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  • Independent evaluation of the UK health care system performance ranking

    Commonwealth Fund Health Evaluation – 2017

    Following the end of World War II, the UK established the National Health Service (NHS) as the first universal healthcare system free at the point of care.

    What began as the largest health and social care experiment in history has developed into a global leader in high quality and efficient health care.

    This is evidenced by the fact that the NHS has been independently and consistently ranked as having the best healthcare system in the world.

    Notably, the Commonwealth Fund based in the US has ranked the UK as the best system in the world in its last two reports (2014, 2017). 

    The mission of The Commonwealth Fund is to promote the development of high-performing health care systems that achieve better access, improved quality, and greater efficiency, particularly for society’s most vulnerable.

    Data sources included Commonwealth Fund international surveys of patients and physicians, and selected measures from the OECD, WHO, and the European Observatory on Health Systems and Policies.  Looking at the overall rankings across The Commonwealth Funds’ (2017) five domains:

    1.Care Process: The UK ranks first in safety, prevention coordination and patient engagement domains;

    2.Accessibility: The UK is top-ranked performer in terms affordability and timeliness subdomains;

    3.Administrative Efficiency: Top performers are Australia, New Zealand and the UK;

    4.Equity: The UK ranks highest for equity of health systems;

    5.Health Outcomes: In comparison to the other domains, health outcomes are an area for relative improvement.  However, over the last decade, the UK saw a larger decline in mortality amenable to health care (i.e., a greater improvement in the measure) than all of the other countries studied. Since the early 2000s, the NHS has made massive investment in reforming of primary and cancer care as well as increased health care spending (from 6.2% of GDP in 2000 to 9.9% in 2014). The benefits of this investment will take time to realise in terms of long-term health outcomes.

    The NHS does a lot with its funding, and deals with over 1 million patients every 36 hours:

    • 16.3 million total hospital admissions;
    • 23.4m attendances at ED;
    • 89.4m outpatient attendances; and
    • 95.79% of inpatients would recommend the NHS.

    The private sector now recognises the commercial benefits of taking the effectiveness and efficiency that the NHS delivers into a for-profit model.


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