Our reflections on NHS landmark report and what that means for longevity projections
Health Pensions & benefits Mortality, longevity and demographic modelling
Lord Darzi’s independent review, published earlier this month, describes the NHS as being “in serious trouble”, citing long waiting times, reduced productivity, and low patient and staff engagement. It was followed last week by the Institute for Public Policy Research (IPPR)’s report, ‘Our greatest asset’, which describes the UK as the “sick man of Europe” and recommends shifting health policy from a sickness model to one of health creation. This is the final report of the IPPR Commission on Health and Prosperity, a multi-year investigation into the state of the nation’s health and economic wellbeing following the Covid-19 pandemic. Dr Jonathan Pearson-Stuttard, head of LCP Health Analytics, is vice-chair of the commission and we were delighted to support the commission’s previous interim report released in September 2023 which discussed the benefits of increased focus on prevention and productivity in public healthcare.
While both reports emphasise the current scale of the challenges faced, most of the problems described are the culmination of mounting challenges facing the NHS in recent years. We summarise some of the key themes below.
Excessive A&E waits are leading to excess deaths
The Darzi review cites analysis by the Royal College of Emergency Medicine that long waits are likely to be causing 14,000 extra deaths per year. This figure aligns with LCP analysis from 2023, which found that additional delays of over 4 hours in A&E may be associated with between 200 and 340 excess deaths each week (10,400 to 17,680 per year).
Cancer treatment targets are consistently being missed
The Darzi review points to slight improvements in early-stage cancer diagnoses but notes that the NHS target of treating 85% of patients within 62 days of referral has not been met since 2015, with only 65.8% of patients treated within this benchmark in May 2024. In 2023, LCP worked alongside Macmillan Cancer Support to estimate that 64,000 people in the UK diagnosed with cancer over the next five years could live half a year longer if they were treated within the target. Separate LCP research for Pfizer quantified inequalities in the breast cancer pathway, finding that diagnosis via screening was less common among more deprived communities and ethnic minorities.
The number of people who are economically inactive is rising
The IPPR report finds that economic inactivity due to ill health has reduced the workforce by 900,000 compared to what would have been expected based on pre-pandemic trends. Our detailed 2023 analysis breaks down some of the trends in the rise in economic inactivity.
What does this mean for longevity projections?
It is likely that the challenges that the NHS is facing are not only impacting patient experience but resulting in increased mortality through longer waits for treatment, worse population health and reduced economic productivity. As the population continues to age, more people will become dependent on health and social care, and the quality and availability of this care will be paramount in ensuring they remain in good health and live as long as possible.
Both the Darzi review and the IPPR report make clear that the problems facing the NHS are deep-rooted and will require time and substantial reform to fix. This points towards a likely continuation of the modest longevity improvements seen over the 2010s and suggests that the indirect effects of the pandemic will continue to be felt over the short-medium term, for example, through increased waiting lists and reduced NHS performance.
Allowing for trends in public health when setting mortality assumptions requires a joined-up approach that leverages clinical insights where possible. Our longevity advice uniquely draws from our multi-disciplinary team, combining actuarial modelling with real-world insights from our health analytics department to provide clients with robust forward-looking scenarios. Longevity insights can help trustees and employers achieve better outcomes for their members and wider stakeholders, for example when assessing the most appropriate pace of scheme funding or whether an insurance transaction offers value for money.
For further information, please see our latest longevity report or speak to one of our mortality experts.
