More than nine million people to be living with major illnesses by 2040

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A total of 9.1 million people in England are projected to be living with major illness by 2040, according to a report published today by the Health Foundation. 

That represents an increase of some 2.5 million people compared to 2019. 

Overall, the number of people living with major disease in England 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 finances. 

The rate of increase for people living with major illnesses will also far exceed the rate of growth for the working age population. The 37% growth rate for major illness is nine times the rate at which the working age population (20-69 year-olds) is expected to grow over the same period (4%). 

The report is part of a four-year project led by the Health Foundation’s REAL Centre in partnership with the University of Liverpool, and focusses on levels of ill health in the adult population in England up to 2040. 

No silver bullet

Most of the projected increase (80%) will be due to growing numbers of people over the age of 70, as life expectancy increases.

But the report warned 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. 

Toby Watt, lead economist for demand at the REAL Centre at the Health Foundation, said: “The rise in people living with major illness will not occur overnight. Managing these pressures is achievable with careful planning, investment and changes in how care is delivered.” 

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

Not unique to England

But 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.  

“However, with the NHS already under unprecedented strain, the findings point to big changes in how care should be delivered in future,” the Health Foundation said. 

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.” 

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.  

“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 report said. 

The analysis also projected 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 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, the Health Foundation said. 

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