Executive summary
1. The overall priority in 2024/25 planning guidance remains the recovery of our core services and productivity, to improve patient experience and outcomes. This annex provides details of performance and work being undertaken to improve those services in our wider priority operational areas, ie those not covered by the monthly operational statistics reporting.
Primary care and community health services
2. In 2024/25 we are aiming to make it easier for people to access community and primary care services, particularly general practice and dentistry. We also want to improve patient experience, including through expanding capacity, ensuring people can see a clinician when they need to and increasing use of the NHS App, making it easier for people to access information and routine services such as repeat prescriptions, and increasingly to book appointments.
3. As at the end of September 2024, there have been 376.5 million GP appointments in the previous 12 months. This includes COVID-19 vaccinations and primary care network appointments and is an increase of 69.2 million appointments (22.5%) compared to 2019/20.
4. In September 2024, the majority (50.4%) of all practice appointments took place on the same day or day after booking, an increase of 3.3 percentage points from September 2023.
5. Nearly 9 out of 10 practice appointments (81.9%) took place within 14 days of booking) which is an increase of 3.5 percentage points from September 2023.
6. Latest publication of Health Insight Survey, published 7 November, reported:
- 42.3% of the respondents had tried to contact their GP practice in the last 28 days. Of these respondents 78.0% were able to make contact on the same day and of these, 69.6% found it easy to contact their GP practice and 72.6% had a good overall experience with their GP practice.
- 52.6% of respondents reported having an NHS dentist, compared to 12.6% who reported having no dentist.
7. In September 2024, 1,101,248 referrals were waiting for a first treatment from a community health service.
8. The largest waiting lists in September 2024 were for adult musculoskeletal services (348,799), children and young people’s (CYP) community paediatric service (135,074) and adult podiatry and podiatric surgery (126,189).
9. The community services with the largest number of people waiting over 52 weeks in September 2024 were CYP community paediatric service (64% of all over 52 week waits), children and young people speech and language therapy (8% of all over 52 week waits) and podiatry and podiatric surgery (7% of all over 52 week waits).
Mental health
10. For mental health, the 2024/25 planning guidance sets out NHS priorities to improve access to mental health services so that more people of all ages receive the treatment they need. We continue to expand care to address historic underinvestment and meet rapidly growing demand, particularly among children and young people within a constrained environment. The programme is working in parallel to maximise productivity and digital assets through transformed pathways to ensure good guardianship of public money.
11. Access to transformed models of community mental health (CMH), aligned with primary care networks (PCNs) for new integrated models of community mental healthcare, is being achieved with 467,978 people receiving 2 or more contacts as of July 2024. From September 2024, NHS England published full CMH metrics, including showing the percentage of people receiving meaningful help within 4 weeks of referral in adult CMH and CYP services. We expect a further focus on data quality improvement in 2024/25 to enable more accurate data from April 2025 onwards.
12. In 2024/25 the NHS committed to increasing the number of adults and older adults completing a course of treatment for anxiety and depression via NHS Talking Therapies to 700,000, with at least 67% achieving reliable improvement and 48% achieving reliable recovery. To date in 2024/25, 342,303 adults completed a course of treatment, with reliable improvement of 67.5% and reliable recovery of 45.0%.
13. Access to individual placement and support (IPS) services, an evidence-based approach to help people with mental health issues find and keep paid jobs, has increased, to date in 2024/25 over 28,000 people reported to have accessed an IPS service, compared to over 20,000 to August 2023/24. To further increase access, NHS England is working with IPS Grow (a voluntary, community and social enterprise organisation supporting delivery of IPS) to disseminate learnings from 5 pilot sites aiming to increase referrals from primary care, as well as increase recruitment and retention of staff in the IPS workforce.
14. The urgent and emergency mental health pathway continues to be under significant pressure, experiencing high bed occupancy (95-97%) since May 2022. In 2024/25, NHS England is continuing to work on supporting systems to improve flow and reduce out of area placements, focusing on key issues including data and good practice. Challenged systems are being additionally supported through joint working with the Getting It Right First Time (GIRFT) Programme.
15. As of September 2024, 798,479 CYP aged 0-17 received support (1+ contacts) from an NHS-funded service.
Children and young people (CYP) 1+ access (0-17 data) 12 month rolling

