Short of capacity? Why the government must address the capacity constraints in the English National Health Service

Abstract

A decade of low investment in the English National Health Service (NHS) resulted in strong headline productivity growth but undermined the health system's resilience and left it exposed during the COVID-19 pandemic. Projected demographic pressures, driven by the aging of the baby-boom generation and the rise in multi-morbidity levels in the population, will add pressures to already stretched health care resources. As the NHS faces the twin challenges of recovering services after the pandemic and meeting care needs from an aging population, our projections of demand for care indicate the NHS almost certainly needs significantly more beds as well as more staff. Productivity improvements in hospital care can reduce the amount of additional resources needed, but this will require significant concomitant investment in community-based health and long-term-care services.