How fit is the NHS? We gave it a full health check

Seventy years ago this week, a revolutionary institution was born. As the leaflet that announced the formation of the National Health Service avowed, “Everyone – rich or poor, man, woman or child – can use it or any part of it.” With that pledge the NHS became, in the words of its architect Nye Bevan, the “envy of the world”.

But few of us can expect to remain strong over seven decades. The NHS is facing the toughest tests in its history, with an ageing population, increasing demand and ever more pressure on budgets. Our NHS at 70 series takes a deeper look at the current state of our National Health Service as it enters its seventh decade.

It’s time for a check-up. We’ve ploughed through a raft of reports in order to assess the current state of the NHS, examining the main causes of its problems so a cure can be found.

MONEY

£150bn
Overall spending on the NHS across the UK is around £150bn this year

7% 
That accounts to more than seven per cent of national income

10%
Including private spending and the social care sector, health represents 10 per cent of the entire UK economy

In England, spending in the last year was around £125bn – or a little over £2,200 per person

In Wales it was £7.3bn, or £2,300 per person

In Scotland it was £13.2bn, or £2,500 per person

In Northern Ireland it was £5bn, or £2,700 per person

0.6%
In 2016/17 the total budget rose by 0.6 per cent in England. That rate of increase was lower than population growth, so total healthcare spending per person in England actually fell

£95bn
Despite the government’s £20bn birthday present for the NHS, just to maintain current service levels spending will need to increase by £95bn over the next 15 years. That is an increase of 3.3 per cent annually

Since the NHS was founded, budgets have increased by an average of 3.7 per cent a year

£437m
In 1948, the NHS budget was £437m (the equivalent of around £15bn today)

In today’s prices, spending on the NHS did not reach £20bn until the mid-1960s. It reached £40bn in the mid-1980s, and £80bn at the turn of the century

Over the last eight years, spending has grown at a slower rate than in any other period since 1948

4%
To improve the current service, an increase of around four per cent may be needed

54%
Investment in equipment has taken a hit, falling 54 per cent in the last five years

STAFF

2 million
More than two million people work for the NHS in the UK

After the US and Chinese armies, Walmart and McDonald’s, the NHS is the world’s fifth-largest employer

70%
In the last 20 years, the number of hospital doctors has increased by 70 per cent. The number of nurses has gone up by 10 per cent

However, the number of GPs has been falling since 2010

£1.1bn
Over the last year, staff costs increased by £1.1bn, driven by a one per cent increase in staff numbers

60%
The biggest cost for the NHS is staff wages, accounting for 60 per cent of the overall budget

Overall there are 2.8 doctors per 1,000 people, or one for every 356 people, fewer than in any comparable European country

4.4 million
With an ageing population (an estimated 4.4 million more people aged 65 and over, with 1.3 million over 85) the NHS in England is estimated to require 64,000 extra hospital doctors and 171,000 extra nurses

28%
8 per cent of doctors and 21 per cent of nurses were trained outside the UK

A&E

42%
In England, the number of emergency admissions has grown by 42 per cent over the last 12 years

Around 14 per cent of emergency admissions are for conditions that could have been managed before getting to that stage

15,379,166
In the last year, 15,379,166 people attended A&E in England

26.5%
A study estimated that 26.5 per cent of unplanned A&E visits were preceded by the patient being unable to obtain a convenient GP appointment

10,977,909
71 per cent of patients (10,977,909) were sent home without needing admission

400,000
Around 400,000 emergency admissions were re-admissions – meaning the patient had been discharged from hospital within the previous 30 days

58.9%
Emergency admissions for people aged 85 or over have risen by 58.9 per cent. Once admitted they are likely to spend longer in hospital

6.9days
The average length of stay in hospital is 6.9 days

PATIENTS

66
In 1948, life expectancy for men was 66 and 71 for women

79.2
The life expectancy of a man in the UK today is 79.2 years and 82.8 for a woman, but healthy life expectancy is only 71.9 years

1.1 million
There were 1.1 million hospital admissions related to alcohol consumption

The economic burden of alcohol is estimated to be 1.3-2.7 per cent of the UK’s GDP

1 million
More than one million hospital in-patients are smokers

One in four people admitted to hospital are smokers

3.8 million
There are 3.8 million people with Type-2 diabetes in England, with 200,000 new diagnoses each year

Nearly two thirds of adults in the UK are classed as overweight

A third of children aged two to 15 are overweight or obese

Obesity is responsible for increasing cancer rates, making a person 2.5 times more likely to have high blood pressure and five times more likely to develop Type-2 diabetes. Obesity is responsible for an estimated 30,000 deaths each year

£6bn
Ill-health linked to being overweight or obese is estimated to have cost the NHS in England more than £6bn

Sources: The Health Foundation, Full Fact