Domain review
Public Service Capacity
Measures whether the state can deliver core public services.
Public Service Capacity is currently rated Fragile. The domain score is driven primarily by Crown Court outstanding caseload (E&W), Adult social care requests and A&E four-hour performance (England). Data confidence is high across its component metrics.
Component indicators
Public Service Capacity — Metrics
NHS referral-to-treatment waiting list (England)
March 2026
Verified official value from NHS England (RTT incomplete pathways), accessed 2026-06-13.
Evidence file
NHS referral-to-treatment waiting list (England)
Latest reading
March 2026
Scoring breakdown
Source
Consultant-led RTT waiting times
- Update frequency
- Monthly
- Reliability
- high
Provenance
- Provider
- NHS England
- Series ID
- RTT incomplete pathways
- Frequency
- monthly
- Accessed
- 13 June 2026
Known weakness
Covers England only; pathway counting rules have changed over time, and the list excludes patients who have given up seeking treatment.
Notes
Verified official value from NHS England (RTT incomplete pathways), accessed 2026-06-13.
A&E four-hour performance (England)
May 2026
Verified official value from NHS England (A&E 4-hour performance (all types)), accessed 2026-06-13.
Evidence file
A&E four-hour performance (England)
Latest reading
May 2026
Scoring breakdown
Source
A&E attendances and emergency admissions
- Update frequency
- Monthly
- Reliability
- high
Provenance
- Provider
- NHS England
- Series ID
- A&E 4-hour performance (all types)
- Frequency
- monthly
- Accessed
- 13 June 2026
Known weakness
England-only; the four-hour target has been paused and reintroduced at different points, and Type 1 (major A&E) performance differs markedly from the blended figure.
Notes
Verified official value from NHS England (A&E 4-hour performance (all types)), accessed 2026-06-13.
Cancer 62-day treatment standard (England)
March 2026
Verified official value from NHS England (Cancer 62-day standard), accessed 2026-06-13.
Evidence file
Cancer 62-day treatment standard (England)
Latest reading
March 2026
Scoring breakdown
Source
Provenance
- Provider
- NHS England
- Series ID
- Cancer 62-day standard
- Frequency
- monthly
- Accessed
- 13 June 2026
Known weakness
England-only; the 62-day clock can be paused for patient-initiated delays, and pathway complexity means like-for-like comparisons over time require care.
Notes
Verified official value from NHS England (Cancer 62-day standard), accessed 2026-06-13.
GP access pressure (England)
April 2026
Verified official value from NHS England (Appointments in General Practice) (GP appointments booked >2 weeks ahead), accessed 2026-06-13.
Evidence file
GP access pressure (England)
Latest reading
April 2026
Scoring breakdown
Source
Appointments in general practice
- Update frequency
- Monthly
- Reliability
- medium
Provenance
- Provider
- NHS England (Appointments in General Practice)
- Series ID
- GP appointments booked >2 weeks ahead
- Frequency
- monthly
- Accessed
- 13 June 2026
Known weakness
GP appointments dataset is still classified as official statistics in development; practice coverage and booking system compatibility vary, affecting completeness.
Notes
Verified official value from NHS England (Appointments in General Practice) (GP appointments booked >2 weeks ahead), accessed 2026-06-13.
Delayed hospital discharges (England)
January 2026
Verified official value from NHS England (Acute Discharge SitRep) (patients no longer meeting criteria to reside), accessed 2026-06-13.
Evidence file
Delayed hospital discharges (England)
Latest reading
January 2026
Scoring breakdown
Source
Discharge delays situation reports
- Update frequency
- Monthly
- Reliability
- medium
Provenance
- Provider
- NHS England (Acute Discharge SitRep)
- Series ID
- patients no longer meeting criteria to reside
- Frequency
- monthly
- Accessed
- 13 June 2026
Known weakness
Administrative data; the definition of 'delayed discharge' has changed in reporting criteria over time, and reporting compliance varies across trusts.
Notes
Verified official value from NHS England (Acute Discharge SitRep) (patients no longer meeting criteria to reside), accessed 2026-06-13.
Crown Court outstanding caseload (E&W)
End Jun 2025
Verified official value from Ministry of Justice (Crown Court outstanding caseload), accessed 2026-06-13.
Evidence file
Crown Court outstanding caseload (E&W)
Latest reading
End Jun 2025
Scoring breakdown
Source
Criminal court statistics quarterly
- Update frequency
- Quarterly
- Reliability
- high
Provenance
- Provider
- Ministry of Justice
- Series ID
- Crown Court outstanding caseload
- Frequency
- quarterly
- Accessed
- 13 June 2026
Known weakness
Caseload counts reflect court listing practices and capacity rather than purely demand, and case complexity is not captured in simple caseload totals.
