New research reveals one in five people in England will have a major illness by 2040

As reported by The Times, according to new research, more than nine million people in England will be living with major illnesses by 2040, with the majority of the burden being placed on primary care

Rising rates of obesity are counteracting progress on other causes of poor health, such as fewer people smoking and lower cholesterol rates, a new report warns.

Illnesses including cancer, diabetes, anxiety and depression, chronic pain and kidney disease are all expected to increase, with the result that 9.1 million people have levels of ill health that affect their lives.

The growth in major illness has significant implications for other public services, not just the NHS.

While life expectancy is projected to increase by more than a year, the report, by the Health Foundation’s Real Centre and the University of Liverpool, finds the average age at which people are expected to be living with chronic conditions will remain constant at about 70 years.

Anita Charlesworth, director of the Real Centre, said 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”.

She said the impact would extend “well beyond the health service and has significant implications for other public services, the labour market and the public finances”.

The number of people living with major illness is expected to increase by 37%, while the working-age population is projected to grow by only four per cent.

In 2019, about one adult in six, or 6.7mn people, was living with major illness, but the figure will be almost one in five, or 9.1mn, by 2040.

The report used a scoring system that assigns a weight to different illnesses based on their impact both on the health care system and individuals’ life expectancy. High blood pressure has a score of 0.08, while dementia has a score of 2.5. People were deemed to have “major illness” if they had a total score of 1.5 or above.

Someone’s chance of having a particular illness at any given age is likely to be “more or less stable”, the report said, meaning that the vast majority of the increase in major illness is driven by demographic changes. Some two million of the additional people living with major illness will be 70 and over.

Cases of dementia are expected to rise 45% by 2040, heart failure by 92%, cancer by 31%, diabetes by 49%, chronic pain by 32% and anxiety or depression by 165. Only one out of 20 conditions listed — coronary heart disease — is expected to drop.

Charlesworth urged services to prepare, saying that much of the projection was already “baked in” by present levels of obesity and ill health. She added that, while the report looks at adults, there are “really concerning obesity rates” among children, which will have a big future impact on the NHS.

Writing for The Times Health Commission, a year-long inquiry into health and social care, she said changes to the NHS funding model were not needed but that “part of the reason the NHS is under such strain is that the government hasn’t planned for the rising demand for services associated with increasing ill health”.

She said meeting the challenge between now and 2040 would require investment in NHS infrastructure and improving productivity, using new tools like AI, data and digital tech. She said services needed to be better designed around the growing number of people living with major illness.

Toby Watt, the lead economist of the Real Centre, said the projections were for gradual change that should be manageable “with careful planning, investment and changes in how care is delivered”.

Elaine Kelly, assistant director of the centre, said the rising numbers should not be seen only as a burden, adding: “People are living longer. Most people will enjoy those extra years. We will enjoy spending those extra years with them.“It’s a nice problem to have. It’s better than the reverse where we can’t keep people alive when they get major illness.” NHS leaders said more action was needed on prevention and wider public services in order to help the NHS prepare for and cope with the increase in numbers.

Miriam Deakin, director of policy and strategy at NHS Providers, said: “Prevention is better than cure. More support and money for public health services are vital to stave off poor health and ease pressure on the NHS.”

Dr Layla McCay, director of policy at the NHS Confederation said: “Health leaders are clear that more needs to be done to prevent people from falling ill. A greater shift towards preventative health and care services will save money in the long run, improve population health and reduce health inequalities.”

A Department of Health and Social Care spokesperson said: “We are ensuring the NHS is fit for both the challenges of today and for the future and we have committed an extra £39bn in the last year to recover from Covid, cut waiting lists and put health and care services on a sustainable footing.

“Our forthcoming Major Conditions Strategy will also outline how best to prevent, diagnose, and manage six key conditions, such as cancer and cardiovascular diseases, that drive ill health and early death in England.”