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United Kingdom
Health systems in transition
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4 December 2024
Health systems in action: United Kingdom
Health Systems in Action Insight Series (2024)
Country overview
Access to services based on need rather than ability to pay is a core value of the National Health Service (NHS) and all people who are ordinarily resident in the United Kingdom are entitled to comprehensive care. Since 1998, health care has been a devolved responsibility in the four nations of the United Kingdom and while all nations have retained the tax-funded NHS model, the way in which services are organized and paid for has diverged.
Each nation has its own planning and monitoring frameworks and its own public health agencies, with clear differences in some policies. The English NHS is the largest health service as over 80% of the United Kingdom’s population lives in England. A fixed formula determines the relative level of funding for each of the United Kingdom’s four nations (England, Northern Ireland, Scotland and Wales).
Financial protection is very good as most NHS care is free at the point of use. Fixed co-payments are applied to dental care and prescription pharmaceuticals (in England only), although exemptions exist for many groups (such as children, pregnant women and low-income households).
The NHS does not have an explicit list of benefits and is required by law to deliver necessary health services and remain committed to patient’s rights. Local bodies responsible for commissioning services decide what is considered “necessary” in each region.
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