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What's the NHS annual budget? How many doctors and nurses are there? What's the cost of an operation?

Our press and public affairs team, library service and policy experts deal with hundreds of enquiries every year. Below are our answers to some key questions that have been frequently or recently posed to us. If you’ve got a question, get in touch with us.

The most recent figures have been used where possible – except where pandemic data is anomalous, in which case 2019/20 data is used.

How much is spent on health and care?

In 2021/22 the Department for Health and Social Care spent £190 billion. This money is used to fund a wide range of health and care services, including GP services, ambulance, mental health, community and hospital services, which are commissioned by the NHS, and public health. It also funds some social care services, which are mainly commissioned by local authorities. £2.7 billion of the Department for Health and Social Care’s budget is spent on administration costs for the department and the health and care system, such as departmental running costs, regulatory costs and business services, eg, the NHS payroll. The total budget for 2022/23 is £10 billion lower than in 2021/22 (£17 billion adjusted for inflation), as extra funding for Covid-19 pandemic has been scaled back. Additional funding commitments from the government will see the Department’s budget reach nearly £149 billion again by 2024/25. However, when adjusted for inflation, the budget will actually flatline over the next three years.

What percentage of GDP does the UK spend on health compared to other countries?

Pre-pandemic, in 2019, the UK spent 9.9 per cent of GDP on health, just below the average for comparable countries. In 2020 this rose to 12.0 per cent due to the increased funding allocated to tackling the Covid-19 pandemic, and the contraction of the rest of the UK economy. The provisional estimate for 2021 is similar at 11.9 per cent.

In 2019 the United Kingdom spent 9.9 per cent of GDP on health, just below the average for comparable countries

How much of the NHS budget is spent on the workforce?

The NHS is one of the world’s largest employers with around 1.26 million full-time equivalent staff in England, as of November 2022. Consequently, the wage bill for the NHS makes up a substantial proportion of its budget. In 2021/22, the total cost of NHS staff was £66.2 billion  which amounted to 45.2 per cent of the NHS budget. These statistics don’t include salaries for GPs (who are not directly employed by the NHS) or employees from the Department of Health and Social Care and other national bodies, such as NHS England. GPs and GP practice staff are indirectly funded by the NHS, but the flow of money to GPs is more complex.

What’s the cost of going to A&E?

The cost of an individual going to A&E depends on the type of A&E an individual attends – from a major, consultant-led department in a hospital to an urgent care centre or walk-in clinic – and the type of treatment they receive. For someone who attends an urgent care centre and receives the lowest level of investigation and treatment the average cost in 2022/23 is £86. For an individual at a major A&E department who receives more complex investigation and treatment the costs start at £418.

What’s the cost of an ambulance trip to A&E?

In 2020/21, the estimated average cost of a patient being taken to A&E by ambulance was £367. Ambulance call-outs that didn’t result in a trip to A&E cost an estimated average of £276.

What's the cost of an operation?

The cost of an operation depends on a range of factors, such as the complexity of the procedure and how long the patient stays in hospital. In the NHS in England, the national tariff outlines the average cost of procedures. These average costs are then adjusted to take account of local variation, such as higher costs of staffing in London (this is known as the market forces factor).

For example, in 2022/23 an emergency appendix removal operation for a child without complications costs, on average, £3,409, and the average cost of an emergency coronary artery bypass graft without complications is £10,828. The cost of an elective hip fracture procedure varies from £2,092 to £6,797 depending on the complexity of the procedure and the condition of the patient.

As part of wider health and social care reforms the national tariff system will be replaced by the NHS Payment Scheme in 2023.

What’s the cost of a GP appointment?

A recent study estimated that, in 2021/22, the average 9-minute GP face-to-face consultation costs £42.

What does the money buy?

When it comes to health and care funding, it can be hard to make sense of the numbers discussed and what they actually mean for patients, staff and the system. Below we outline what £1 billion in health and social care spending would buy in 2022.

£1 billion is enough to cover the current annual budget of United Lincolnshire Hospitals NHS Trust £1 billion is enough to pay the salary of 9,700 consultants for a year £1 billion is enough to run the NHS in England for 2.4 days £1 billion is enough the pay the salaries of 27,600 nurses for a year £1 billion is enough to cover 17 days of adult social care spending by local councils

How many...?

How many doctors, nurses and managers are there in the NHS in England?

In November 2022 there were 132,900 doctors, 350,600 nursing staff (including midwives and health visitors) and 36,600 managers in the NHS out of a total workforce of 1.26 million (all figures are full-time equivalent). Between 2012 and 2022, the number of doctors and nurses rose while the number of managers is broadly similar (doctors increased by 31 per cent and nurses by 16 per cent between March 2012 and March 2022). NHS vacancy statistics estimate that there are 124,000 vacancies in the NHS, as of Q3 2022/23 (including 8,700 medical professionals and 43,600 nursing staff). This includes vacancies in hospitals and in the community. However, these numbers are only estimates as there is not yet a standardised method for reporting NHS vacancies.

