A new report published by the Health Foundation has found that the UK’s performance on hospital-based care is consistently languishing near the bottom in a public survey of 10 high-income countries.

The analysis of the 2023 Commonwealth Fund survey highlights key areas where the UK performs poorly, particularly on long waits for specialist care, lack of access to out-of-hours care, and affordability for treatments like dental care.

Over 21,000 people from across 10 developed countries took part in the survey last year, including over 3,000 from the UK.

The countries that took part in the survey were: Australia, Canada, France, Germany, the Netherlands, New Zealand, Sweden, Switzerland, the US, and the UK. A total of 21,341 participants took part in the survey, including 3,361 living in the UK. Respondents for the 2023 survey were selected, using a random sampling approach, to be representative of adults in each country.

Participants were asked a series of questions related to their experience of healthcare, including access to hospital care and general practice, affordability, and care coordination.

For hospital care, the UK had among the longest waiting times compared to the other countries in the survey, with 11 percent of people waiting a year or more for a specialist appointment and 19 percent waiting a year or more for non-emergency surgery. Only Canada is comparable, the findings reveal.

The report also highlights that waiting times for a specialist appointment have risen more rapidly in the UK than in other countries. In 2023, 61 percent of people in the UK reported waiting more than four weeks for a specialist appointment, up from 14 percent in 2013.

The Health Foundation’s assistant director of policy, Ruth Thorlby, said: “These findings show the UK consistently coming near the bottom of the pack on people’s experience of healthcare compared to other high-income countries. It sheds yet more light on just how much work the government has to do to get the NHS back on its feet.”

On general practice, the UK is one of the better performing countries for people reporting same- or next-day appointments (42 percent).

However, the report highlights a number of areas where the UK performs less well. Only 16 percent of people in the UK reported it was ‘very’ or ‘somewhat easy’ to get medical care in the evenings and weekends without going to A&E.

The UK performed towards the bottom on people’s experience of seeing a GP, including having things explained in a way they could understand and spending enough time with their GP. The UK also performed poorly on care coordination between health care professionals (e.g. GPs and specialists).

Additionally, the survey shows that problems related to the affordability of healthcare have grown significantly in the UK since 2013. In 2023, around a quarter of people skipped dental care or dental checkups because of the cost, compared to six percent of people in 2013.

While the NHS remains mostly free at the point of use, the proportion of people who did not visit or consult with a doctor for cost reasons tripled in the last 10 years, from two percent of people surveyed in 2013 to seven percent in 2023, which is likely due to recent increases in living costs, the Health Foundation warns.

Ruth continued: “The combined effect of the pandemic and below average spending growth has left the NHS in a fragile state. The government is right to prioritise bringing down waiting lists, but that can only be done with a concerted effort to improve primary care and ensuring good coordination between hospitals and GPs.

“National and local health leaders also need to be vigilant against creeping costs denying people access to healthcare. Nowhere is this more apparent than dental care where too many people are avoiding treatment due to costs. If these trends continue, the risk is that more and more people, particularly from deprived communities, will delay seeking care, which could store up more health problems in the future.

“There are no quick fixes, but the NHS can recover with the right mix of policy change, innovation and investment.”

A recent report from The King’s Fund concluded that bolstering digital technologies in GPs, pharmacies, community trusts, and care providers can help reduce the number of people needing to access already over-stretched hospitals.