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A healthy system

The NHS remains a great source of national pride. But the service today is under significant financial and demand pressures which only look set to increase. People are living longer but with more chronic diseases, placing further demands on the system, while budgets are tightening across the board. Commissioners and providers across the country are having to make difficult decisions about what services can be delivered and how the future NHS should be paid for.

Longer lives, more chronic diseases

Within the next decade shifts in the demographic profile of England will see demand for services in the UK rise substantially, with a growing ageing population. These demographic changes are significant as they have a major impact on demand and patterns of need.

76% people think that health services... ...should take priority over balancing the books

Quality of care is paramount

We asked patients about their feelings towards the NHS and how much they value the service provided and how they feel it should be funded.

Quality of care is paramount in the eyes of the public. The vast majority of people think that the quality of health services should take priority over balancing the books for hospitals - 76%, up from 68% when we last asked the question in April 2016.


Despite the pressures the NHS is under, there is little recognition from the public of the efficiency savings the service has made, with only 16% agreeing that the NHS has become more efficient over the past five years and 45% disagreeing.

Doing more with less

In terms of raising additional funding, 50% of the public are supportive of additional national insurance to improve NHS services nationally, while 31% are supportive of paying an additional local tax to improve NHS services in their local area.

Pressure points

We gave patients a list of suggestions about how rationing or behavioural incentives might ease financial pressure on the NHS. In some areas they thought treatment should be subject to certain conditions. But in other areas, the public is clear that the free at the point of use principle must be maintained:

66% support immunisation being compulsory where it is known to prevent illness (except where the person is allergic to immunisation).

52% say that people who are given advice to lose weight to help their condition should not receive any other treatment for that condition until they lose weight.

41% thought patients should be treated where and when it is most cost effective for the NHS rather than having a choice of location and provider.

Only 26% support the idea that conditions which are predominantly caused by lifestyle choices should be funded in part by the patient.

29% agree that the NHS should not fund treatments that only benefit people by a small amount.

Contact us

Quentin  Cole

Quentin Cole

Head of Industries, PwC United Kingdom

Tel: +44 (0)7770 303846

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