Can we compare healthcare performance across the four nations of the UK?
Retiring to another part of the UK is an appealing thought for many of us. However, ensuring the facilities are in place to support a safe and enjoyable life is important.
There are many issues to be considered before making a move, and one of those is access to good NHS healthcare.
Recently, there’s been much discussion about how the different regions of the UK compare in terms of NHS care – and it’s often used to make political points.
Drawing direct comparisons is difficult though, because different organisations are asking different questions, and the four regions – England, Wales, Scotland and Northern Ireland – are managed separately with their own challenges. They also have their own targets and ways of measuring performance, making comparisons even more difficult.
The fact-checking organisation Full Fact has attempted to explain the figures available from the NHS and the Office of National Statistics (ONS). The full article is well worth a read, while here are some of its key findings.
Planned care and waiting lists
There isn’t a straightforward way to compare waiting lists across the four nations. The only way to get an idea of how waiting compares across England, Wales and Scotland is from an ONS survey conducted between October 2023 and March 2024, in which people were asked: “Are you currently waiting for a hospital appointment, test, or to start receiving medical treatment through the NHS?” More people in Wales (29%) than in England (25%) or Scotland (22%) gave the answer yes.
A&E performance
Comparisons are easier when it comes to A&E performance for England, Wales and Scotland. All three have a target of at least 95% of attendees to be admitted, transferred or discharges within four hours of arriving at the department. Waiting times tend to be longer in winter, but missed targets happen year-round.
The standard target for A&E wait times in England was reduced from 98% to 95% under the Coalition government. Recent years have seen more missed targets and longer waiting times compared to previous years.
- England: A&E departments in England saw a record number of attendances in 2017/18, with almost 24 million visits. However, only 88% of patients were seen within the target time of four hours, falling short of the 95% target. Major A&E units performed worse, with 82% seen within four hours.
- Wales: In 2016/17, 3.4% of A&E patients waited more than 12 hours, compared to 1.3% in England. Wales has higher per capita spending on health but faces greater challenges due to its older population and higher levels of socioeconomic deprivation.
Funding and Resources
- Funding Per Person: Health spending per person is slightly higher in Wales (£2,233) compared to England (£2,169). The funding is influenced by the Barnett Formula, which adjusts the block grant based on changes in funding levels in England.
- Budget Management: Wales’ NHS funding is managed by the Welsh government, which allocates resources based on local needs. Despite higher spending, Wales’ healthcare needs are more pronounced due to its demographics and socioeconomic factors. Wales has been historically argued to need a funding level 9-10% higher than England’s to meet healthcare needs.
In summary, from the information available, it’s difficult to be precise about where the best healthcare is being provided, in terms of targets achieved and missed. Different measurement systems make comparisons hard. It is worth bearing in mind though that areas of high social deprivation and larger older populations are likely to make greater demands on the healthcare available, with potentially lower levels of service delivered as planned or emergency care.
Also worth a read:
Ministers confuse waiting lists with patient cases
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