Report findings reveal nearly 1 in 5 adults will have a major illness by 2040

Findings point to big changes in how care should be delivered in the future in a new report published by the Health Foundation, as it revealed 9.1 million people will be living with major illness by 2040, which is 2.5 million more than in 2019.

The new analysis is part of a four-year project led by the Health Foundation’s Real Centre in partnership with the University of Liverpool, focusing on levels of ill health in the adult population in England up to 2040. It lays out the scale and impact of the growth in the number of people living with major illness as the population ages.

The analysis finds that 19 of the 20 health conditions studied are projected to increase in prevalence, including a rise of more than 30 percent in the number of people with conditions such as cancer, diabetes, and kidney disease.

Overall, the number of people with a disease is set to increase from almost one in six of the adult population in 2019, to nearly one in five by 2040, with significant implications for the NHS, other public services, and the public’s finances.

The challenges of improving care for an ageing population and enabling people to live independent lives for longer are not unique to England, with countries across the globe facing similar pressures on their health services, says the Health Foundation. However, with the NHS already under unprecedented strain, the findings point to big changes in how care should be delivered in future.

Much of the projected growth in illness relates to conditions such as anxiety and depression, chronic pain, and diabetes, which are predominantly managed outside hospitals in primary care and the community. According to the Health Foundation, this reinforces the need for investment in general practice and community-based services, focusing on prevention and early intervention, to reduce the impact of illness and improve the quality of people’s lives.

The analysis finds that 80 percent of the projected increase in major illness will be among people aged 70 and over, with the remaining 20 percent among the working-age population.

It also projects that improvements in some of the main causes of poor health, such as fewer people smoking and lower cholesterol rates, will be offset by the impact of obesity, as many people who have been obese for long periods of their lives reach old age.

The report warns that there is no silver bullet to reduce the growth in people living with major illness and that supporting people to live well with illness will increasingly be an essential function of healthcare and other services in the future.

Findings underline the need for a long-term plan to reform, modernise, and invest in the NHS alongside a bold, new approach that invests in the nation’s health and wellbeing.

Anita Charlesworth, Director of the REAL Centre, said: “‘The challenge of an ageing population with rising levels of major illness is not unique to the NHS. Countries across the globe face the same pressures. How well prepared we are to meet the challenge is what will set us apart.

“Over the next two decades, the growth in major illness will place additional demand on all parts of the NHS, particularly primary care, where services are already under extreme pressure. But with one in five people projected to be living with major illness in less than two decades’ time, the impact will extend well beyond the health service and has significant implications for other public services, the labour market and the public finances.”

The report is the first in a new programme of research from the Health Foundation’s REAL Centre, which aims to support policymakers by looking at patterns of illness over the next two decades. A second report will focus on the implications for health inequalities in autumn 2023.

Recent polling data from Ipsos and the Health Foundation shows that despite the NHS making people most proud to be British, the public is worried about its future.