The Kings Fund: The rise and decline of the NHS in England 2000–20

A paper from the Kings Fund former Chief Executive Chris Ham analyses how a major public service was allowed to deteriorate. It focuses on the period since 2010 and the factors that contributed to the decline of the NHS after the progress that had been made in the previous decade.

The report concludes that funding increases and a series of reforms resulted in major improvements in NHS performance between 2000 and 2010, but since 2010 performance has declined as a result of much lower funding increases, limited funds for capital investment, and neglect of workforce planning. Constraints on social care spending has also resulted in fewer people receiving publicly funded social care and a repeated cycle of governments promising to reform social care but failing to do so.

While the current situation can feel overwhelming, the improvements that occurred between 2000 and 2010 show that change is possible where the political will exists. The paper concludes by setting out what now needs to be done to sustain and reform the NHS, with a focus on spending decisions, moderating demand and sharing responsibility with patients and the public, alongside a long-term perspective.

Full report available on the Kings Fund website, 12 April 2023