Sir Derek Wanless to lead The King's Fund review of health care spending over last five years

Sir Derek Wanless is to revisit his 2002 review for the Treasury which paved the way for the unprecedented levels of funding the NHS has received in recent years as part of a major King's Fund investigation into health care spending.

The former NatWest Group chief executive will review progress on his recommendations for the Chancellor which estimated the amount of money which health care would require over a 20-year period up to 2023. The review led to the Chancellor's decision to increase annual NHS funding by 7.4 per cent in real terms from 2002/03 up to 2007/08.

Sir Derek will work with The King's Fund to examine many of the assumptions underlying the future spending recommendations he made in his original report and test whether these are on track. He will examine how changes in the health of the population, demographics, productivity, staff pay, drug costs and medical advances have influenced health care spending, as well as analysing how the NHS has spent the extra resources. He will also look at progress made in health prevention strategies.

Sir Derek said:

'The 2002 report showed that health services required much extra resource but said that success was not guaranteed just by spending the money. It revealed many issues about the way resources were being used. They needed to be used more effectively in future. Both additional resources and radical reform were vital; neither would succeed without the other.

'This is an ideal time to look back at the lessons of the last five years and see if the extra money has been spent productively. We will attempt to unravel what has worked well, what went wrong and what needs to change if we are to move in the right direction. A lot has changed over the last five years and we’ll be looking at what it means for the future of the health service and how our assumptions on resource needs may change.'

See our work on the Wanless Social Care Review

He added: 'I am delighted to be working again with The King's Fund and am grateful to them for commissioning this important review. It was always clear in my mind at the time of the 2002 report that there should be a independent review of the health service every five years. We look forward to seeing how the original assumptions have worked out in practice.'

Welcoming Sir Derek's review, The King's Fund Chief Executive Niall Dickson said:

'This is an important piece of work. The health service has received unprecedented levels of funding in recent years and clearly we need to know whether it has been well spent. But it is almost more vital to understand how future investment can be made more effective. We know that the government has made significant strides in reducing waiting times and improving care in the three clinical priorities, but there are many other challenges in the system. As far as this study is concerned we need to keep an open mind and assess the evidence. We hope it will prove to be useful as we enter a more testing financial landscape.'

Sir Derek's original report was the first ever evidence-based assessment of the long-term resource requirements for the NHS. Sir Derek concluded that in order to meet people's expectations and to deliver the highest quality over the next 20 years, the UK will need to devote more resources to health care and that this must be matched by reform to ensure resources are used effectively.

The original review looked at three different scenarios, including a 'fully engaged' scenario in which the level of public engagement in relation to health is high, life expectancy goes beyond current forecasts, health status improves dramatically, use of resources is more efficient and the health service is responsive with high rates of technology uptake. The fully engaged scenario was the least expensive scenario modelled and delivered better health outcomes.

This is the second time Sir Derek has worked with The King's Fund - he was previously commissioned to undertake a review into the long-term funding of social care for older people in England which was published earlier this year. Sir Derek will be assisted for his latest review by King's Fund Chief Economist John Appleby, with a final report expected to be published next spring ahead of the Comprehensive Spending Review.

Notes to editors: 

  1. For further information or interviews, please contact the King’s Fund media and public relations office on 020 7307 2585, 020 7307 2632 or 020 7307 2581. An ISDN line is available for interviews on 020 7637 0185. 
  2. Prior to the 2002 spending review, Sir Derek Wanless was asked to assess “the financial and other resources required to ensure that the NHS can provide a publicly funded, comprehensive, high quality service on the basis of clinical need and not ability to pay”. Sir Derek’s subsequent report for the government, Securing Our Future Health: Taking a Long-Term View, was published in April 2002. The report sets out the review's projections of resources required over the next 20 years to deliver a high-quality health service, recognising a range of possibilities for the future in three scenarios. The projections show the UK spending between 10.6 and 12.5 per cent of GDP on health care by 2022-23, compared to 7.7 per cent in 2002. The average annual real terms growth rate in UK NHS spending is between 4.2 and 5.1 per cent over the 20 year period. 
  3. In April 2003, the Prime Minister, the Chancellor and the Secretary of State for Health asked Sir Derek to provide an update of the challenges in implementing the fully engaged scenario set out in his first report on long-term health trends. Sir Derek’s final report, Securing Good Health for the Whole Population, was published in February 2004.
  4. Following his two significant reports for the government on the NHS, the King’s Fund commissioned Sir Derek in January 2005 to undertake a review into the long-term funding of social care for older people. Sir Derek’s report, Securing Good Care for Older People: Taking a long-term view, is free to download from the King’s Fund website.
  5. The King’s Fund is an independent charitable foundation working for better health, especially in London. We carry out research, policy analysis and development activities, working on our own, in partnerships, and through funding. We are a major resource to people working in health and social care, offering leadership development programmes; seminars and workshops; publications; information and library services; and conference and meeting facilities.