10 (more) interesting facts about the NHS
This is a longer version of this article.
1. How much is spent on health and care?
The NHS is not free. In 2022/23, the Department for Health and Social Care (DHSC) cost £182 billion.
This money is used to fund a wide range of health and care services, including GP services, ambulance, mental health, community and hospital services that are commissioned by the NHS, as well as public health services that are commissioned by local authorities (councils). It also funds some (not the main part of) social care services, which are mainly commissioned by local authorities.
In 2024/25, the total budget is set to increase to £192 billion, an increase of £1.1 billion on 2023/24 when adjusted for inflation.
£2.8 billion of the DHSC’s budget is spent on administration costs for the department and the health and care system, such as departmental running costs, regulatory costs and business services, e.g NHS payroll.
2. What percentage of GDP does the UK spend on health compared with other countries?
In 2022, the UK spent 11.3% of GDP on health, i.e. 11.3% of your hard earnt taxes. It is the second largest component of the cost of the UK state.
This is just above the average for comparable countries. This was an increase on pre-COVID-19 pandemic levels, when 9.9% of GDP was spent on health.
3. How much of the NHS budget is spent on the workforce?
46%.
The NHS is the largest employer in Europe and 5th largest in the world.
It has around 1.5 million full-time equivalent staff in England, as of February 2024. Consequently, the wage bill for the NHS makes up a substantial proportion of its budget. In 2022/23, the total cost of employing the staff in the NHS was £71.1 billion – 45.6% of the NHS budget.
These statistics don’t include salaries for GPs (who are not directly employed by the NHS) or employees in the DHSC and other national bodies, such as NHS England, NICE, CQC etc. GPs and GP practice staff are indirectly funded by the NHS through a complex system of contracts.
4. How many doctors, nurses and managers are there in the NHS in England?
In February 2024, there were 140,700 doctors, 377,600 nursing staff (including midwives and health visitors) and 39,800 managers in the NHS out of a total workforce of 1.5 million (all figures are full-time equivalent, excluding general practice staff). Between 2011 and 2024, the number of doctors, nurses and managers rose (doctors increased by 45%, nurses by 26% and managers by 18%).
As of March 2024, NHS vacancy statistics estimate that there are 100,700 vacancies in the NHS (including 8,800 medical professionals and 31,300 nursing staff). This includes vacancies in hospitals and in the community. However, these numbers are only estimates, as there is not yet a standardised method for reporting NHS vacancies.
5. What’s the cost of things?
What is the cost of going to A&E?
The cost of an individual going to A&E depends on the type of A&E – which can range from a major consultant-led department in a hospital to an urgent care centre or walk-in clinic – and the type of treatment the individual receives.
For someone who attends an urgent care centre and receives the lowest level of investigation and treatment, the average cost in 2024/25 is £91.
For an individual at a major A&E department who receives more complex investigation and treatment, the costs range on average from £137 to £445.
What’s the cost of an ambulance trip to A&E?
In 2022/23, the estimated average cost of a patient taken to A&E by ambulance was £417. Ambulance call outs that didn’t result in a trip to A&E cost an estimated average of £287.
What’s the cost of an operation?
The cost of an operation depends on a range of factors, such as the complexity of the procedure and how long the patient stays in hospital. In the NHS in England, the NHS payment scheme outlines the average cost of procedures.
These average costs are then adjusted to take account of local variation, such as higher staffing costs in London (this is known as the market forces factor).
For example, in 2024/25:
- Hip fracture procedure varies from £2,205 to £7,165, depending on the complexity of the procedure and the condition of the patient.
- An emergency appendix removal operation for a child without complications costs, on average, £3,603
- Emergency coronary artery bypass graft (CABG) without complications is £14,547.
What is the cost of a GP appointment?
A recent study estimated that in 2022/23 the average 10-minute face-to-face GP consultation costs £56 – quite cheap really.
What’s the cost of a dentistry appointment?
Unlike most other NHS services, which are free at the point of use, most adults in England pay for NHS dentistry services. As of 2024, patients were paying between £26.80 and £319.10 for services, depending on the treatment needed.
6. How regions are there, and how many subregional groups commission (buy) care?
There are 7 NHS England regions, with 42 Integrated Care Systems (ICSs; sub-regional commissioning groups; 3-11 each), which are the main purchasers of NHS care.
ICSs are responsible for planning most primary, community and hospital care services in their local areas, including urgent and emergency care.
Each ICS is responsible for about 1-2 million people (i.e. is about ‘county-sized’).
As well as commissioning, ICSs also focus on integrating health and care services, improving population health and reducing health inequalities.
Other bodies commission (buy) care – e.g. specialised commissioning, NHS Health & Justice, Defence Medical Services (DMS) etc.
7. How many NHS hospitals are there in England?
It’s surprisingly hard to say. Working out the number of hospitals in England is challenging.
All NHS hospitals are managed by acute, mental health, specialist or community trusts, and as of mid 2024 there were 215 trusts, including 10 ambulance trusts.
However, the number of NHS trusts does not correlate to the number of hospitals as many trusts run more than one hospital – for example, Manchester University NHS Foundation Trust runs 10 acute and specialist hospitals.
8. How many available beds are there in the NHS?
As of March 2024, there were 141,903 consultant-led beds available in the NHS. The total number of beds in the NHS will be higher, as this doesn’t include critical care beds or those where the patient is under the care of a nurse rather than a consultant.
9. And bed numbers increasing or decreasing?
The number of beds is decreasing. The number of beds in England has halved over the past 30 years. Proportionally, the largest falls have been in beds for people with a learning disability, people with mental illness, and long-term beds for older people.
Medical advances that mean patients don’t have to stay in hospital for as long and a shift in policy towards providing treatment and care outside hospital have contributed to the reduction in bed numbers.
10. What has been the long-term trend in demand for health care?
Before the COVID-19 pandemic, demand for health care had been rising across all services and sectors. During the pandemic, demand for services fell, but by 2023/24 demand had almost reached, or in some areas surpassed, pre-pandemic levels of demand.
For example, in emergency care, there were 2.6 million more attendances and 1.2 million more admissions at major (type 1) A&E departments in 2023/24 than there were in 2010/11. Demand for A&E services has returned to pre-pandemic levels, with a total of 16.5 million attendances and 4.7 million admissions in 2023/24.
Pre-pandemic, the number of referrals to elective outpatient services were increasing by an average of 3.2% a year (2008/09 to 2019/20). The total number of referrals for outpatient services fell during the pandemic but has since recovered, and in Q4 2023/24 the number of referrals hit a record high of 6.0 million.
Elective admissions were also increasing. They fell during the pandemic to 5.6 million in 2020/21; however, in 2022/23 admissions were almost at pre-pandemic levels again at 8.6 million.
This growth in demand is also reflected in general practice. Routine reporting on the number of GP appointments has only been available since March 2018, and estimates that there were 353 million GP appointments available in 2023/24.
Summary
We have provided 10 (more) interesting facts about the NHS. We hope it has been helpful.
Other resources
The NHS in 10 numbers today
Key facts and figures for the NHS (Kings Fund)
NHS key statistics: England (House of Commons library, July 2024)
How good is the NHS?
