The Treatment Access Index is a monthly view of pressure across key parts of NHS treatment access in England.
It is designed to help people understand the wider healthcare-access picture when they are thinking about private medical insurance, often shortened to PMI.
Private medical insurance does not replace the NHS. It does not replace A&E, ambulance services, emergency care, chronic condition management or every type of treatment.
But many people start comparing PMI because they are worried about waiting times, access to scans, specialist appointments, planned treatment or uncertainty around diagnosis.
The Treatment Access Index gives useful background context for those concerns.
It does not tell you whether you personally need PMI.
It does not say private medical insurance is right for everyone.
It simply helps explain where NHS access pressure may be building, and which PMI cover features may be worth comparing carefully.
Why we created the Treatment Access Index
People often search for private medical insurance because they are worried about access to care.
They may be asking questions like:
How long would I wait for a scan?
Could I see a specialist privately?
Would PMI help with planned treatment?
Does PMI cover cancer treatment?
Would private medical insurance help if NHS waiting lists are long?
Can PMI replace NHS emergency care?
The answers are not always simple.
PMI can help with some eligible private diagnosis and treatment, depending on the policy. But it also has clear limits, exclusions and underwriting rules.
The Treatment Access Index was created to add context before people compare cover.
Instead of looking at PMI in isolation, it helps users understand the wider access pressures that may influence why someone is considering private cover in the first place.
What does the Treatment Access Index measure?
The index combines five areas of NHS access pressure.
Each area is shown as a score out of 100, where a higher score means more pressure.
The five areas are:
Elective treatment access
Diagnostic access
Time-critical pathways
Whole-system pressure
Patient access sentiment
Together, these give a broader view of how treatment access is feeling across the system.
The index is not a clinical tool, and it is not a prediction of what will happen to any one person. It is a public-facing way to track pressure using available NHS and ONS data.
Elective treatment access
Elective treatment means planned hospital treatment.
This may include appointments, procedures, operations or treatment pathways that are important but not usually classed as immediate emergencies.
The elective treatment part of the index looks at NHS referral-to-treatment waiting-time pressure.
This matters for PMI because many private medical insurance policies are designed around eligible planned diagnosis and treatment for new acute conditions.
If waiting for planned treatment would affect your work, income, family life or peace of mind, this may be one reason you compare PMI.
But the policy wording still matters.
PMI will not automatically cover every condition or every treatment simply because NHS waits are long.
👉 View elective treatment access data
👉 Read what PMI cover can include
Diagnostic access
Diagnostic access looks at pressure around tests and scans.
This can include waits for things such as:
MRI scans
CT scans
Ultrasound scans
X-rays
Blood tests
Other investigations
This is one of the most important areas for people comparing PMI.
A lot of medical uncertainty happens before treatment. You may need a consultation, scan or test before anyone knows what the problem is.
That is why outpatient cover and diagnostic cover matter so much.
Some PMI policies include generous outpatient and diagnostic benefits. Others have lower outpatient limits or restrictions. Some cheaper policies may still help with inpatient treatment but provide less support before you reach that stage.
If scans and tests are one of your main concerns, do not just compare prices.
Check:
Whether outpatient consultations are included
Whether MRI and CT scans are covered
Whether there are outpatient limits
Whether pre-authorisation is needed
Whether the policy restricts where tests can be carried out
Whether diagnostic tests are only covered after certain referral routes
👉 View diagnostic access data
👉 Read about PMI cover for MRI and CT scans
👉 Read about outpatient cover
Time-critical pathways
Time-critical pathways include areas where delays can feel especially serious, such as cancer pathway pressure.
Cancer cover is one of the most important areas to compare in PMI.
Some private medical insurance policies include strong cancer cover. Others may have limits, exclusions or conditions around drugs, diagnostics, follow-up appointments or treatment routes.
The Treatment Access Index tracks time-critical pathway pressure to help users understand why cancer cover and serious-diagnosis wording should be checked carefully.