Notes
Verified official value from Ministry of Justice (Crown Court outstanding caseload), accessed 2026-06-13.
Adult social care requests
2024-25
Verified official value from NHS England Digital / DHSC (nhse_ascfr), accessed 2026-06-14.
Evidence file
Adult social care requests
Latest reading
2024-25
Scoring breakdown
Source
Adult Social Care Activity and Finance Report
- Update frequency
- Annual
- Reliability
- high
Provenance
- Provider
- NHS England Digital / DHSC
- Series ID
- nhse_ascfr
- Frequency
- Annual
- Accessed
- 14 June 2026
Known weakness
England; counts requests with a determined outcome (not pure demand), and the 2024-25 switch to Client Level Data breaks comparability with earlier years.
Notes
Verified official value from NHS England Digital / DHSC (nhse_ascfr), accessed 2026-06-14.
Adult social care vacancies
2024-25
Verified official value from Skills for Care (skills_for_care), accessed 2026-06-14.
Evidence file
Adult social care vacancies
Latest reading
2024-25
Scoring breakdown
Source
The state of the adult social care sector and workforce in England
- Update frequency
- Annual
- Reliability
- high
Provenance
- Provider
- Skills for Care
- Series ID
- skills_for_care
- Frequency
- Annual
- Accessed
- 14 June 2026
Known weakness
England; a Skills for Care modelled estimate (sector body, not official statistics), and high international recruitment has suppressed recent headline vacancy rates.
Notes
Verified official value from Skills for Care (skills_for_care), accessed 2026-06-14.
Historical values
Metric trends
Historical values
NHS referral-to-treatment waiting list (England)
Latest
7.11million incomplete pathwaysNHS referral-to-treatment waiting list (England) — million incomplete pathways — reported values, not stress scores.
Historical values
A&E four-hour performance (England)
Latest
75.7% attendances within 4 hours (target 95)A&E four-hour performance (England) — % attendances within 4 hours (target 95) — reported values, not stress scores.
Historical values
Cancer 62-day treatment standard (England)
Latest
72.8% treated within 62 days of referral (target 85)Cancer 62-day treatment standard (England) — % treated within 62 days of referral (target 85) — reported values, not stress scores.
Historical values
GP access pressure (England)
Latest
19.1% appointments more than 14 days after bookingGP access pressure (England) — % appointments more than 14 days after booking — reported values, not stress scores.
Historical values
Delayed hospital discharges (England)
Latest
13.8thousand patients per day not discharged when readyDelayed hospital discharges (England) — thousand patients per day not discharged when ready — reported values, not stress scores.
Historical values
Crown Court outstanding caseload (E&W)
Latest
78.3thousand open casesCrown Court outstanding caseload (E&W) — thousand open cases — reported values, not stress scores.
Historical values
Adult social care requests
Latest
2.02million new requests for adult social care supportAdult social care requests — million new requests for adult social care support — reported values, not stress scores.
Historical values
Adult social care vacancies
Latest
7% of adult social care roles vacantAdult social care vacancies — % of adult social care roles vacant — reported values, not stress scores.
Data provenance
Sources for this domain
| Organisation | Dataset | Type | Frequency | Link |
|---|---|---|---|---|
| NHS England | Consultant-led RTT waiting times | Official | Monthly | Source ↗ |
| NHS England | A&E attendances and emergency admissions | Official | Monthly | Source ↗ |
| NHS England | Cancer waiting times | Official | Monthly | Source ↗ |
| NHS England | Appointments in general practice | Official (Development) | Monthly | Source ↗ |
| NHS England | Discharge delays situation reports | Administrative | Monthly | Source ↗ |
| Ministry of Justice | Criminal court statistics quarterly | Official | Quarterly | Source ↗ |
| NHS England Digital | Adult Social Care Activity and Finance Report | Official | Annual | Source ↗ |
| Skills for Care | The state of the adult social care sector and workforce in England | Independent | Annual | Source ↗ |
How the Public Service Capacity domain is scored
The domain score is the median of the 8 component metric stress scores. Using the median reduces sensitivity to a single anomalous metric.
Each metric stress score is calculated as:
metric_stress = clamp(0.6 × level_score + 0.3 × trend_score + 0.1 × volatility_score, 0, 100)The Public Service Capacity domain carries a weight of 12% in the national index. Full methodology: methodology page.
Sensitivity analysis
What would move this domain?
The Public Service Capacity domain score is most sensitive to its two highest-stress indicators. Meaningful improvement in either of the following metrics would be the most direct path to improving the domain score:
- 85
Crown Court outstanding caseload (E&W)
Total number of open Crown Court cases awaiting hearing in England and Wales, measuring the depth of the criminal justice backlog.
- 63
Adult social care requests
New requests for adult social care support received by local authorities (millions), England, by financial year.