Overview
The United Kingdom has a national health service (NHS) with access based on clinical need, and not ability to pay. All individuals, irrespective of their nationality or immigration status, are eligible to access primary, emergency and compulsory psychiatric care, free of charge. Coverage for secondary care services, however, is only available for those who are ordinarily resident. Health care expenditure accounted for 10.2% of GDP in 2019, the eighth highest in the WHO European Region. Public funding for health (79.5% of health expenditure) is relatively high and out-of-pocket spending reached 17% in 2019. Private medical insurance is usually used to finance a few select services not offered by the NHS or to access NHS-covered services more quickly.
Principal health reforms in each of the United Kingdom’s constituent countries are focused on promoting integration of care and facilitating cross-sectoral partnerships that improve the health and wellbeing of local populations. Most recently, in England, the NHS is undergoing a structural reorganization, with Clinical Commissioning Groups being replaced from July 2022 with Integrated Care Systems, which will be responsible for delivering health and social care services to local populations of 1 to 3 million people. Northern Ireland has also conducted a consultation on the development of a new planning model to strengthen the delivery of integrated healthcare services.
