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.

• Average day-to-day health spending in the UK between 2010 and 2019 was £3,005 per person – 18% below the EU14 average of £3,655.
• If UK spending per person had matched the EU14 average, then the UK would have spent an average of £227bn a year on health between 2010 and 2019 – £40bn higher than actual average annual spending during this period (£187bn).
• Matching spending per head to France or Germany would have led to an additional £40bn and £73bn (21% to 39% increase respectively) of total health spending each year in the UK.
• Over the past decade, the UK had a lower level of capital investment in health care compared with the EU14 countries for which data are available. Between 2010 and 2019, average health capital investment in the UK was £5.8bn a year. If the UK had matched other EU14 countries’ average investment in health capital (as a share of GDP), the UK would have invested £33bn more between 2010 and 2019 (around 55% higher than actual investment during that period).

• May’s data show that pressure on the system remains steady. Despite sustained volume of the most serious incidents, there were improvements in call answering and response times – although the latter continue to exceed national standards by some margin. Patient handover delays remain very high, with many thousands of patients waiting three hours or more, increasing their risk of harm and resulting in a significant impact on resources.
• The volume of 999 calls dropped for the second consecutive month, but remain well above the series average. 999 calls answered in the most recent 12 months exceeds the previous period by more than 2 million.
• Call answer time decreased for the second month since March but remains more than twice that seen the same time last year. Call answer delays of 2 minutes or more spiked at the end of May.
• Volume of Category 1 and 2 incidents remain significantly higher the same month last year. Annualised data show much higher volumes for the most recent 12 months, compared with the previous period. C1 continues to account for more than 10% of all incidents (compared with 7% in 2020). Meanwhile C4 incidents continue to shrink, accounting for 0.7% of incidents in May 2022 compared with 2.6% in May 2019. Response times for all incidents continue to exceed national standards, but in every category the time taken to respond decreased in May 2022. Nonetheless, mean response times have now exceeded the national standard for over 12 months for C1 incidents, and nearly 2 years for C2 incidents.
• Transport to Emergency Departments increased in May 2022. However, volume remained below the series average with the year-on-year trend showing a steady decrease. Conversely, Hear and Treat incidents continue to increase steadily.
• Despite a second month of contraction, the number of longer patient handover delays remain some of the highest seen to date. The longest delay across the month was just under 24 hours, while 387 patient handovers took 10 hours or longer

• UK health spending in 2019 of 10.2% of gross domestic product (GDP) matched the average of the comparator countries.
• UK life expectancy of 81.4 years in 2019 was the 17th lowest of 19 countries. The average was 82.3 years.
• The UK breast cancer five-year survival rate of 85.6% was the 15th lowest of 18 countries. The average was 87.0%.
• The UK colon cancer five-year survival rate of 60% was the lowest of 18 countries. The average was 64.3%.
• The UK rectal cancer five-year survival rate of 62.5% was the 12th lowest of 18 countries. The average was 63.9%.
• The UK lung cancer five-year survival rate of 13.3% was the 17th lowest of 18 countries. The average was 18.1%.
• The UK stomach cancer five-year survival rate of 20.7% was the 17th lowest of 18 countries. The average was 30.4%.
• For every 100,000 people in the UK, on average 80.9 were admitted to hospital with diabetes in 2019, the sixth best rate of 13 countries. The average was 98.5.
• For every 100,000 people in the UK, on average 3.0 had a foot or leg amputation caused by diabetes in 2017, the best rate of 10 countries. The average was 5.9.
• For every 100,000 people in the UK, on average 222.9 were admitted to hospital with chronic obstructive pulmonary disease in 2019, the ninth best rate of 14 countries. The average was 201.1.
• For every 100 people admitted to hospital with an ischaemic stroke in 2019, on average 12.0 died within 30 days in the UK – ranking it ninth out of nine comparable countries. The average was 9.5.
• For every 100 people admitted to hospital with a haemorrhagic stroke in 2019 in the UK, on average 41.7 died within 30 days – ranking it ninth out of nine comparable countries. The average was 28.9.
• For every 100 people admitted to hospital with acute myocardial infarction (a heart attack) in 2019 in the UK, on average 8.1 died within 30 days – ranking it ninth out of nine comparable countries. The average was seven.
• For every 100,000 people in the UK in 2019, on average 69 people died of a treatable disease, the 15th lowest rate of 16 countries. The average was 58 people. Note that the UK ranking for amenable mortality was the same as that analysed by the Global Burden of Disease study published in the Lancet in 2017.
• For every 1,000 live births in the UK, on average 2.8 died within 30 days in 2018, the 15th lowest rate of 18 countries. The average was 2.4.
• For every 1,000 live births in the UK, on average 6.1 were still births or died within seven days of birth in 2019, the 15th lowest rate of 18 countries. The average was 5.3.
• For every 100,000 births in the UK, on average there were 6.5 maternal deaths in 2017, the 12th lowest rate of 18 countries. The average was 5.1.

In terms of access to health care, the OECD reports that:

• 100% of the UK population were eligible for a defined set of health care goods and services under public programmes (2019). This is identical to, or very similar to, that in all the comparator countries with the exception of the USA;
• The UK ranked 12th out of 14 countries in terms of unmet need for medical examination due to financial, geographical or waiting time reasons (2018);
• The UK ranked seventh out of 17 countries in terms of government and compulsory funding of total health funding (2019 or earliest year); The UK ranked second out of 15 countries in terms of households who faced catastrophic health spending (latest year).

The Index is composed of 75 indicators that run across five dimensions:

• The absence of extreme sentencing and responses to drugs, such as the death penalty
• The proportionality of criminal justice responses to drugs
• Funding, availability, and coverage of harm reduction interventions
• Availability of international controlled substances for pain relief
• Development

The UK scores relatively low on 'Proportionality and Criminal Justice' and there is a need to reflect on this at a policy level.

Read testimonies of people who have been directly affected by drug policies in the 30 countries covered by the Global Drug Policy Index.

• Coronavirus remains the biggest health problem facing people around the world (selected by 70% of people across all 30 countries, only slightly down on the 72% recorded last year).
• Half as many (34%) say that cancer is an important health concern in 2021, down from 37% last year. Meanwhile, mental health sees a 5-point increase to 31%, putting it just 3 points behind global concern about cancer.
• Despite a challenging couple of years for healthcare services, public perceptions are holding up well overall: 53% rate their country’s healthcare services positively, and 51% trust they will receive the best treatment.
• That said, a majority worldwide (56%) say that their country’s healthcare system is overstretched while access to treatment/waiting times is seen to be the main challenge for healthcare services (41%), followed by lack of staff (39%).

NHS performance summary: May-June 2021

NHS performance summary: April-May 2021

Combined Performance Summary: November–December 2019

Combined Performance Summary: October-November 2019

Combined Performance Summary: September–October 2019

Combined Performance Summary: August–September 2019

Combined Performance Summary: July–August 2019

Combined Performance Summary: January – February 2019

Combined Performance Summary: December 2018 - January 2019

Combined Performance Summary: November – December 2018

Record your measurements here