Key Hurdles Confronting the Healthcare and Care Systems in England


England (Parliament Politic Magazine) – Whichever political party assumes power following the upcoming general election will face the daunting challenge of addressing a healthcare system in a state of crisis. The National Health Service (NHS) is grappling with an unprecedented level of strain, resulting in many individuals being unable to access the necessary medical care. As of July 2023, the waiting list for routine hospital treatments in England had surged to an all-time high of nearly 7.7 million patients, with approximately 390,000 individuals enduring waits exceeding a year.

This distressing data reflects the overwhelming pressures throughout the entire healthcare ecosystem, encompassing general practice, community services, mental health, and social care. These pressures inflict unnecessary suffering on patients and their families while imposing a severe burden on healthcare staff .Public satisfaction with the healthcare system has reached an all-time low.

Health Influenced by Various Factors

It’s crucial to recognize that the NHS was never designed to operate in isolation. A person’s overall health is influenced by a broad spectrum of factors extending beyond healthcare, including income, employment, housing, and the availability of public services. Sadly, many of these foundational elements of health have deteriorated over the years due to a decade of austerity measures and the disruptive impact of the COVID-19 pandemic, particularly for individuals residing in the most economically disadvantaged regions.

 Progress in life expectancy within the UK has stagnated, giving rise to significant health disparities between affluent and less affluent areas. Moreover, a considerable number of individuals are unemployed due to health-related issues.

The upcoming government in the UK will confront a series of formidable decisions regarding the healthcare and social care sectors. Urgent attention is required to address the immediate pressures on the NHS, but equal consideration must be given to the long-term challenges that will shape the nation’s health and, in turn, influence the future demands placed on the healthcare system and the available resources to meet these demands. A comprehensive understanding of the array of challenges on the horizon for health and care is vital for policymakers to identify the necessary actions.

Life Expectancy Is Stalling & Health Inequalities Are Widening

We have identified nine key trends that encapsulate some of the primary challenges that any incoming government will face in the realms of health and care, with a specific focus on the NHS, social care, and public health services in England. We then bring together several implications for policymakers stemming from these trends. This work has been prepared as part of Nesta’s UK 2040 Options project, which is dedicated to examining the pivotal issues that will confront the country leading up to the next general election.

Over the course of a century, life expectancy in the UK consistently rose; however, in the decade preceding the COVID-19 pandemic, these improvements came to a halt. Some segments of the population experienced a reversal in these gains. Between 2010-2012 and 2016-2018, the life expectancy of women residing in the most economically deprived 10% of areas in England declined, with the most significant decreases observed in the North- East region.

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Population Facing Health Issues

This trend of stalling life expectancy was not unique to the UK; many countries witnessed similar patterns. Nevertheless, the extent of the UK’s slowdown sets it apart from other comparable nations. In 2000, the UK ranked 21st out of 38 countries in terms of female life expectancy at birth, but by 2019, it had fallen to the 26th position.

Moreover, healthy life expectancy, which measures the number of years a person can anticipate living in good health, not just their overall lifespan, also exhibited stagnation. Recent analyses indicate that if the trends observed in the decade leading up to the COVID-19 pandemic persist, it would take nearly two centuries (192 years) to achieve the current government’s objective of improving healthy life expectancy by five years for men.

The overall health of a population is influenced by a complex interplay of social and economic factors, including income, employment, education, housing, and transportation. These factors come together to shape the daily circumstances of individuals’ lives, impacting their ability to afford housing, the conditions in their local neighborhoods, and more.

However, these fundamental components of good health are not evenly distributed across the population, and a decade of reduced real-terms spending on public services from 2009/10 to 2019/20 has left many people without access to these essential elements.

Beth Malcolm

Beth Malcolm is Scottish based Journalist at Heriot-Watt University studying French and British Sign Language. She is originally from the north west of England but is living in Edinburgh to complete her studies.