The analysis finds that 19 of the 20 health conditions studied are projected to increase in prevalence, including a rise of more than 30% in the number of people living with conditions such as cancer, diabetes and kidney disease. Overall, the number of people living with major disease is set to increase from almost 1 in 6 of the adult population in 2019, to nearly 1 in 5 by 2040, with significant implications for the NHS, other public services and the public finances.
The challenges of improving care for an ageing population and enabling people to live independent lives for longer are not unique to England, with countries across the globe facing similar pressures on their health services. However, with the NHS already under unprecedented strain, the findings point to big changes in how care should be delivered in future.
‘This report should act as a wake-up call to a government that has failed to plan properly, and left health and care services without the funding desperately needed. With over 40,000 nursing vacancies in England’s NHS alone, the NHS is already in crisis and is in no way prepared,’ said RCN Director for England, Patricia Marquis.
‘Nursing staff play a vital role caring for people with long-term conditions as well as preventing them from happening in the first place – but none of this can happen without investment in a workforce that has seen its numbers fall. A recent Royal College of Nursing assessment revealed that the number of community and district nurses fell by over 40% over 13 years. One way to reduce the workforce crisis, and help ensure patients get the care they need, is by awarding a fair pay rise for nursing, otherwise we’ll see nurses continue to leave in their droves.’
Much of the projected growth in illness relates to conditions such as anxiety and depression, chronic pain and diabetes, which are predominantly managed outside hospitals in primary care and the community. This reinforces the need for investment in general practice and community-based services, focusing on prevention and early intervention to reduce the impact of illness and improve the quality of people’s lives.
The analysis finds that 80% of the projected increase in major illness (2 million people) will be among people aged 70 and over, with the remaining 20 per cent (500,000 people) among the working-age population (20-69 years old). It also projects that improvements in some of the main causes of poor health, such as fewer people smoking and lower cholesterol rates, will be offset by the impact of obesity as many people who have been obese for long periods of their lives reach old age.
‘The findings from this report give us new insight into the future demand for health care in England. It is crucial to emphasise that these are projections, not forecasts, which are designed to support policymakers in preparing for the future.
‘The rise in people living with major illness will not occur overnight. Managing these pressures is achievable with careful planning, investment and changes in how care is delivered,’ said Toby Watt, Lead Economist: Demand, REAL Centre.
The report is the first in a new programme of research from the Health Foundation’s REAL Centre, which aims to support policymakers by looking at patterns of illness over the next two decades. Following in the autumn, a second report will focus on the implications for health inequalities.
‘The challenge of an ageing population with rising levels of major illness is not unique to the NHS. Countries across the globe face the same pressures. How well prepared we are to meet the challenge is what will set us apart,’ said Anita Charlesworth, Director of the REAL Centre.
‘Over the next two decades, the growth in major illness will place additional demand on all parts of the NHS, particularly primary care, where services are already under extreme pressure. But with 1 in 5 people projected to be living with major illness in less than two decades’ time, the impact will extend well beyond the health service and has significant implications for other public services, the labour market and the public finances.’