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Prevention measures and primary care to save NHS from ‘mid-table’ international ranking

A new study conducted by the King’s Fund has found that the UK is lagging behind other countries in preventing deaths through out of hospital care and has received a ‘mid-table’ ranking overall, with lacking resources and poorer health outcomes for patients

The report measured the outcomes of 18 higher-income peer countries, and asked the question, ‘how does the NHS compare to the health care systems of other countries?’. Overall, the UK ranked mid-table in most areas measured, lacking resources but protecting people from some of the financial cost of ill health.

Both avoidable and treatable mortality rates were higher in the UK than in comparator countries. This is caused by below average survival rates for certain cancers as well as poorer outcomes for heart attacks and strokes.

The report grouped both health outcomes and life expectancy as ‘significantly affected by factors beyond the direct control of any health system’, pointing towards the pressures and promise of primary care.

The UK’s five-year cancer survival rates lag behind those of other countries with below average survival rates for major cancers, including cancer of the breast, cervix, colon, rectum, lung and stomach. The report acknowledges the multiple factors which can influence these outcomes, highlighting the need for ‘health-seeking’ behaviours.

Despite breast cancer five-year survival rates improving over the previous decade, they are still below average when compared internationally and a lower-than average share of breast cancers are detected in the UK at an early or localised stage, rather than an intermediate or advanced stage.

Similar conclusions can be drawn from circulatory diseases, including heart attack and strokes. During the pandemic, mortality rates from these conditions fell in many countries, because of changes in lifestyle, such as falling smoking rates. But, the report found that heart attack and strokes are still a major cause of death in the UK which is among countries with the highest rates of people dying within 30 days of admission to hospital for Ischaemic stroke and for acute myocardial infection.

Primary prevention of cardiovascular disease can ‘improve population health, reduce health inequalities, and mitigate against escalating pressures on health care systems’ the report found.

Responding to the ‘mid-table’ ranking, Dr Layla McCay, director of policy at the NHS Confederation, expressed surprise that the UK was not placed even lower down, and said: ‘The NHS punches above its weight in many ways and this report shows that leaders are continuing to deliver bang for the taxpayer’s buck, all while having one arm tied behind their backs.

‘Leaders are acutely aware of the areas the NHS underperforms in and are keen to deliver better outcomes for patients, particularly around cancer rates, but progress is being made. However, they need help to do more and will hope that this report prompts the government to invest in areas around workforce, capital and – with life expectancy lower than other countries in the report – prevention. With every £1 invested in the NHS returning £4 to the economy, it makes sound economic sense to have greater ambitions for the nation’s health.’

Read the full report here.