But this needs to be handled with care.
PMI does not replace urgent NHS cancer pathways.
It also does not mean a policy will automatically cover cancer in every situation. Cover depends on:
The policy wording
The underwriting method
Whether the condition is new or pre-existing
The insurer’s rules
The treatment being recommended
Whether the provider authorises the claim
If cancer cover matters to you, it is worth comparing policies in detail rather than assuming every insurer offers the same level of support.
👉 View time-critical pathway data
👉 Read about PMI and cancer treatment
Whole-system pressure
Whole-system pressure looks at wider NHS pressure, including emergency-care strain.
This is useful context, but it is also where one of the biggest PMI misunderstandings appears.
PMI does not usually replace emergency NHS care.
It is not normally designed for:
A&E
Ambulance services
Emergency resuscitation
Major trauma
Emergency stabilisation
Intensive emergency treatment
In an emergency, the NHS remains the correct route.
PMI may sometimes help later if you are stable and need eligible follow-up private treatment, rehabilitation, specialist review or planned care, depending on the policy.
That is why whole-system pressure is included in the index, but it should not be misunderstood.
It helps explain the wider access environment.
It does not turn PMI into emergency cover.
👉 View system pressure data
👉 Read about PMI and emergency treatment
👉 Read what PMI usually does not cover
Patient access sentiment
Patient access sentiment looks at how people report their experience of accessing NHS services.
This includes ONS Health Insight Survey data around GP access and treatment waiting-list experience.
This is important because healthcare access is not only about official waiting-time figures.
It is also about how confident people feel, whether they understand what is happening, and how difficult it feels to get answers.
Patient sentiment may influence why someone starts looking at PMI.
For example, someone may compare private medical insurance because they want:
Faster access to a specialist
More certainty around diagnosis
More control over appointment timing
Private hospital options
Extra reassurance for their family
Advice about what is and is not covered
But again, sentiment is context.
It does not mean PMI is suitable for everyone.
If you are comparing PMI because you feel worried or uncertain, the important thing is to match the policy to your actual needs, budget and expectations.
👉 View patient access sentiment data
👉 Read how to compare PMI providers
👉 Read whether you should use a PMI broker
How is the Treatment Access Index scored?
The index uses a composite score out of 100.
A higher score means more pressure.
The score is built from five weighted areas:
Elective treatment access
Diagnostic access
Time-critical pathways
Whole-system pressure
Patient access sentiment
The purpose is to give a clearer monthly view of treatment access pressure rather than relying on one single waiting-time statistic.
Some healthcare measures move in different directions.
For example, a higher number of people waiting over a certain threshold may suggest more pressure. But for another metric, such as the percentage seen within a target time, a lower number may indicate more pressure.
The index converts these different measures into a common pressure score so they can be viewed together.
This makes the index easier to understand for non-specialists.
Instead of asking users to interpret several NHS datasets separately, the index provides a simple monthly pressure view and then lets users explore the underlying pillars.
Why does the index include data from different sources?
The Treatment Access Index uses recognised public sources, including NHS England and ONS datasets.
These sources cover different aspects of healthcare access.
NHS waiting-time data helps show what is happening in treatment, diagnostics, cancer pathways and emergency pressure.
ONS Health Insight Survey data helps show how people report access experiences and sentiment.
Using several sources gives a broader view than one dataset alone.
That matters because someone comparing PMI is not usually worried about just one number.
They may be worried about diagnosis, treatment, waiting, communication, work disruption, family responsibilities and peace of mind at the same time.
The index tries to reflect that broader picture.
Why is some older sentiment data missing?
The patient sentiment part of the index relies on ONS Health Insight Survey data.
That data is available from July 2024 onwards.
For months before that point, the index can still show treatment-access pressure using the other available NHS datasets, but the sentiment pillar is not available in the same way.
That means older periods may be shown as a backcast without the sentiment component.
Where sentiment is missing, the index should be treated as a historical estimate based on the available non-sentiment pillars.