Compared to 2011 the number of doctors and nurses rose, while the number of managers is broadly similar

How many groups commission care?

Since July 2022, new integrated care systems (ICSs) have been responsible for planning most primary, community and hospital care services, including urgent and emergency care, in their local area. Currently, 42 ICSs operate across England. As well as commissioning, ICSs also focus on integrating health and care services, improving population health and reducing health inequalities.

How many NHS hospitals are there in England?

Working out the number of hospitals in England is challenging. All NHS hospitals are managed by acute, mental health, specialist or community trusts and as of 2022 there were 215 trusts, including 10 ambulance trusts. However, the number of NHS trusts does not correlate to the number of hospitals as many trusts run more than one hospital, for example, Manchester University NHS Foundation Trust runs 10 acute and specialist hospitals.

How many available beds are there in the NHS? Is the number of beds decreasing or increasing?

There were 141,960 consultant-led beds available in the NHS, as of Q3 2022/23. The total number of beds in the NHS will be higher as this doesn’t include critical care beds or those where the patient is under the care of a nurse rather than a consultant.

The graph below shows the number of available consultant-led beds in England has halved over the past 30 years. Proportionally, the largest falls have been in beds for people with learning disability, people with mental illness and long-term beds for older people. Medical advances that mean patients don’t have to stay in hospital for as long and a shift in policy towards providing treatment and care outside hospital have contributed to the reduction in bed numbers.

The number of hospital beds in England has halved over the past 30 years

In 2020/21, there was a significant decline in the number of hospital beds due to the impact of the pandemic. Changes included new safety and infection control standards to separate Covid-19 and non-Covid-19 patients, and the converting of general beds into critical care beds.

Find out more about trends in hospital beds in our explainer.

What has been the long-term trend?

Before the pandemic, demand for health care had been rising across all services and sectors. During the pandemic, demand for services fell, but in 2022 demand had almost reached pre-pandemic levels again.

For example, in emergency care, there were 2.2 million more attendances and 1.2 million more admissions at major (type 1) A&E departments in 2019 than there were in 2011. Demand for A&E services is now starting to return to pre-pandemic levels, with a total of 16.2 million attendances and 4.33 million admissions in 2022.

bPre-pandemic, demand for type 1 A&E services was rising rapidly

Pre-pandemic, the number of referrals to elective outpatient services were increasing by an average of 3.2 per cent a year (2008/09 to 2019/20). The total number of referrals for outpatient services in Q3 2022/23 was 5.4 million, still slightly below pre-pandemic peaks in demand. Elective admissions were also increasing pre-pandemic – from 7.3 million in 2009/10 to 8.8 million in 2019/20, largely due to an increase in day-case admissions.

Pre-pandemic, the number of patients referred for an outpatient appointment was increasing by 3.2 per cent a year

This growth in demand is also reflected in general practice. Routine reporting on the number of GP appointments has only been available since March 2018, and estimates there were 329 million GP appointments available in 2022. While we can’t show equivalent trends as we have for A&E or elective care, a research study using a sample of GP data estimated that the total number of face-to-face and telephone consultations increased 15.4 per cent between 2010/11 and 2014/15.

What was the impact of the Covid-19 pandemic on the NHS and has it recovered?

The Covid-19 pandemic completely changed the activity profile for the NHS. In 2020/21, fewer people attended a major A&E department – a decline of 22 per cent (3.5 million attendances) compared to the previous year. At the same time, hospital patients needed more intensive care – there were nearly 2,000 more critical care beds in acute trusts in January 2021 compared to the end of 2020. Hospitals cancelled routine procedures to ensure Covid-19 patients could be treated; this meant the backlog of patients waiting for treatment grew to nearly 6 million by October 2021. Infection prevention controls, such as separating Covid-19 positive patients from negative patients, also limited hospital activity levels.

Many services had to change the way they operated. Pre-pandemic, GPs were conducting around 3 million telephone appointments a month, but during the pandemic it is estimated that number peaked at 11 million (March 2021).

Some areas of activity are expected to return to normal as the country recovers from the pandemic. For example, type 1 A&E attendances in June 2021 were already higher than pre-pandemic levels. The backlog of people waiting for care means some activities, such as routine operations, are likely to be affected for years.

What does the average day in the NHS look like?

There is no ‘average day’ for the NHS. Each day varies depending on the day of the week, the environment (eg, the season), social and cultural events (eg, bank holidays) and disaster events (eg, global pandemics). But if there was an average day for the NHS in England in 2022, it might look like this.

On an average day in the NHS…1

  • more than 1.2 million people would attend a GP appointment2

  • nearly 260,000 people would attend an outpatient appointment

  • more than 37,000 people would call 999

  • more than 44,000 people would attend a major A&E department, and about 25 per cent of A&E patients would be admitted into hospital

  • around 675 patients would go into critical care.

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