A storm brewing in healthcare

The challenges facing healthcare in the UK today are complex and the consequences of the pandemic will continue to be felt across both the NHS and the private sector. They are now more than ever reliant on each other to meet the health needs of the UK population, says Tim Morris.

We have seen unprecedented challenges over the last two years across healthcare, with resources from both public and private hospitals being used to fight the global Covid-19 pandemic. 

The traditional dynamic between the two sectors has become distorted since 2020, and as we emerge into a post-pandemic world; both private and public practice are facing significant challenges. 

At Elsevier, we want to understand these future challenges better, so we can work with partners across the healthcare sector to meet them head on and continue to improve patient outcomes.

In the UK, there is currently a huge backlog of patients, particularly in oncology. Many patients had their surgeries and treatments postponed throughout the pandemic, as hospitals looked to manage the mass influx of Covid-19 admissions.

Rise in self-pay 

Private hospitals, which traditionally are heavily dependent on patients funded by insurance, saw an increase in the number of self-paying patients who perhaps would not have previously considered private practice for everyday ailments. 

Most recent data, as I write, from the Private Healthcare Information Network (PHIN) shows the number of UK self-pay admissions between 2019 and 2021 increased by 29%. Now, concerns around delays for referrals and waiting lists for treatment are motivating new patients into the private sector for care.  

To support efforts to reduce patients’ wait for routine care, the NHS again may have to rely on private practice and increase spending on private facilities. 

The Government needed the independent hospital sector throughout the pandemic to increase capacity – requiring access to additional beds, staff and equipment to treat patients during the peak of the pandemic. As a result, spending by NHS commissioners on services delivered by the private sector increased by £2.5bn between 2019-20 and 2020-21 to £12.2bn. 

The longer-term perspective is that there is a storm brewing across UK health and care services. 

Ageing population

We have an ageing population and the proportion of those who are living with long-term chronic conditions is growing, as is the number of younger people presenting with co-morbidities. 

The reality is that both public and private healthcare will increasingly be dealing with a significant number of patients requiring more complex and continuous care.

The number of Brits over the age of 85 is predicted to double to 2.6m in the next 25 years and, as such, the population that is dependent on continuous care will also significantly grow. 

In addition to this, it is now estimated that a third of middle-aged adults in the UK have at least two chronic health issues. And research published in the BMJ has found the risk of middle-aged adults in the UK developing dementia is 2.5 times greater for those that have two or more chronic health issues. 

There is also a growing number of younger people with comorbidities and obesity-related diseases, as well as the unknown toll of patients suffering from both the physical and mental health impact of Covid-19. 

These groups of patients will contribute to the healthcare burden as they age, presenting challenges when planning health and care services for the future. 

Critically, these challenges will be coupled with a growing clinician shortage due to persistent burnout and stress. 

Global survey

Elsevier Health recently developed the Clinician of the Future report to explore global trends and changes that will impact the future of healthcare. 

Through a global survey of nearly 3,000 clinicians from 111 countries, healthcare professionals considered the consequences of the pandemic and provided insights on the challenges and opportunities they expect to face over the next decade. 

The data published in the report reveals that 94% of clinicians globally believe the rise of chronic health issues – including heart disease, cancer, chronic obstructive pulmonary disease, and diabetes – will be a key driver of change in healthcare over the next ten years. 

Furthermore, 71% of clinicians believe the increase in comorbidities in younger patients will also play a pivotal role in the changing healthcare landscape.

The report suggests a shift to preventive care could potentially reduce the burden of chronic illness and, in the longer term, result in people visiting healthcare facilities less often. 

However, findings show that 79% of clinicians believe there is currently not enough being done on preventive care, and 84% agreed that patients with age-associated diseases will make up the majority of the patient population in ten years’ time.

The Clinician of the Future report highlighted the widespread workforce shortages and staff burnout resulting from sustained work pressure, with 47% of UK clinicians indicating they are considering leaving their current role within the next two to three years. 

In addition to this, 86% and 88% believe there will be a shortage of doctors and nurses in the next ten years. Findings suggested those leaving the profession may be doing so due to a general feeling of being undervalued and unappreciated.

Only 18% of UK doctors believe the critical importance of the work they do is fully appreciated by government officials, and only 39% feel appreciated by the public.

The challenges facing healthcare in the UK today are complex, and the consequences of the pandemic will continue to be felt across both the NHS and the private sector. The reality is that the NHS and the private sector are now more than ever reliant on each other to meet the health needs of the UK population. 

Only by listening to clinicians and understanding where and how the two systems need to work together effectively, can we begin to manage the scale of the health crisis in the UK. 

To find out more on the Clinician of the Future report, visit www.elsevier.com/connect/clinician-of-the-future

Tim Morris (right) is vice-president of Clinical Solutions at Elsevier Health