Overview

Key points

• Universal health coverage is central to the National Health Service (NHS). It is primarily funded through general taxation and is based on the principle of access to comprehensive care dependent on need, not ability to pay.
  
• The United Kingdom comprises England, Scotland, Northern Ireland and Wales. Each has devolved responsibilities for health and social care, and designs, delivers and regulates services differently.
  
• The COVID-19 pandemic pushed public spending on health up to 11% of GDP in 2022. However, a prolonged period of government funding restraint has limited investment in long-term priorities such as infrastructure, workforce and technology.
  
• The United Kingdom reports some of the lowest rates of out-of-pocket (OOP) and catastrophic health spending in Europe.
  
• Access to planned hospital care is impeded by long waits, which grew steadily before the pandemic and then rapidly as services returned to normality. Access to primary care appointments has also worsened.
  
• The hospital sector takes up just over half of public spending on health, although bed numbers are relatively low, leaving little excess bed capacity to respond to surges in demand.
  
• There has been a longstanding focus on integration between health and social care in all four countries.
  
• The rates of doctors and nurses are relatively low compared to the EU, reflecting historic issues with planning and retention. Reliance on health professionals trained abroad is high.
  
• There are wide variations in health outcomes and infant and maternal mortality rates are above the EU averages, reflecting socioeconomic inequalities and increasing poverty rates.