Research shows hospital activity remains stubbornly below pre-pandemic levels, despite the Government's targets to increase activity and staffing.

Max Warner, research economist at IFS and author of the briefing, said: ‘The Scottish and English NHS are now recovering differently from the COVID-19 pandemic. In Scotland, hospital activity remains below pre-pandemic levels, and waiting time performance has worsened over the last year. The same is not true in England, where performance remains poor but is at least moving in the right direction. The UK Government has been honest about the poor performance of the English NHS and has made understanding and improving NHS performance and productivity a major priority. It is vital the Scottish Government does the same, particularly given the concerning divergence in recovery between England and Scotland.'

In April to June 2024, hospitals treated 6% fewer inpatient and day cases and delivered 6% fewer outpatient appointments than pre-pandemic in Scotland. The Scottish Government's NHS recovery plan, published in 2021, aimed to increase inpatient and day case activity to 15% above pre-pandemic levels this year.

The IFS said one reason for the failure to increase activity above pre-pandemic levels was patients now have a much higher average length of stay in hospital, in part because of challenges with delayed discharges.

The IFS said many measures of waiting time performance in Scotland – as in England – were worse than pre-pandemic. However, over the last year, most measures of performance in Scotland have deteriorated, while in England most have improved. While the elective waiting list, long waits at A&E, long waits for cancer treatment and long waits for diagnostic tests are all still rising in Scotland, they all are falling in England.

Scottish health secretary Neil Gray said: ‘We are investing £30m to reduce pandemic backlogs, adding 12,000 outpatient appointments, 12,000 inpatient procedures, and over 40,000 diagnostic tests.

‘There is more to do but we are making progress, with improvements in waiting lists for diagnostics and the Treatment Time Guarantee, as well as cancer care, where - despite still being a challenge - the most recently published data shows improvement.

‘Additionally, Scotland's core A&Es have been the best performing in the UK for nine years.'