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Rise in People with Ill Health to Hit the NHS, Report Warns

The number of people in England living with major illness is projected to rise by more than a third to 9.1 million by 2040, according to a new report.

Most of the expected 2.5 million increase will be among those aged 70 years and over, as the 'baby boomer' generation reaches older age, the study by the Health Foundation anticipated. 

The report noted that life expectancy has increased by more than 20 years over the past half century and is expected to increase further in the coming years. However, while longer lives "are to be celebrated", the pattern has brought increased demand for health services. 

Predicted Pressure on NHS Budgets

The report by the Health Foundation's REAL Centre, in partnership with the University of Liverpool, forecasts additional pressure on NHS and social care spending, as the population of working age people contributing the bulk of Government revenue rises by an estimated 4% by 2040, while the population with major illness increases by 37%.

The researchers based their forecast by looking at 20 health conditions that account for 65% of the burden of illness in England. These conditions comprise the Cambridge Multimorbidity Score (CMS) – a metric that assigns a weight to different illnesses based on their impact on the health system and individual life expectancy.

The analysis predicted that 19 of the 20 health conditions would 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 was likely to increase from almost 1 in 6 of the adult population in 2019, to nearly 1 in 5 by 2040.

The amount of time that people were projected to live with major illness is expected to increase from 11.2 years in 2019 to 12.6 years in 2040, according to the analysis.

The researchers highlighted 10 of the conditions in the CMS with the highest impact on healthcare use and mortality among people aged 30 years and older. After adjusting for demographic changes, the projected percentage increase in conditions from 2019 to 2040 included:

  • Heart failure (+92%)
  • Atrial fibrillation (+51%)
  • Diabetes (+49%)
  • Dementia (+45%)

Much of the projected growth in illness relates to conditions, such as diabetes, chronic pain, and anxiety and depression, which are predominantly managed in primary care and the community, reinforcing the need for investment in general practice and community-based services, the authors emphasised. They suggested that while there was "no silver bullet" to stem the expected increase in people living with major illness, long-term NHS reform and funding, alongside investment in the nation's health and wellbeing, would be essential.

Services Already "Under Extreme Pressure"

Anita Charlesworth, Director of the REAL Centre, and report co-author, said: "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." Toby Watt, lead economist at the REAL Centre, and the report's first author, said: "Managing these pressures is achievable with careful planning, investment, and changes in how care is delivered."

Commenting on the study, Miriam Deakin, director of policy and strategy at NHS Providers, said: "Prevention is better than cure. More support and money for public health services are vital to stave off poor health and ease pressure on the NHS."

Dr Layla McCay, director of policy at the NHS Confederation said: "Alongside the recently announced NHS Long Term Workforce Plan, we urge the Government to set out a long term plan for the social care workforce, in order to combat the social care vacancies and ensure staff are supported to provide quick and high quality care."

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