Patients contacting the NHS for mental health support is soaring as GPs admit never turning down sick notes.

Latest data for England shows 2.24 million people contacted the NHS needing treatment in January. This is up from the 2.04 million in January 2025 and 1.39 million in January 2020, before the Covid-19 pandemic. Experts are unsure what is driving the huge surge in demand for mental health services which often have long waits for care.

It comes as a BBC investigation found most GPs have never turned down a request for a sick note - now officially known as "fit notes" - to get someone signed off work. New data out today also shows the overall NHS waiting list for planned care came down for the third consecutive month to 7.25 million appointments.

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Brett Hill, employment expert at the consultancy Broadstone, said: “While the referral to treatment waiting list may be at its lowest level in three years, this positive trend is masking a troubling reality. Mental health services are in record demand, with overstretched NHS services grappling to meet it.”

The BBC survey of 752 GPs saw 540 say they had never refused to issue a sick note, while 162 said they had turned down at least one down. Some 50 said they would prefer not to say. Many GPs have criticised the current system and say fit notes should not be part of their job.

They reported some patients becoming aggressive if they were not signed off work. One GP said a patient had refused to leave the practice without a fit note.

In England there were an estimated 7.25 million treatments waiting to be carried out at the end of January, relating to 6.13 million patients. This is down from 7.29 million treatments and 6.17 million patients at the end of December and is the lowest level since February 2023, when it stood at 7.22 million.

The list hit a record high in September 2023, with 7.77 million treatments and 6.50 million patients. Health Secretary Wes Streeting said: "After years of rising waiting times, patients are finally starting to see things move in the right direction - with waiting lists at their lowest level for almost three years and more people getting treated within 18 weeks.

"Despite record demand this winter, A&E and ambulance services improved - meaning patients are getting help faster when they need it most, thanks to the hard work of NHS staff, better planning and modernisation.”

Nuffield Trust deputy director Sarah Scobie said: "Seeing the waiting list fall substantially for a few months in a row is a relief, but the NHS is still some way off hitting the March goal of 65% of patients treated within 18 weeks. Even if they get close to this through short bursts of improvement, it remains incredibly difficult to sustain this trend over longer periods.”

Tim Gardner, assistant director of policy at the Health Foundation, said: "Today's data shows tentative signs of improvement across the health service after a gruelling winter, which should provide some relief for patients and staff. Achieving lasting improvements will require a concerted focus on addressing the root causes of delays.”