Health in 2040: projected patterns of illness in England (Health Foundation, 24 July 2023)

Summary

9.1 million people will be living with major illness by 2040, 2.5 million more than in 2019, according to this new report published by the Health Foundation.

The analysis is part of a four-year project led by the Health Foundation’s Real Centre in partnership with the University of Liverpool, focusing on levels of ill health in the adult population in England up to 2040. It lays out the scale and impact of the growth in the number of people living with major illness as the population ages.

Content

The analysis finds that 19 of the 20 health conditions studied are projected to increase in prevalence, including a rise of more than 30% in the number of people living with conditions such as cancer, diabetes and kidney disease. Overall, the number of people living with major disease is set to increase from almost 1 in 6 of the adult population in 2019, to nearly 1 in 5 by 2040, with significant implications for the NHS, other public services and the public finances.

The challenges of improving care for an ageing population and enabling people to live independent lives for longer are not unique to England, with countries across the globe facing similar pressures on their health services. However, with the NHS already under unprecedented strain, the findings point to big changes in how care should be delivered in future.

Much of the projected growth in illness relates to conditions such as anxiety and depression, chronic pain and diabetes, which are predominantly managed outside hospitals in primary care and the community. This reinforces the need for investment in general practice and community-based services, focusing on prevention and early intervention to reduce the impact of illness and improve the quality of people’s lives.

The analysis finds that 80% of the projected increase in major illness (2 million people) will be among people aged 70 and over, with the remaining 20% (500,000 people) among the working-age population (20-69 years old). It also projects that improvements in some of the main causes of poor health, such as fewer people smoking and lower cholesterol rates, will be offset by the impact of obesity as many people who have been obese for long periods of their lives reach old age.

The report warns that there is no silver bullet to reduce the growth in people living with major illness and that supporting people to live well with illness will increasingly be an essential function of health care and other services in the future. Its findings underline the need for a long-term plan to reform, modernise and invest in the NHS alongside a bold, new approach that invests in the nation’s health and wellbeing.