inpatient and day case activity to 15% above pre-pandemic levels this year.
2/11
2/11
To put this another way: NHS productivity in England is still below pre-pandemic levels, and is still lagging behind its backlog recovery plan – but it’s now at least heading in the right direction, which gives some grounds for cautious optimism.
7/12
7/12
November 12, 2024 at 9:11 AM
To put this another way: NHS productivity in England is still below pre-pandemic levels, and is still lagging behind its backlog recovery plan – but it’s now at least heading in the right direction, which gives some grounds for cautious optimism.
7/12
7/12
If we compare Jan-July 2024 to Jan-July 2023, increases in hospital activity in England have been much greater than increases in clinical staffing. That means hospital labour productivity (measured as treatments per staff member) has increased!
5/12
5/12
November 12, 2024 at 9:11 AM
If we compare Jan-July 2024 to Jan-July 2023, increases in hospital activity in England have been much greater than increases in clinical staffing. That means hospital labour productivity (measured as treatments per staff member) has increased!
5/12
5/12
And as a side note, while hospital activity is up on pre-pandemic levels, elective activity is still far from what was planned in the 2022 elective recovery plan (which we have long warned was very ambitious!)
3/12
3/12
November 12, 2024 at 9:11 AM
And as a side note, while hospital activity is up on pre-pandemic levels, elective activity is still far from what was planned in the 2022 elective recovery plan (which we have long warned was very ambitious!)
3/12
3/12
Let’s first consider hospital activity in England. Across a broad range of measures, hospital activity has increased substantially over the last year. (Though it’s interesting that treatments from the waiting list haven’t increased as much as other measures/types of elective activity)
2/12
2/12
November 12, 2024 at 9:11 AM
Let’s first consider hospital activity in England. Across a broad range of measures, hospital activity has increased substantially over the last year. (Though it’s interesting that treatments from the waiting list haven’t increased as much as other measures/types of elective activity)
2/12
2/12