What does the index mean for private medical insurance?
The Treatment Access Index does not tell you to buy PMI.
It helps you think more clearly about why you might be comparing it.
For example:
If diagnostic pressure is high, you may want to check outpatient and scan cover.
If elective treatment pressure is high, you may want to understand planned private treatment cover.
If time-critical pathway pressure is high, you may want to compare cancer cover wording carefully.
If system pressure is high, you should remember PMI does not replace A&E or emergency NHS care.
If patient sentiment is worsening, you may want advice before choosing a policy so expectations are realistic.
The index gives context.
The policy wording gives the answer.
That distinction matters.
A PMI policy may be useful for one person and unsuitable for another, even if both people are looking at the same NHS waiting-time environment.
What PMI features should you compare alongside the index?
If the Treatment Access Index is one reason you are thinking about PMI, the most important policy features to compare include:
Outpatient cover
This can affect consultations, tests, scans and follow-up appointments before hospital treatment.
Diagnostic scan cover
Check whether MRI, CT, ultrasound and other investigations are included, limited or subject to authorisation.
Cancer cover
Compare the wording carefully. Look at diagnosis, treatment, drugs, follow-up and any limits.
Hospital list
This affects which private hospitals you may be able to use.
Consultant choice
Some policies offer wider choice, while others use guided consultant lists.
Excess
This is the amount you may pay towards a claim.
Underwriting
This affects how pre-existing conditions are treated.
Exclusions
Check what is not covered, especially chronic conditions, emergency care, routine healthcare and pre-existing conditions.
Mental health cover
This varies widely between policies and may be optional, limited or excluded.
Price
Price matters, but it should not be the only comparison. Cheap PMI may still be useful, but only if it covers the features that matter to you.
👉 Read how to compare private medical insurance providers
👉 Read whether cheap PMI is worth it
What the index does not mean
The Treatment Access Index should not be misunderstood.
It does not mean:
PMI replaces the NHS
Everyone needs private medical insurance
A high score means you personally need cover
A policy will cover every treatment
Cancer treatment is automatically covered
Emergency care can be handled privately through PMI
Pre-existing conditions will be accepted
Cheaper cover is always poor value
More expensive cover is always better
The index is a context tool.
It should sit alongside proper policy comparison and, where needed, advice.
Why this matters when comparing quotes
Many people start a PMI quote because they are worried about waiting.
That is understandable.
But a quote should not just be about the monthly premium.
It should help you compare:
What is included
What is excluded
How outpatient cover works
Whether scans and diagnostics are covered
How cancer cover works
How pre-existing conditions are treated
Whether mental health cover is included
What excess you would pay
Which hospitals you can use
Whether the policy matches your reason for buying
The Treatment Access Index can help you ask better questions before choosing cover.
That is its real value.
Should you use the Treatment Access Index before comparing PMI?
Yes, as context. It can help you understand the wider access picture before you look at policies. But it should not be the only thing you use.
A sensible route is:
Use the Treatment Access Index to understand current access pressure.
Read what PMI does and does not cover.
Decide which features matter most to you.
Compare policies based on those features.
Ask for advice if you are unsure.
Make sure expectations are realistic before applying.
This is especially important if you have existing symptoms, a previous diagnosis, a chronic condition, or a specific treatment in mind.
The bottom line
The Treatment Access Index tracks NHS treatment access pressure across elective treatment, diagnostics, cancer pathways, whole-system pressure and patient sentiment.
It helps explain why some people compare private medical insurance.
But it does not replace proper PMI comparison.
Private medical insurance can help with faster private diagnosis and treatment for eligible new medical conditions, depending on the policy.
It does not usually replace emergency NHS care, chronic condition management, routine healthcare or treatment for pre-existing conditions.
Used properly, the index gives useful context.
The next step is comparing the policy detail.
👉 View the Treatment Access Index
👉 Read what PMI cover includes
👉 Compare private medical insurance quotes
