title: United Kingdom: Health System Review.
abstract: This analysis of the United Kingdom health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. It provides an overview of how the national health services operate in the four nations that make up the United Kingdom, as responsibility for organizing health financing and services was devolved from 1997. With devolution, the health systems in the United Kingdom have diverged in the details of how services are organized and paid for, but all have maintained national health services which provide universal access to a comprehensive package of services that are mostly free at the point of use. These health services are predominantly financed from general taxation and 83.5% of total health expenditure in the United Kingdom came from public sources in 2013. Life expectancy has increased steadily across the United Kingdom, but health inequalities have proved stubbornly resistant to improvement, and the gap between the most deprived and the most privileged continues to widen, rather than close. The United Kingdom faces challenges going forward, including how to cope with the needs of an ageing population, how to manage populations with poor health behaviours and associated chronic conditions, how to meet patient expectations of access to the latest available medicines and technologies, and how to adapt a system that has limited resources to expand its workforce and infrastructural capacity so it can rise to these challenges.
authors.affiliation: European Observatory on Health Systems and Policies.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cylus
authors.affiliation: European Observatory on Health Systems and Policies.
authors.forename: Erica
authors.initials: E
authors.lastname: Richardson
authors.affiliation: Editorial Consultant.
authors.forename: Lisa
authors.initials: L
authors.lastname: Findley
authors.affiliation: Welsh Institute for Health and Social Care, University of South Wales.
authors.forename: Marcus
authors.initials: M
authors.lastname: Longley
authors.affiliation: NUI Galway and Queen's University Belfast.
authors.forename: Ciaran
authors.initials: C
authors.lastname: O'Neill
authors.affiliation: University of Aberdeen, (formerly Chief Executive, NHS Quality Improvement Scotland.
authors.forename: David
authors.initials: D
authors.lastname: Steel
mesh_terms: D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration*; D018166:Health Care Reform / Q000458:organization & administration; D006268:Health Facilities / Q000706:statistics & numerical data; D006302:Health Services Research; D054624:Health Status Disparities; D006280:Health Workforce / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D033181:Information Dissemination; D007255:Information Services / Q000458:organization & administration; D008017:Life Expectancy; D009313:National Health Programs / Q000191:economics / Q000458:organization & administration*; D011787:Quality of Health Care / Q000458:organization & administration; D012959:Socioeconomic Factors; D006113:United Kingdom