What does the pledge mean?

Labour’s manifesto pledged to raise the level of NHS activity so that in England there are “an extra two million NHS operations, scans, and appointments every year”. It said this would help to “cut NHS waiting times”. It also expressed this as a pledge for 40,000 more appointments a week, as 40,000 multiplied by the 52 weeks in a year makes about two million.

In February 2025, the government announced that the pledge had been delivered, based on data published the same day by NHS England, which has since been updated monthly. Until then, it had not been clear exactly what it meant or how progress on it would be measured because the government hadn’t fully explained what the extra appointments were or how they would be counted.

But historic data, which Full Fact at first had to obtain with a Freedom of Information request, and which has now been published as an official statistic, shows that the rise delivered in the government’s first year (5.2 million more appointments) was smaller than it was the year before (6.5 million)—raising questions about how meaningful the pledge was in the first place.

The way in which the pledge has been described has also changed over time.

When publishing the data with which to measure progress, NHS England described it as a manifesto commitment to deliver “an extra two million NHS operations, scans and appointments”. But the full quote from the Labour manifesto is “an extra two million NHS operations, scans, and appointments every year” [our emphasis]. This is potentially significant for reasons we’ll explain in the section below.

The Labour manifesto also described the pledge as a commitment to deliver 40,000 more appointments each week “during evenings and weekends”. In declaring the pledge to be met, the government said it was “delivered in part by extra evening and weekend working” [our emphasis]. It therefore sounds as though the extra appointments the government says it has delivered were not only during evenings and weekends, as appeared to have been originally promised, although we cannot find any data showing when they happened.

Before declaring the pledge delivered in February 2025, the government repeatedly failed to explain how it was actually defined, with neither the Department for Health and Social Care (DHSC) nor NHS England providing answers to our specific questions at the end of 2024.

This pledge only refers to the NHS in England, since this is the part of the health service that the UK government directly controls, with the rest devolved to the governments of Wales, Scotland and Northern Ireland.

What progress has been made?

We’re rating this pledge “Achieved”. The latest data shows that between July 2024 and June 2025 there were around 103,000 more appointments per week, which suggests that Labour has far exceeded the target. But it’s also debatable how meaningful that target really was.

In the past, as we have said, the government described the promise of two million extra appointments as a rise that would happen “a year”, “every year” or “in its first year”. But when the government announced that the pledge had been delivered, the annual element was missing, as it also was from NHS England’s page on which the supporting data was published.

In its analysis, NHS England counts the total number for specific types of elective operations, outpatient appointments and diagnostic tests and finds that there were 75,435,185 in the first year of the new government, compared with 70,223,535 in the same period the year before (once the data has been standardised to the same number of working days).

This means there has been a rise in the number of appointments of about 5.2 million.

As we said earlier, there is also the question of whether the pledge, as now defined, was meaningful to begin with.

Although NHS England published the data in February 2025 that allowed a comparison of Labour’s first months in office with the same months the year before, it didn’t at first publish the same data going further back. This made it impossible to know how significant the rise recorded under Labour really was, until we obtained the historic data from NHS England.

This data (see chart above) was finally published in July 2025. It shows that the number of appointments being counted towards this pledge had been rising steadily for several years, since roughly the beginning of 2021. This isn’t surprising, since the population was growing and ageing, and government health spending and the NHS workforce were rising during that time.

In this context, Labour’s pledge to raise the number of these appointments by two million in a year appears very modest. Indeed, if it had achieved a rise of just two million in its first year in office, it would have been by far the smallest rise since the pandemic.

While the number of these appointments did rise by 5.2 million between July 2024 and June 2025 compared to the same period the previous year, when standardised for the number of working days per month, they also rose by 6.5 million in the same period the year before.