The NHS Under the Microscope

The NHS Confederation is the voice of NHS leadership. They are the only membership body that brings together, and speaks on behalf of, the whole health and care system.

Their mission, vision and values inform the work of the NHS Confederation and guide how they interact with members, partners and stakeholders.

The NHS Confederation plays a crucial leadership role by bringing together all parts of the system through their networks, corporate members and associations but they also work in partnership with a wide range of organisations that represent health professionals, patients, their families and carers, supply chain organisations, local government and partners from across the wider health and social care industry.

The following are figures released by the NHS Confederation to give a snapshot of the NHS at the moment:


  • NHS net expenditure (resource plus capital, minus depreciation) has increased from £64.173 billion in 2003/04 to £109.721bn in 2013/14. Planned expenditure for 2014/15 is £113.035bn.
  • Health expenditure per capita in England has risen from £1,712 in 2008/09 to £1,912 in 2012/13.
  • The NHS surplus for the 2012/13 financial year (covering strategic health authorities, primary care trusts, NHS foundation trusts and NHS trusts) was £2.1 billion.
  • The most recently published national surveys of investment for mental health found there had been real term reductions of 1% for working age adults and 3.1% for older people in 2011/12.


In the NHS there are currently in England (unless stated):

  • 211 clinical commissioning groups (including 198 now authorised without conditions).
  • 160 acute trusts (including 102 foundation trusts).
  • 56 mental health trusts (including 41 foundation trusts).
  • 34 community providers (16 NHS trusts, two foundation trusts and 16 social enterprises).
  • 10 ambulance trusts (including five foundation trusts).
  • 8,000 GP practices.
  • 2,300 hospitals in the UK.


In 2013 the NHS employed 147,087 doctors, 371,777 qualified nursing staff, 154,109 qualified scientific, therapeutic and technical staff and 36,360 managers.

There were 37,843 additional doctors employed in the NHS in 2013 compared to 2003. The number has increased by an annual average of 3% over that time.

There were 23,531 more NHS nurses in 2013 compared to 10 years earlier. While the total employed in 2013 was an increase on the previous year, it remains below the number in 2010.

2,166 more practice nurses were employed by GPs in 2013 than 10 years earlier.

50.6% of NHS employees are professionally qualified clinical staff.

There were 13,974 more qualified allied health professionals and 3,968 more health scientists employed in the NHS in 2013 compared to 2003. However, the number within the latter group has declined for each of the past four years.

Since 2003 the number of professionally qualified clinical staff within the NHS has risen by 16.1%. This rise includes an increase in doctors of 34.4%; a rise in the number of nurses of 6.8%; and 17.4% more qualified ambulance staff.

Medical school intake rose from 5,062 in 1997/98 to 8,035 in 2011/12 – a rise of 58.7%.  

The following seven points have been published as ‘Targets to meet’

  • Needs – meeting the rising demand for care, particularly from people with complex needs or long-term conditions.
  • Culture – creating a more open and transparent NHS, working in partnership with patients and the public.
  • Design – redesigning the health and care system including shifting more care closer to people’s homes, while maintaining excellent hospital services.
  • Finance – recognising the financial pressures on all parts of the system and squeezing value from every penny of public money spent on health and care. (Debating honestly and openly the future levels and sources of funding for health and social care.)
  • Leadership – creating leaders across the NHS and empowering them to improve health and wellbeing for local people.
  • Workforce – planning for a workforce that matches changing demand.
  • Technology – using technology to help transform care, and enabling people to access information and treatment in a way that meets their needs.

Within just seven points the NHS Confederation has challenged itself to completely evolve the way it works from top to bottom. It isn’t just about skills it’s going to be about finding people with the right attitude and mindset to cope in what is likely to be a sector in flux over the next few years.

How the NHS is rebuilt will of course be decided through political discourse but also and perhaps more realistically, how things are managed on the ground. This might well be where Service-leavers can have a big impact and show their capabilities in the best light.

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