NHS 75th anniversary: how the health service in England and Wales has changed since 1948

Today marks 75 years since the UK’s National Health Service (NHS) was created.

From the world’s first CT scan on a patient in 1971 to delivering the world’s first Covid-19 vaccine (outside a clinical trial) in 2020, the NHS remains one of the country’s most treasured assets. But the health system, and the country, look very different to what was created back in post-war Britain.

Here we reveal how the NHS, and England and Wales, have changed since the health service was created 75 years ago today.

A changing population

One of the biggest challenges the NHS faces is delivering care for an ever-increasing population.

Data published by the Office for National Statistics (ONS) shows how the country is home to millions more people than when the health service launched 75 years ago, surging by 38% between 1948 and 2021 – an increase of 16.3 million people.

From cradle to grave

The introduction of the universal healthcare system had a dramatic effect on infant mortality rates.

In 1948 almost 27,000 infant deaths were registered in England and Wales among children aged under one, representing a rate of 34.5 deaths per 1‚000 live births – nine times greater than in 2021 when 2,498 deaths were recorded at a rate of 4, according to the ONS.

A healthier population also means living longer.

ONS figures show the life expectancies of both men and women have significantly increased since the creation of the healthcare system in 1948.

Men in England and Wales had an average life expectancy of 78.6 as of 2020, 12.2 years greater than in 1951 when it was 66.4. The same trend follows for women who have an average life expectancy of 82.6, 11.1 years greater than in 1951 when it  was 71.5.

But with an ageing population comes further strain on health services and additional figures from the ONS shows how the number of people aged 85 years and over in the UK is projected to almost double to 3.1 million by 2045 (representing 4.3% of the UK population), from 1.7 million in 2020 (2.5%).

The leading causes of death

Historical figures also show how causes of death have changed from 1948 to 2022.

Last year dementia and Alzheimer’s disease were the leading cause of death in England and Wales, according to the ONS. In total 65,967 such deaths were registered, representing 11.4% of all deaths in 2021. In 1948, when the health service began, dementia and ‘senility’ was only the eighth most common cause of death, responsible for 2.6% of fatalities.

Heart disease was the number one cause of death, representing 28.8% of all deaths. Ischaemic heart disease was still the second most common cause of death in 2022, representing 10.3% of all deaths.

A changing workforce

The NHS workforce is totally different to the early days of the health service.

In 1949, there were 11,735 full time equivalent hospital doctors in England and Wales, according to NHS Digital. There were also 68,013 registered nurses in hospitals and 5,637 midwifery staff.

The number of doctors is more than 11 times greater in 2023 than what it was when the NHS was created 75 years ago, while the number of nurses is almost five times greater and the number of midwives is four times greater.

But it’s not just the number of staff that has changed since the health service’s inception. Immigrants play a vital role in its operation and recent figures give a snapshot of just how diverse the NHS is.

Around 220,000 out of 1.4 million staff in the NHS are not British nationals, which represents around 16.5% of the workforce. These workers hold more than 200 different nationalities, stretching everywhere from Spain to Nepal.