Nine major challenges facing health and care in England

People are living for longer but with major health conditions A mix of factors affect the number of people living in poor health, including changes in the prevalence of leading risk factors for ill health, social and economic conditions, the size and age of the population and more. [...] In England, the decade before the pandemic saw a more than 25% increase in the number of people living with major illness – conditions such as cancer and dementia or combinations of other illnesses.42 There has been a significant rise in the number of people living with multiple health conditions since the early 2000s.43 The burden of illness is not spread evenly. [...] The rate of growth in hospital managers in the NHS has been slower than for clinical staff – and the NHS appears to be severely undermanaged compared with other sectors and health systems.78,79,80 As the population grows, ages and develops more complex health needs (Section 3), the capacity of the health and care system will need to expand to keep up. [...] Staff gaps are one of the main reasons for falling public satisfaction with the NHS (Section 8), and boosting staff numbers and reducing staff workload are among the public’s top priorities for the NHS.98 The experience of GPs in the UK compared with other countries is stark. [...] Policy choices made by the next government will shape the future of the nation’s health The rollcall of health and care challenges facing the next government is long and daunting.