2021: the health policy year in 12 charts

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2021 may have been another ‘year of Covid’ but there was still plenty of other health policy news, notes and data to recap in our annual round-up of the year. So before we turn the page to 2022, let’s take our annual chart-based look at the year that was.

January

As 2021 began, the starting pistol was fired for a global race to vaccinate as many people as possible. The UK got off to a strong start and was towards the front of the pack before being joined by other countries as the year went on.

Share of people vaccinated against Covid-19

February

This month the government announced its White Paper on The future of health and care which, among other things, set out an intention to put integrated care systems on a legislative footing and once again change the number of local NHS organisations that plan and pay for health care in England.

Hover over each column to find out how many commissioning organisations there were in each year.

Number of commissioning organisations in England

March

The Spring Budget 2021 provided more funding to help health and care services respond to the ongoing pandemic, which saw the Department of Health and Social Care’s budget cement its position as the largest spending department in Whitehall.

Hover over each department group bubble to find out what its expenditure limit is.

Total departmental expenditure limit

April

Google searches for ‘blood clots’ peaked this month after reports that a small number of people developed these rare side effects after receiving the Astra Zeneca vaccine. Those under 40-years-old would be offered an alternative vaccine, while Dr June Raine, the head of the UK medicines regulator, reiterated ‘the benefits of the vaccine continue to outweigh the risks for most people’.

Google search interest for 'blood clots'

May

Efforts to respond to Covid-19 and tackle backlogs of care continued to be hampered by workforce shortages as the year went on. Annual data from the Nursing and Midwifery Council showed more staff were joining the NHS from ‘overseas’ but recruitment from the European Economic Area has continued to stagnate years after the Brexit vote and changes to language testing rules.

Nurses and midwives joining the UK permanent register for the first time, by place of initial registration

June

The Department of Health and Social Care Secretary of State Matt Hancock resigned after breaking social distancing guidelines and was replaced by Sajid Javid. The year would see further change at the top of the NHS with Amanda Pritchard replacing Simon Stevens as chief executive of NHS England, the merger of more NHS arms length bodies, the creation of the Office for Health Improvement and Disparities.

Year in review - heads of government departments

Source: The King’s Fund analysis of board reports and press statements. Notes: The person taking up a new position is listed in cases where there is a change of leadership within the year.

July

In the same month the NHS was awarded the George Cross, NHS pay review bodies recommended a 3 per cent pay rise for health care staff – a recommendation later accepted by the government, potentially to make up for some (but hardly all) of the ground lost over recent years on pay growth for some NHS staff groups.

Change in NHS staff pay over the past decade

August

New estimates this month suggested up to 14 million people could be waiting for planned hospital care by Autumn 2022, highlighting just how high a mountain the NHS will have to climb to return performance to the levels achieved before the pandemic, let alone to 2016 levels when the national target was last met.

Hover over each data point to find out which NHS provider achieved or missed its waiting time targets.

Number of NHS providers meeting waiting time targets for routine planned care

September

The government sprung a September surprise with its Build back better publication this month. A new health and care levy would see increases to national insurance to provide more funding for the NHS and reform adult social care. But the government’s later White Paper on adult social care and proposals on how to cap adult care costs received a more critical response, which raised questions over whether the Prime Minister’s commitment to ‘fix social care’ would ultimately be fulfilled.

Hover over each square to find out the funding for each area of spending.

The new health and care levy will provide more than £30 billion of extra funding for health and care services over the next three years

October

This month the government announced a programme to build 100 community diagnostic hubs. These one-stop-shops would offer a range of services from X-rays to MRIs to help tackle growing backlogs of care and reduce waits for diagnostic tests.

The number of people waiting more than 6 weeks for a diagnostic test ballooned during the Covid-19 pandemic

November

In a month when most health headlines focused on a row between GPs and the government over face-to-face appointments, data published this month showed that while Covid-19 caused a decrease in life expectancy for most countries in the Organisation for Economic Co-operation and Development (OECD) between 2019 and 2020, the UK was one of only two countries that saw a fall big enough to drop them below their 2010 life expectancy.

Average life expectancy, years

December

The end of the year ended on the same downbeat tone as 2020 did, as the Omicron variant led to a rapid increase in Covid-19 cases, more pressure on health and care services and the further restrictions on social contact in the UK.

Variants of concern or under investigation

Looking ahead to 2022

At a time when weeks seem like months and months can feel like years it is inevitable that a quick review of the year will exclude some important topics. Some of these were of horror and suffering – with sexual assaults in NHS mortuaries and persistent concerns about the safety of some maternity units. Add to this the dispiriting news of rising obesity rates in children and unfulfilled promises to fix social care or build new hospitals.

But there were achievements and victories too. From the technical, such as using robotic process automation to monitor oxygen supplies or artificial intelligence to prioritise waiting lists, to the human, with vaccination campaigns bolstered by legions of volunteers and health and care staff putting their lives on the line to continue delivering care.

So what will the next year bring? The Secretary of State for health and care has said he wants the next 12 months to be a ‘year of reform’ for services. But, if the past two years are any guide, we can unfortunately expect the zodiac to stay paused and for 2022 to be another year of coping with Covid-19 and its aftermath – with all the innovation, exhaustion, triumphs and tragedy that entails.

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