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NHS lagging on preventing cancer and heart deaths

Report finds NHS provides ‘average’ levels of care

Jo Carlowe

Tuesday, 26 June 2018

The NHS is the third poorest performer compared to other developed countries on “amenable mortality”.

In a major report, published today by the Nuffield Trust, the Health Foundation, the Institute for Fiscal Studies and The King’s Fund, the NHS ranked badly when compared to 18 developed countries on the overall rate at which people die when successful medical care could have saved their lives.

Moreover, the report, produced for the BBC to mark its coverage of the NHS’s 70th birthday, revealed a worse than average performance by the NHS in the treatment of eight out of the 12 most common causes of death, including deaths within 30 days of having a heart attack and within five years of being diagnosed with breast cancer, rectal cancer, colon cancer, pancreatic cancer and lung cancer, despite narrowing the gap in recent years.

In addition, the NHS was found to have consistently higher rates of perinatal and neonatal mortality compared to the other countries in the report. Seven in 1,000 babies died at birth or in the week afterwards in the UK in 2016, compared to an average of 5.5 across the comparator countries.

The report, How good is the NHS?, used OECD data and a range of other public sources to compare the NHS to health systems in 18 similar developed countries, including France, Germany, Italy, Japan and the USA. It looked at three aspects of what could be considered “a good health care system”: the speed and accessibility of care, the efficiency of the system, and the outcomes delivered for patients.

The report found, compared with health systems in similar countries, the NHS had some notable weakness but also some significant strengths. The latter included its ability to provide “unusually good financial protection to the public from the consequences of ill health.” For example, it had the lowest proportion of people who skipped medicine due to cost (2.3% in 2016 compared to an average of 7.2% across the comparator countries).

The NHS was also found to be relatively efficient: the UK has the largest share of generic prescribing of all comparator countries, at 84% in 2015 compared to an average of 50%.

And it performed well in managing patients with some long-term conditions like diabetes and kidney diseases: fewer than one in a thousand people are admitted to hospital for diabetes in a given year, compared to over two in a thousand admitted in Austria or Germany.

Commenting on the report, Nigel Edwards, chief executive of the Nuffield Trust said: “The truth about the NHS is that by international standards it is a perfectly ordinary healthcare system, providing average levels of care for a middling level of cost. Access is good and people are protected from high costs, but its performance in treating people with cancer is poor, and international comparisons suggest too many people in the UK die when good medical care could have saved their lives.”

Chris Ham, chief executive of The King’s Fund said: ”As it turns 70, the NHS is neither performing as well as its supporters sometimes claim, nor as badly as its critics often allege. While this is a moment to celebrate its many achievements, the evidence that the NHS lags behind other countries in reducing premature deaths from diseases like cancer and heart attacks is a timely reality check. The UK stands out in removing financial barriers to people accessing care but needs to do better in improving health outcomes.”

A Department for Health and Social Care spokesperson said: “As this report rightly points out, the NHS is world-leading in providing patients with high quality care, free at the point of use. To secure its future we recently announced an increase of NHS funding by an average 3.4% per year, which will see it receive £20.5 billion a year in real terms by 2023.

“We are taking strong action to help people live longer and healthier lives—cancer survival is at a record high while smoking rates are at an all-time low, and the independent Commonwealth Fund has ranked the NHS as the best and safest healthcare system in the world out of 11 countries.”

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