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UK healthcare standards 'trailing rest of developed world'

Published 04/11/2015

The UK needs 47,700 more nurses to match standards in the rest of the developed world, according to the OECD report
The UK needs 47,700 more nurses to match standards in the rest of the developed world, according to the OECD report

The UK would need over 75,000 more doctors and nurses to match standards in the rest of the developed world, leading health experts have warned.

The quality of care in the UK is "pretty mediocre" across several key areas, while obesity levels are "dire" and the NHS struggles to get even the "basics" right, they said.

A new report from the Organisation for Economic Co-operation and Development (OECD) compared the quality of healthcare across 34 countries.

The UK lags behind in key areas, including coming 21st out of 23 countries on cervical cancer survival, 20th out of 23 countries on breast and bowel cancer survival and 19th out of 31 countries on stroke.

On heart attack deaths, the UK is ranked 20th out of 32 countries. While survival after hospital admission for heart attack and stroke is improving, it is "worse than many other OECD countries", including Canada, Italy, the Netherlands and Spain, the study said.

The UK is also a "middling to low performer" on three out of four key health areas, including quality of care and life expectancy. Furthermore, there is a need for "urgent attention" to tackle the UK's high rates of smoking, harmful alcohol consumption and obesity.

Some 19% of adults in the OECD are obese on average, but the figure in the UK is 25%.

Spending on health is also lower in the UK than the OECD average, with "zero growth in health spending per person in real terms between 2009 and 2013", the report said.

Countries that spend more include France, Canada, Belgium, Germany, New Zealand and Denmark.

Nigel Edwards, chief executive of the think tank the Nuffield Trust, who helped launch the report at a meeting in central London, said thousands more doctors and nurses were needed to match the OECD average.

The UK would need 47,700 more nurses and 26,500 more doctors to match the OECD average, he said, at a cost of an extra £5 billion a year.

The OECD average number of nurses is 9.1 per 1,000 population, while the figure in the UK is 8.2.

The UK also lags behind on numbers of doctors, with 2.8 per 1,000 population, compared to the OECD average of 3.3.

Countries with more doctors include Greece, Italy, Germany, Spain, Portugal, Switzerland, the Czech Republic, Israel and Australia.

Mark Pearson, OECD deputy director of employment, labour and social affairs, said the UK was doing "outstandingly poorly" on preventing ill health by tackling issues like obesity.

He added: "While access to care in the UK is good, the quality of care is uneven and continues to lag behind that in many other OECD countries."

He said the UK "often does not do the basic things very well", and said the lower than average levels of public investment in healthcare was mirrored by a "somewhat mediocre performance across the board - from relatively low staffing levels, to high rates of avoidable admissions for asthma and lung disease".

Mr Pearson said the UK "can and must do much better", adding that in healthcare "you get what you pay for".

The UK was spending "considerably less" on health than many of the countries it would like to compare itself to, he added.

Mr Pearson pointed to NHS achievements, including being efficient in some areas, such as lengths of stay in hospital and good performance on avoidable admissions for diabetes.

But s taffing levels were not adequate and there were still too high rates of hospital-acquired infections. Guidelines were also published but not followed, he said.

"These basic sort of things don't seem to be done to the extent in the UK that they are done in other countries," he said.

"I think it's unrealistic, if you spend less, that you can expect a performance that is as good as these other countries."

Mr Pearson said many medics were too rushed to improve the care they give.

He said: "At the moment in the NHS I think there is the risk that people do not have the time to do that.

"What they are doing is going through the processes ... rather than being a learning organisation, an organisation that can improve."

Mr Edwards added: "If people are stretched, people don't have the bandwidth to make a change."

Mr Edwards also said junior doctors were also relied upon to provide healthcare.

"What's unusual about British hospitals is that when you see someone, they are quite junior.

"We use juniors to provide the backbone of the workforce in hospitals rather than (more highly qualified) doctors."

Dr Fran Woodard, director of policy and impact at Macmillan Cancer Support, said: " These figures are a depressing reminder that a lack of investment in cancer care is clearly impacting negatively on the outcomes for cancer patients.

"The NHS is capable of excellent care, but as these findings show, this is not always translating into results that match the best in Europe."

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