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Identifying options for funding the NHS and social care in the UK: international evidence

Cylus, Jonathan and Roland, Daniel and Corbett, Jennie and Jones, Karen C. and Forder, Julien E. and Sussex, Jon (2018) Identifying options for funding the NHS and social care in the UK: international evidence. Working paper. The Health Foundation, London, United Kingdom (KAR id:69339)


We investigate how other high-income countries have thought about and implemented changes to their funding systems for health and social care to better meet the challenges ahead. This paper is part of a broader project funded by the Health Foundation, which aims to identify a range of feasible options for the future funding of health and social care in the four countries of the UK, and assess the relative (un-)attractiveness of different funding approaches to the general public. The research reported here examines trends and innovations in health and social care funding in a selection of high-income countries. We focus on where the money to pay for care comes from, not on how it is then spent.

Drawing on a review of the literature and interviews with 30 key informants in a range of high-income countries, we explore current thinking on the options for funding health care and social care. Our aim is to add to the evidence base and improve the quality of the debate, rather than make recommendations. Specifically, we:

• provide examples of funding configurations for health and social care, as well as changes that have been implemented, or are being considered, in a range of high income countries

• explore the drivers of recent or planned health and social care funding changes and reforms and the contexts within which decisions around funding were taken

• highlight key points that can inform the range of conceivable options for funding health care and social care in the four countries of the UK.

Overall we find that:

• most reviewed countries fund health care primarily from public sources, such as taxation and mandatory health insurance, while social care often relies to a comparatively greater extent on individuals paying privately

• health and social care funding reforms tend to be incremental rather than radical, are path-dependent, and are catalysed by changes in economic conditions rather than by rising demand for care

• high-income countries have taken diverse approaches to tackling the need to increase health and social care funding and there is no single optimal, or commonly preferred, solution to achieving sustainable revenues.

Item Type: Reports and Papers (Working paper)
Uncontrolled keywords: funding, NHS, social care.
Subjects: R Medicine > RA Public aspects of medicine > RA421 Public health. Hygiene. Preventive Medicine
Divisions: Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Personal Social Services Research Unit
Depositing User: Daniel de Araujo Joao Roland
Date Deposited: 02 Oct 2018 12:43 UTC
Last Modified: 10 Dec 2022 04:24 UTC
Resource URI: (The current URI for this page, for reference purposes)

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