NHS making progress but not yet world class says The King's Fund

The NHS has addressed many of the challenges it faced in 1997 but needs to change rapidly if it is to meet the big challenges it faces in the future according to a major review of the NHS in England since 1997 published today by The King's Fund.

The review provides a comprehensive, independent assessment of the progress made by the NHS between 1997 and 2010. The main successes it identifies since 1997 include:

  • Significant reductions in waiting times and improved access to primary care
  • Less variation in access to drugs and treatment
  • Significant reductions in MRSA and C.difficile infection rates
  • Sustained reductions in deaths due to cancer and cardiovascular disease
  • Sustained reductions in rates of smoking

Although life expectancy has improved for everyone, the most significant failure identified by the review is that health inequalities - the difference in health outcomes between different groups in society - have widened since 1997. Other key areas where further progress is needed include:

  • Improving productivity which has declined since 1997
  • Embedding a stronger safety culture across the NHS
  • Improving cancer survival rates which despite recent progress still lag behind some other EU countries
  • Increasing access to out of hours GP care
  • Tackling obesity and alcohol-related illness which have increased since 1997

The review identifies three key challenges now facing the NHS:

  • The financial challenge: with a potential £21 billion productivity gap facing the NHS by 2013/14 and efficiency having declined since 1997, a relentless drive to improve productivity must be its top priority in the short term.
  • The public health challenge: rising levels of obesity and alcohol-related illness will place NHS services under significant pressure in the decades ahead unless the progress made in reducing smoking can be replicated.
  • The demographic challenge: with the population ageing, the NHS has a long way to go to transform the delivery of care to support increasing numbers of people with chronic conditions such as diabetes, heart disease and dementia.

Professor Chris Ham, the new Chief Executive of The King's Fund said:

'Back in 1997, the NHS was in intensive care. As a result of investment and reform, it is now in active rehabilitation and is delivering more care to more people, more quickly. The next government faces a huge challenge in nursing the NHS to full health at a time when funding will grow very slowly, if at all. Doing more of the same is no longer an option. The NHS will have to do things differently by embracing innovation and becoming much more efficient in how it uses the £100bn it spends each year.

'The NHS must now transform itself from a service that not only diagnoses and treats sickness but also predicts and prevents it. If the same energy and innovation that went into reducing waiting times and hospital infections could be put into prevention and chronic care, the NHS could become truly world class. This will not be easy and it is vital that politicians engage in an honest dialogue with the public about the changes needed.'

Read the final review: A high-performing NHS? A review of progress 1997-2010

Notes to editors: 

  1. The King's Fund chief executive Professor Chris Ham will be available for interviews. For more information please contact The King's Fund press and public affairs office on 07584146035.
  2. The King's Fund is a charity that seeks to understand how the health system in England can be improved. Using that insight, we help to shape policy, transform services and bring about behaviour change. Our work includes research, analysis, leadership development and service improvement. We also offer a wide range of resources to help everyone working in health to share knowledge, learning and ideas.