16. CYP eating disorder (ED) pathways continue to be challenged. As of August 2024, 74.8% of routine CYP ED referrals were seen within 4 weeks, and 69.3% of urgent referrals were seen within 1 week. NHS England continues to help providers to improve the quality and completeness of data submissions which aims to support improved reporting of performance against the 95% access and wait standard.
17. Access to specialist perinatal mental health (PMH) and maternal mental health services (MMHS) has seen steady growth since March 2021. In the 12 months to September 2024, 60,637 women accessed these services which is an increase from 54,010 in the 12 months to September 2023.
National progress towards perinatal mental health (MH) ambition

18. The dementia diagnosis rate (DDR) has continued to steadily improve since January 2023. For September 2024 the DDR is 65.5% against the ambition of 66.7% by March 2025, which is an increase of 0.1ppt compared with August 2024 (65.4%). The number of people with a recorded dementia diagnosis has reached a record high at 495,000. NHS England funded an evidence-based improvement project to fund 2 trusts in each region to pilot the DiADeM (diagnosing advanced dementia mandate) tool designed to improve the diagnosis of dementia in care homes. All pilots completed at the end of May 2024 and learning is currently being developed and expected to be shared in quarter 4 of 2024/25.
National dementia diagnosis rate

19. NHS England has committed to developing reporting against the nationally-held data and information set out in the Patient and carer race equality framework (PCREF) for 2024/25.
Learning disabilities and autism
20. There continues to be a steady reduction in the number of adults with a learning disability and/or who are autistic in a mental health inpatient setting. Provisional data for September 2024 shows there were 1,820 adult inpatients, a reduction of approximately 7% from the inpatient population as of March 2024.
21. As of September 2024, provisional data shows there were 200 inpatients under the age of 18 with a learning disability and/or who are autistic. In line with the trends seen for adult inpatients, since March 2017 there has been a decrease in under 18 inpatients with a learning disability and/or who are autistic.
22. There has been an increase in the number of people receiving an annual health check compared to the same period last year. Up to September 2024, 29.9% of people on GP learning disability registers received a check, compared to 27.9% between April and September 2023.We remain on trajectory to achieve the 75% annual health check target by March 2025.
Proportion of people aged 14+ with a learning disability on the GP register receiving annual health check

23. In addition, work is continuing to increase the size and accuracy of GP learning disability registers. As of September 2024, there were 336,062 people aged 14 and over on registers, representing an increase of 15,870 (5%) compared to the position in September 2023.
Prevention and long-term conditions
24. A total of 10 dental and 9 optometry sites have been selected to take part in the pilots to test the effectiveness of blood pressure checks in wider primary care settings and funding has been transferred to systems. A community of practice group has been set up to support successful sites to share experiences and good practice. To date 1 site has commenced with others due to start by December 2024. The pilots will run until summer 2025 and the evaluation partner (South West Health Innovation Network) will report on their findings by the end of August 2025.
25. Since 2016, over 1.6 million referrals have been made into the Heathier You NHS Diabetes Prevention Programme.
Recovery Support Programme
26. The Recovery Support Programme (RSP) provides national mandated intensive support to trusts and integrated care boards (ICBs) in NHS Oversight Framework segment 4 that have complex, deep-seated concerns around leadership, governance, finance, patient safety, quality, or performance. There are currently 20 trusts (4 legacy special measures) and 3 ICBs enrolled in the RSP. Over the last 12 months, 3 trusts and 2 systems have exited RSP having demonstrated sufficient and sustainable improvement against their exit criteria.
Genomics
27. The NHS continues to provide and develop the NHS Genomic Medicine Service (GMS), delivering over 809,888 genomic reports in 2023/24.
28. The NHS GMS has now sequenced over 100,000 whole genome equivalents since the inception of the Whole Genome Sequencing Service in November 2021.
29. As a result of increased growth in testing in the NHS Genomic Medicine Service, compliance with turnaround times has been impacted. Minimising backlogs and the time taken to deliver a genomic test is a key priority for NHS England and genomic laboratory hubs have been provided with additional funding to support recovery and reduce backlogs.
30. NHS England is continuing to support the Generation Study delivered by Genomics England, to sequence the genomes of 100,000 newborn babies. It is estimated that the study will identify around 200 conditions in otherwise asymptomatic babies where symptoms might not present until later in childhood. Discussions are ongoing to increase the number of sites participating in the study, ensuring geographical coverage across the country.
Publication reference: Public Board paper (BM/24/41(Pu)