Intended for healthcare professionals

Feature Data Briefing

What’s happened to NHS spending and staffing in the past 25 years?

BMJ 2023; 380 doi: (Published 15 March 2023) Cite this as: BMJ 2023;380:p564
  1. John Appleby, director of research and chief economist
  1. Nuffield Trust, London, UK
  1. john.appleby{at}

Ministers are often heard referring to increases in NHS spending and staffing—but what’s the true picture behind those numbers? John Appleby finds some interesting stories in his analysis of the data from England over time and with demographic change

Twenty five years ago, in the financial year 1998-99, the Department of Health in England spent £36.6bn in total, equivalent to £59bn in 2021-22 prices. The bulk of this covered the NHS but also included public health, arm’s length health bodies, and other health services. Today, in 2022-23, the department’s planned spending (excluding special covid spending) is likely to be around £165bn in 2021-22 prices, a real terms increase of 180%.

On average, this has meant …

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