The number of individuals reaching out to the NHS for mental health assistance has significantly increased, with GPs acknowledging a lack of refusal for sick notes. Recent figures from England reveal a rise in demand, with 2.24 million people seeking treatment in January compared to 2.04 million in January 2025 and 1.39 million in January 2020 pre-pandemic. The surge in mental health service requests, which often encounter lengthy wait times, has puzzled experts.
Amid this trend, a BBC investigation discovered that most GPs have never declined requests for sick notes, now termed “fit notes,” to excuse individuals from work. Additionally, new data indicates a decrease in the overall NHS waiting list for planned care over the last three months, reaching 7.25 million appointments.
Brett Hill from Broadstone consultancy highlighted the concerning reality that while referral waiting lists have decreased, mental health services are facing unprecedented demand, straining NHS resources.
A survey of 752 GPs conducted by the BBC found that the majority had never refused to issue a sick note, with some expressing discomfort over this responsibility. Instances were reported of patients displaying aggression when denied sick notes, with one patient even refusing to leave a medical practice without one.
In England, the number of treatments awaiting completion at the end of January decreased to 7.25 million, involving 6.13 million patients, marking the lowest level since February 2023. Health Secretary Wes Streeting noted the positive shift in waiting times and improved services despite the high winter demand.
Although the recent decline in waiting lists is a positive development, Nuffield Trust’s Sarah Scobie emphasized the need to reach the target of treating 65% of patients within 18 weeks by March. Tim Gardner from the Health Foundation acknowledged slight improvements in the health service and stressed the importance of addressing delays at their core for sustained progress.