Overview

Four separate health care systems are responsible for delivering health services

Since devolution in the late 1990s, the respective governments in England, Scotland, Wales and Northern Ireland have been responsible for organising and delivering health care services.

United Kingdom residents enjoy access to a National Health Services (NHS) based on clinical need, and not ability to pay. In contrast, free access to social care services is means-tested, with different eligibility criteria across the nations of the United Kingdom.

There are shortages of doctors, nurses and health care infrastructure

The United Kingdom has relatively lower levels of both doctors and nurses, as well as lower levels of hospital beds and of diagnostic equipment, than most other high-income countries. These shortages have left the country with little spare capacity and vulnerable to acute shocks such as the COVID-19 pandemic. Also, they have led to growing waiting lists for elective care, with over 6 million people in England alone on a waiting list in 2022.

Health care financing provides high levels of protection against the financial consequences of ill health

Historically, health spending in the United Kingdom has gone through cycles of sustained growth and austerity. Nevertheless, total health expenditure has increased in the last decade, reaching just over 10% of GDP in 2019. The proportion of public funding for health is high and has remained relatively unchanged over the last two decades, at around 80% of total health spending. Consequently, UK citizens enjoy high levels of protection against the financial consequences of ill health and minimal out-of-pocket payments.

Reforms are targeting greater integration of care and cross-sectoral partnerships that improve the health and well-being of local populations

Several barriers persist across the four nations to facilitate meaningful integration between health care services, such as unlinked health information technology systems, duplication of governance arrangements and a lack of strategic planning. Northern Ireland is the only United Kingdom constituent country where the NHS and social care are fully organisationally integrated, although efforts to promote such integration with cross-sectoral partnerships in England, Scotland and Wales have accelerated in recent years.

 

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United Kingdom	United Kingdom - Health Systems and Policy Monitor (HSPM)