NHS
Spending, outcomes, and international comparison.
Section 1
NHS spending since 2000
Real-terms spending has risen by ~£120bn since 2000/01, but year-on-year growth has slowed sharply since 2010. The COVID spike to £216bn (and 9.2% of GDP) is visible in both views; the planned 2025/26 settlement returns spending close to its pre-COVID trajectory.
NHS budget — real (2024/25 £) vs nominal £
NHS as a share of GDP and total government spending
Section 2
Healthcare outcomes — the UK vs comparable countries
The UK spends more than the OECD average, but still trails Germany, France, Sweden and Japan on treatable mortality in this peer group. The Civitas International Health Care Outcomes Index (2022) ranked the UK second worst of 19 comparable nations — bottom of the league in 4 out of 16 outcome measures, and in the bottom three for 8 out of 16. The Commonwealth Fund Mirror Mirror 2024 placed the UK in the overall top three, but found the strongest health outcomes in Australia, Switzerland and New Zealand. If the UK matched the average treatable mortality rate of comparable countries, over 6,500 additional lives would be saved each year.
UK vs Germany, France, Sweden and Japan
OECD average shown for context| Metric | UK | Germany | France | Sweden | Japan | OECD avg |
|---|---|---|---|---|---|---|
| Health spend (% GDP) | 11.1% | 12.3% | 11.5% | 11.3% | 10.6% | 9.3% |
| Spend per capita (USD PPP) | $6,747 | $9,365 | $7,367 | $7,871 | $5,790 | $5,967 |
| Life expectancy (years) | 81.0 | 81.1 | 83.0 | 83.4 | 84.1 | 81.1 |
| Treatable mortality (per 100k) | 71 | 66 | 48 | 47 | 49 | 77 |
| System type | Tax-funded NHS | Social insurance | Social insurance | Tax-funded | Social insurance | — |
Treatable mortality per 100,000 population
Lower is better. The UK has the highest treatable mortality rate in this peer group, despite spending more than the OECD average.
Health spending per capita (USD PPP, 2024)
Germany leads in this group; the UK spends more per head than Japan, but less than Germany, France and Sweden.
Section 3
Waiting times and performance against targets
NHS England's headline waiting-time measures, shown at March of each year plus the latest month published. Dashed lines mark the NHS Constitution standard for each measure.
RTT waiting list (incomplete pathways)
People waiting to start consultant-led treatment in England.
Waiting under 18 weeks for treatment
Share of the waiting list waiting under 18 weeks. Higher is better.
A&E: seen within 4 hours
All A&E attendances admitted, transferred or discharged within 4 hours. Higher is better.
Cancer: treated within 62 days
Urgent referrals starting treatment within 62 days. Higher is better.
Ambulance: Category 2 mean response
Emergency calls such as strokes and heart attacks, in minutes:seconds. Lower is better.
Notes on the data and definition changes
- 2008-03: RTT incomplete pathways series begins Aug 2007
- 2010-03: Cancer 62-day = urgent GP referral to first treatment (pre-Oct 2023 definition); national series begins Oct 2009
- 2011-03: A&E monthly series begins Nov 2010; Nov 2010 to May 2015 monthly figures are estimated by NHS England by apportioning published weekly data
- 2012-03: A&E figure estimated from weekly data
- 2013-03: A&E figure estimated from weekly data
- 2014-03: A&E figure estimated from weekly data
- 2015-03: A&E figure estimated from weekly data
- 2018-03: Ambulance AQI (ARP categories) begin Aug 2017; all trusts reporting by Dec 2017 except Isle of Wight (from Apr 2018)
- 2020-03: A&E excludes 14 trusts in the Clinical Review of Standards field test (May 2019 to May 2023); not directly comparable
- 2021-03: A&E excludes 14 CRS field-test trusts; not directly comparable; A&E attendances include booked appointments from Aug 2020
- 2022-03: A&E excludes 14 CRS field-test trusts; not directly comparable
- 2023-03: A&E excludes 14 CRS field-test trusts; not directly comparable; Last March on old cancer 62-day (urgent GP referral) definition
- 2024-03: Cancer 62-day = combined standard (urgent suspected cancer/breast symptomatic/screening referral or consultant upgrade) from Oct 2023; not directly comparable with earlier years; RTT excludes community service pathways from Feb 2024; A&E includes CRS trusts again from Jun 2023; current time series shows 74.3% vs 74.2% in the original March 2024 commentary (revised)
- 2026-03: RTT totals include NHS England estimates for missing trusts
- 2026-08: Latest RTT and cancer month (cancer provisional); RTT totals include NHS England estimates for missing trusts
- 2026-09: Latest A&E and ambulance month; RTT and cancer not yet published
- NHS waiting times and performance — latest: August 2026 (waiting list, cancer); September 2026 (A&E, ambulance) · NHS England · next update 12 November 2026
Section 4
Productivity
The ONS measures healthcare productivity as the quantity of care delivered (output, adjusted for quality) divided by the staff, goods and services used to deliver it (inputs). From 1995/96 to 2023/24 productivity grew by an average of 0.57% a year. It fell 22% in 2020/21, when pandemic spending raised inputs while routine care was postponed, and in 2023/24 was still 3.9% below its 2019/20 level.
Healthcare output and inputs (index, 1995/96 = 100)
Output has grown faster than inputs over the long run, except during the pandemic.
Healthcare productivity (index, 1995/96 = 100)
Quality adjustment, introduced from 2001/02, credits improvements such as better survival rates and shorter waits.
- Healthcare productivity, England — latest: 2023/24 · ONS · Next edition March 2027
Section 5
Staff nationality and international recruitment
In December 2025, 21.6% of staff in NHS trusts and other core organisations in England with a recorded nationality were not UK nationals. Shares are of staff whose nationality is known: in 2009 about a fifth of staff had no nationality recorded, compared with around 1% now, so raw counts overstate growth. Nationality is self-reported and is not the same as country of birth or of training.
Non-UK nationals as a share of NHS staff (known nationality)
Headcount in NHS trusts and core organisations in England, September each year (December for the latest).
Where non-UK NHS staff are from (share of all staff with known nationality)
EU/EEA includes the EU27, Iceland, Liechtenstein, Norway and Switzerland, applied consistently across all years.
Most common non-UK nationalities of NHS staff, 2025-12 (headcount)
New joiners to the nursing and midwifery register, by where they trained
UK-wide NMC register, financial years. In 2025/26, 10,479 joiners trained outside the UK and EU/EEA, down from a peak of 28,950.
- NHS staff by nationality — latest: December 2025 · NHS England · Ad hoc, recently around March and October
- Nursing and midwifery register joiners — latest: 2025/26 (to March 2026) · Nursing and Midwifery Council · Six-monthly; next expected late November or early December 2026
Section 6
Key findings
Sources
Data sources
- King's Fund — NHS in a Nutshell
- House of Commons Library SN00724
- OECD Health at a Glance
- Civitas International Health Care Outcomes Index
- Commonwealth Fund Mirror Mirror 2024
- NHS England — Referral to treatment waiting times
- NHS England — A&E attendances and emergency admissions
- NHS England — Cancer waiting times
- NHS England — Ambulance Quality Indicators
- ONS — Public service productivity: healthcare, England
- NHS England — HCHS staff by nationality
- Nursing and Midwifery Council — Registration data reports