What are the biggest challenges facing the NHS?

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Main topic: Humanities
Other topics: UK, NHS
Short answer:

The biggest challenges facing the NHS are

  • An aging population
  • Lack of investment
  • The growth of digital technology
  • Workforce crisis
  • Waiting times
  • Long-term effect of the pandemic
  • Research and Development

The National Health Service (NHS) continues to struggle with its most pressing challenge, which is a shortage of resources and investment. In addition, lengthy waiting times and lists, as well as a shortage of employees, are likely to be a pressing concern. In 2021, a new source of concern emerged in the form of the COVID-19 pandemic. Even when it is believed that the pandemic has ended, the NHS is still going to be faced with a great deal of difficulty. The National Health Service (NHS) will need to adjust in order to meet the challenges presented by rising health disparities and an aging population. While simultaneously attempting to prepare for the future, health and care services are now focusing their attention on patients who have care requirements that are becoming ever more complicated despite the fact that they are facing more challenging situations. The National Health Service (NHS) is confronted with many difficulties and often ranks at the top of the list of worries for a variety of economic, social, and political reasons.

An aging population - the primary challenge facing the NHS[edit]

2017 world map, median age by country

The expense of providing care for elderly patients is substantially higher. Due to their much worse health, those over the age of 65 cost the National Health Service (NHS) around 2.5 times as much as those under 30. A person who is 90 years old will set back more than 7 times as much.

There are presently 3.2 million persons in the UK who are 80 years old or older, and it is anticipated that this number will almost double by the year 2050, reaching nearly 8 million. At this moment, there will be 25 percent of the population is over the age of 65. A longer life expectancy is a beneficial consequence that is brought about by improvements in medical treatment; nevertheless, an aging population also brings about an increase in the strain placed on healthcare systems.[1]

The National Health Service (NHS) is expected to provide treatment for a rising number of age-related chronic diseases including heart disease, type 2 diabetes, arthritis, and Alzheimer's disease as a greater proportion of the population reaches the age of 80. A significant number of older persons also have intricate social demands and want extra assistance with their day-to-day activities. Inadequate social care may make older individuals more susceptible to preventable dangers such as infections, falls, and dehydration than they would be otherwise. The phenomenon known as "bed blockage" occurs when a senior citizen who has fallen and been sent to the emergency room for treatment stays there for many days or even weeks before being released. Because younger people are more likely to reside in cities, some locations are more likely to be impacted than others. This is because elderly individuals are more inclined to live in rural areas or along the seaside.[2]

Lack of Investment as a major challenge for NHS[edit]

The REAL Centre and the Health Foundation has, for a considerable amount of time, been advocating for the prioritization of investments in the future of health and social care. Because of its historically low capital budget and its declining budget for public health, NHS to maintain its investment in order to meet future demand. In the next 25 years, the number of persons aged 85 and older is projected to more than quadruple, reaching 2.6 million people.

In spite of the fact that a growing percentage of older people are living with long-term illnesses, older people are now able to live more independently than ever before. This raises issues about the potential delivery mechanisms for health and social care in the future. For the purpose of informing long-term policy choices and resource allocation, improved evidence and knowledge of the factors that contribute to inequality as well as future pressures are essential. Medical progress saves a significant number of lives each year but comes at a significant financial cost. It is projected that the advancement of medical technology results in an additional expense of at least £10 billion every year for the NHS.[3]

The growth of digital technology - a challenge with data management[edit]

We are aware that making more effective use of the regular data collected by the NHS may directly enhance clinical care, generate improvements in service, and allow research and innovation. In order for the NHS to reap these advantages, it will need to solve several long-standing issues in the way that it tackles data science and innovation that is driven by data.

Main topic=TechQuity - Use of Technology to attain health equity

The National Health Service (NHS) needs both a continuous program of action to address the fundamental barriers and a much closer convergence between initiatives to enhance the use of data and other efforts focused on improving health and care. Both of these things are necessary for the transformation of health and care. Additionally, to strengthen the infrastructure for data and technology in order to provide data of high quality and in a timely manner for the purposes of service improvement, research, and innovation; solid foundations and an effective technological infrastructure are required.

Workforce Crisis as a major obstacle[edit]

Healthcare Workforce Crisis, Source: Flickr

There is a lack of nurses, physicians, and other medical professionals, which is another obstacle that the NHS must overcome. There are times when there are beds available, but there are no nurses to assist the patients. At this moment, many people are quite worn out and drained as a result of working on the front line with such intense demands over the previous year.[4]

There are valid worries over the length of time that this level of effort and pressure can be maintained on personnel. If the NHS is going to continue working and providing patients with safe health care while also maintaining its personnel, then the health and welfare of its employees need immediate attention and involvement. Concerns over workload, nurse retention, and motivation, as well as the longer-term term availability of nurses, have been heightened as a result of the pandemic. The unwillingness of the government to invest in medical education may be one of the factors contributing to the shortage. Training a medical professional or a nurse is costly, and those expenditures are readily apparent in a system that is publicly supported.

