England is facing a “catastrophic” increase in rates of major illness, according to an analysis published today

An additional 2.5 million people in England will be living with a major illness by 2040 – meaning 9.1 million people will be affected, according to the Health Foundation report.
The Royal College of Physicians said the report was a “wake up” call to tackle the nation’s poor health.

The analysis, part of a four-year project led by the Health Foundation’s Real Centre with the University of Liverpool, focuses on levels of ill health in the adult population in England up to 2040. It lays out the scale and impact of the growth in the number of people living with major illness as the population ages.

Wake up call

Overall, the number of people living with major disease is projected to rise from almost one in six of the adult population in 2019, to nearly one in five by 2040.
Anita Charlesworth, director of the REAL Centre, said: “The challenge of an ageing population with rising levels of major illness is not unique to the NHS. Countries across the globe face the same pressures. How well prepared we are to meet the challenge is what will set us apart.
“Over the next two decades, the growth in major illness will place additional demand on all parts of the NHS, particularly primary care, where services are already under extreme pressure. But with 1 in 5 people projected to be living with major illness in less than two decades’ time, the impact will extend well beyond the health service and has significant implications for other public services, the labour market, and the public finances.”
The research team found that 19 of the 20 health conditions studied are expected to increase in prevalence, including more than a 30% rise in the number of people living with conditions such as cancer, diabetes, and kidney disease.

The majority (80%) of cases will be among people aged 70 and over, with the remaining 20% among the working-age population.

Focus on prevention

Much of the projected growth in illness relates to conditions such as anxiety and depression, chronic pain and diabetes. As these are managed in primary care and the community, the researchers say it means there should be investment in general practice and community-based services, focusing on prevention and early intervention to reduce the impact of illness and improve the quality of people’s lives.
Toby Watt, lead economist: demand, REAL Centre, said: “The findings from this report give us new insight into the future demand for health care in England. It is crucial to emphasise that these are projections, not forecasts, which are designed to support policymakers in preparing for the future.
“The rise in people living with major illness will not occur overnight. Managing these pressures is achievable with careful planning, investment and changes in how care is delivered.”
The report is the first in a new programme of research from the Health Foundation’s REAL Centre, which aims to support policymakers by looking at patterns of illness over the next two decades. A second report, to be published this autumn, will focus on the implications for health inequalities.
Dr Sarah Clarke, president of the Royal College of Physicians, said: “The projections laid out in the Health Foundation’s report will quite frankly be catastrophic – for people and their families, for the health of the NHS and its workforce, and for the prosperity of the nation.
“We know that much of this illness is avoidable – it’s caused by smoking, poor housing, unemployment, poor food and air quality, and obesity. It is in the gift of the government to do something about all these things.
“This must surely be a wakeup call for the prime minister that we have to put health at the heart of government. We need a strategy that pulls at every policy lever available in order to build a healthier society and economy.”