Long-term projections of health care funding, bed capacity and workforce needs in England

Changes in population structure and underlying health put a significant strain on health care system resources. In this context, projecting future health care needs can contribute to better health care system planning and resource allocation over the long term. This paper presents a model of future demand and costs of care to estimate long-term funding and resource needs up to 2030/31.

Using data from England, we first calculate health care utilization rates by age, gender and comorbidity, where available, and multiply them by the projected future populations to estimate future demand for a wide range of service areas. We then cost this future demand using 2018/19 unit costs for each service area which we project by accounting for assumptions around future inflation and productivity.

Our results indicate in the longer term, funding for the English NHS would need to increase by around 2.8% per year in real terms to meet these underlying funding pressures. Further, our projections imply that the number of general and acute care beds would need to grow by between 1.3 and 4.1% a year and the NHS workforce would need to grow by between 1.8 and 2.6% a year by 2030/31, depending on productivity assumptions.

Our projections of workforce and hospital beds illustrate the extent of underlying pressures from population ageing and changes in morbidity. Improvements in care emerge as crucial for meeting these pressures.