Waiting Times or backlog as a challenge[edit]

Hospital Waiting Times

The National Health Service (NHS) is now dealing with a significant backlog. one that may not be completely resolved for years. As a result of the pandemic, many regular (non-urgent) procedures and referrals had to be postponed, and individuals were also too afraid or anxious to contact their primary care physician or attend hospital visits.[5]

As a consequence of this, there is currently a very long waiting list for specific treatments or specialties in particular departments and NHS trusts; patients may have to wait for certain items for a number of years. Because the pandemic is still active, an aging population, and a staffing shortfall, the National Health Service (NHS) badly needs to attempt to lessen or work its way through this backlog. However, this may be difficult to do.

Research and Development as a challenge for NHS[edit]

The R&D has to continue to develop in order to make the most of the one-of-a-kind research possibilities presented by the National Health Services (NHS) and to satisfy the growing need that the service has for evidence gleaned through research in every facet of its operations. It will be difficult to maintain this level of pace during a time when the NHS as a whole is undergoing significant organizational changes. The first thing that has to happen is that everyone involved in the healthcare industry, including patients and legislators, needs to acknowledge that research and development are not an extra, but rather an essential component of delivering high-quality healthcare to people. The second condition is that research skills should be cultivated, not only among healthcare professionals but also in nonclinical fields of study such as medical statistics, information technology, and health economics, which are vital ingredients of multidisciplinary groups that are capable of carrying out health research to a high standard. This requirement is intended to ensure that multidisciplinary groups are able to conduct health research to a high standard.[6]

Long-term effect of the pandemic; A passive problem for the NHS[edit]

One last element that should be taken into consideration is the pandemic's possible long-term repercussions. You may already be familiar with the phrase "long covid," and there are already studies being published that investigate this topic in further detail.

Patients run the risk of experiencing long-term alterations and harm to their bodies, which can need continuous medical treatment, treatments, and checkups with their primary care physicians. It is difficult to estimate how much this may affect the NHS since we do not yet have a complete understanding of the scope of this potential issue; nonetheless, considering the growing number of individuals who have been diagnosed with COVID-19, it is possible that the impact may be significant.[7]


  1. "National population projections - Office for National Statistics". www.ons.gov.uk. Retrieved 2022-10-28.
  2. Atella, Vincenzo; Piano Mortari, Andrea; Kopinska, Joanna; Belotti, Federico; Lapi, Francesco; Cricelli, Claudio; Fontana, Luigi (2018-11-29). "Trends in age-related disease burden and healthcare utilization". Aging Cell. 18 (1): e12861. doi:10.1111/acel.12861. ISSN 1474-9718. PMC 6351821. PMID 30488641.
  3. World, National Research Council (US) Panel on a Research Agenda and New Data for an Aging (2001). The Health of Aging Populations. National Academies Press (US).
  4. Billings, Jo; Ching, Brian Chi Fung; Gkofa, Vasiliki; Greene, Talya; Bloomfield, Michael (2021). "Experiences of frontline healthcare workers and their views about support during COVID-19 and previous pandemics: a systematic review and qualitative meta-synthesis". BMC Health Services Research. 21 (1): 923. doi:10.1186/s12913-021-06917-z. ISSN 1472-6963. PMC PMC8419805 Check |pmc= value (help).CS1 maint: PMC format (link)
  5. "NHS backlog data analysis". The British Medical Association is the trade union and professional body for doctors in the UK. Retrieved 2022-10-28.
  6. Oliver, S.; Clarke-Jones, L.; Rees, R.; Milne, R.; Buchanan, P.; Gabbay, J.; Gyte, G.; Oakley, A.; Stein, K. (2004). "Involving consumers in research and development agenda setting for the NHS: developing an evidence-based approach". Health Technology Assessment (Winchester, England). 8 (15): 1–148, III–IV. doi:10.3310/hta8150. ISSN 1366-5278. PMID 15080866.
  7. Phillips, Steven; Williams, Michelle A. (2021-08-12). "Confronting Our Next National Health Disaster — Long-Haul Covid". New England Journal of Medicine. 385 (7): 577–579. doi:10.1056/NEJMp2109285. ISSN 0028-4793.