ABSTRACT
The separate governments in England, Scotland, Wales, and Northern Ireland have been in charge of planning and executing health care services since devolution in the late 1990s. Residents of the UK have access to a National Health Service (NHS) based on clinical need, not financial capacity. Contrarily, free access to social care services is means-tested and subject to a variety of eligibility requirements depending on the United Kingdom country. In comparison to the majority of other high-income nations, the UK has significantly lower levels of physicians and nurses, hospital beds, and diagnostic tools. Due to these deficiencies, the nation has minimal capacity to absorb sudden shocks like the COVID-19 pandemic. Additionally, they have caused an increase in the number of people on waiting lists for elective care, with over 6 million people in England alone in 2022. In the past, the UK's health spending has seen periods of both continuous expansion and austerity. Nevertheless, over the past ten years, total health spending has grown, reaching just over 10% of GDP in 2019. Around 80% of all health spending is public money, which is a significant share and has been stable over the past 20 years. As a result, UK people have little out-of-pocket spending and high levels of protection from the financial effects of illness. To enable real integration amongst health care providers, a number of obstacles still exist in all four countries, including disconnected health information technology systems, duplicate governance structures, and a dearth of strategic planning. Although efforts to encourage such integration through cross-sectoral partnerships have advanced in England, Scotland, and Wales in recent years, Northern Ireland remains the only United Kingdom component county where the NHS and social care are completely organisationally linked.