The King’s Fund, a charity dedicated to improving health and care in the UK, has analysed NHS spending and service use in England for 2023/24. The data reveals not only how resources are being used, but also highlights the increasing pressures on the system—and the vital role self-care can play in helping to reduce demand and manage costs.
NHS Workforce and Salaries
With around 1.37 million full-time staff in England, the NHS remains one of the largest employers in the world. The wage bill is understandably substantial, with £81.7 billion—49% of the NHS budget—spent on staffing costs in 2023/24.
This figure does not include GP salaries, as GPs are independent contractors rather than direct NHS employees
NHS Workforce and Salaries
With around 1.37 million full-time staff in England, the NHS remains one of the largest employers in the world. The wage bill is understandably substantial, with £81.7 billion—49% of the NHS budget—spent on staffing costs in 2023/24.
This figure does not include GP salaries, as GPs are independent contractors rather than direct NHS employees
Breakdown of NHS Service Costs
Understanding the cost of specific services helps illustrate where NHS spending goes:
Service | Cost |
Basic A&E investigation and treatment | £114 |
More complex A&E treatment | £173 – £563 |
A&E attendance via ambulance | £459 |
Ambulance call-out (no A&E attendance) | £327 |
10-minute face-to-face GP consultation | £37 |
District nurse consultation | £57 |
Overnight stay in a rehabilitation centre | £399 |
Diagnostic tests | £5 (urine dipstick) – £1,093 (adult colonoscopy) |
Rising Demand for NHS Services
The King’s Fund also reports significant increases in demand across NHS services over recent years:
- In 2024/25, major A&E departments saw:
- 2.8 million more attendances
- 1.3 million more admissions
compared to 2010/11, the year the four-hour A&E target was introduced.
- General practice has experienced a 20% rise in activity, with 370 million GP appointments available in 2024/25—up from 2018/19, when data collection began.
- Outpatient appointments reached a record high of 104.6 million in 2023/24—double the number from 2003/04.
These figures underline the growing pressure on an already stretched healthcare system, with implications for both service quality and sustainability.
The role of Self-Care in Reducing Pressure and Costs
With demand for services continuing to rise, enabling people to manage their own health—self-care—is increasingly recognised as a vital part of the solution.
Self-care includes managing minor illnesses, long-term conditions, and recovery after treatment. When supported and practiced effectively, it can:
- Reduce unnecessary GP and A&E visits
- Prevent avoidable hospital admissions
- Improve health outcomes and patient confidence
- Help contain rising healthcare costs
Promoting Self-Care through Public Awareness
To successfully embed self-care into everyday life, public awareness and education are essential. National campaigns like Self-Care Week, held every November, are instrumental in achieving this.
These campaigns:
- Educate people on when and how to self-manage common conditions
- Promote healthy lifestyle choices and preventative care
- Provide access to trusted resources and support tools
- Encourage conversations between patients and healthcare professionals
By raising awareness and building confidence, initiatives like Self-Care Week empower individuals to take greater responsibility for their health. This not only improves individual wellbeing but also helps reduce pressure on already stretched NHS service
Conclusion
The NHS continues to provide vital services to millions—but it faces growing challenges related to rising demand and resource constraints. Investment and staffing are critical.
Our view is that empowering individuals and healthcare professionals to boost self‑care practices and improve health literacy can help to reduce some of the demand and costs, whilst also resulting in better health outcomes for people.
In 2002 the Wanless Report outlined a “fully engaged” scenario—a future in which the public is actively involved in managing their health, supported by healthcare that is integrated, prevention-focused, and highly productive. A fully engaged population will improve people’s health outcomes and ensure a sustainable health system, free at the point of delivery.
Now is the time for everyone working in health and care to champion this shift — supporting people to take more control of their health and helping to build a system that is both sustainable and centred on prevention.
