Healthy life expectancy (HALE) — the number of years people live in good health — is one of the most important measures of a nation’s wellbeing. It reflects not just how long people live, but how long they live free from preventable illness, disability, and chronic disease.
In July, the Government’s National Quality Strategy for NHS funded care sounded a clear alarm – healthy life expectancy in the UK has stalled and is now at its lowest level since 2011. This decline is not simply a statistical concern – it represents millions of people living more years in poor health, with profound consequences for families, communities, the NHS, and the economy.
The Strategy highlights several worrying trends. Only 43% of people with type 1 diabetes and 58% of people with type 2 diabetes receive all eight NICE‑recommended care processes. Around 28% of people with hypertension remain undiagnosed, and 31% of those diagnosed do not have their blood pressure successfully controlled. These gaps in care drive avoidable illness, disability, and early mortality — all of which reduce healthy life expectancy.
At the same time, international comparisons show that the UK is falling behind. Countries such as Singapore (73.6 healthy years), Japan (73.4), South Korea (72.5), Iceland (71.4), Switzerland (71.1) and Spain (71.1) consistently outperform the UK. These nations share a set of characteristics that support longer, healthier lives – strong primary care, rapid diagnosis, low midlife mortality, healthier diets, lower inequality, high investment in prevention, and seamless care pathways.
The UK’s independent healthcare sector already delivers many of these strengths — but the system does not yet fully harness them. As the National Quality Strategy makes clear, high‑quality health services improve healthy life expectancy, provide timely access to care, reduce inequalities, and deliver value for money. The independent sector is uniquely positioned to support these aims.
So why is the UK falling behind when it comes to a healthy life expectancy?
Well – five main reasons.
Firstly, the rising burden of preventable chronic disease such as cardiovascular disease, diabetes, obesity, and chronic respiratory disease. These conditions together are the biggest contributors to years living with poor health.
Secondly, slow and inconsistent early diagnosis. The Strategy emphasises the importance of timely access to care, yet many people wait too long. Delays lead to more years lived with unmanaged illness.
Thirdly, there are inequalities in access, experience, and outcomes with healthy life expectancy varies dramatically across the UK.
And then there are fragmented care pathways. The Strategy calls for care delivered “at the right time in the right place”. But many patients experience friction between services, repeated referrals, and poor coordination — this is true at times between NHS and independent providers.
And finally, insufficient investment in prevention – the UK invests less, and inconsistently.
These challenges are well known — but they are not insurmountable. The independent healthcare sector is already a key partner to the NHS, and its strengths align closely with the National Quality Strategy’s definition of high‑quality care. The question, then, is simple – how does the independent sector help improve healthy life expectancy? Here’s four important ways in which the independent sector plays a vital role:
1. Supporting improved healthy life expectancy and quality of life
Independent providers play a vital role in improving healthy life expectancy by delivering prevention, early diagnosis, chronic disease management, rehabilitation, and mental health services — the foundations of long, healthy lives. This contribution is equally significant across both NHS‑funded and privately funded care.
Mental health and musculoskeletal (MSK) conditions are two of the biggest drivers of lost healthy life years in the UK, often determining whether people can remain in work. Independent providers support people through comprehensive wellbeing and occupational health programmes, as well as community‑based pain management and rehabilitation services that help individuals recover faster, maintain independence, and stay economically active.
The sector also plays a major role in reducing long waits for neurodevelopmental assessments. Independent providers now deliver one in three NHS‑funded autism assessments and one in two ADHD assessments, helping to reduce waiting lists that have grown to uncomfortable levels and improving long‑term outcomes for children and adults.
Eye health is another major determinant of healthy ageing. Independent providers deliver over one fifth of all NHS ophthalmology activity, particularly cataract surgery, and National Ophthalmic Database data shows complication rates well below expected limits – demonstrating both safety and value.
Crucially, the quality of these services is consistently recognised – 94% of all independent healthcare providers are rated Good or Outstanding by the CQC.
2. Providing timely access to care
Timely access is one of the strongest levers for improving healthy life expectancy. Independent providers offer access to faster diagnostics, shorter waits, and more flexible scheduling, reducing the time people spend living with unmanaged illness.
The sector delivers a significant share of national diagnostic capacity. Last year, independent providers delivered around 4 million diagnostic tests and images, accounting for one in five of all NHS‑funded diagnostics. This includes rapid access to cancer diagnostics — essential given that early diagnosis is the single biggest opportunity to improve cancer outcomes.
Shorter waits mean fewer complications, less disability, and better long‑term outcomes. For many patients, independent sector capacity is the difference between waiting months and being seen within weeks. Our research shows that when patients are given a genuine choice over where they receive their NHS care, they can be treated significantly faster. On average, patients need to travel just 13 miles — around 30 minutes by car — to cut their wait for NHS treatment by more than two months.
3. Being fair, inclusive, and equitable
Independent providers contribute essential capacity across the whole country — not just in the leafy suburbs, as is often imagined. In reality, independent healthcare providers offer care across every ICB, Region, and constituency. The sector now delivers one in five NHS elective orthopaedic procedures, and the latest Patient Reported Outcome Measures (PROMs) show that seven of the top ten providers treating NHS patients for both hip and knee replacements are independent providers. This demonstrates both reach and quality.
Delivering services into the community is a key mechanism for improving equity, particularly in underserved areas and populations. Independent providers make up 42% of the total provider base delivering NHS‑funded community services. Mobile diagnostic units extend access even further, reaching rural and underserved areas, the majority of which are operated by independent providers. This includes national prevention programmes such as NHS lung health checks, bringing early detection directly into communities where disease burden is highest.
Cancer care is another area where independent providers are reducing inequalities. More than 70 independent providers now hold the Macmillan Quality Environment Mark, awarded to organisations that “go above and beyond to create welcoming and friendly spaces” for people living with cancer. This ensures patients receive high‑quality, compassionate care wherever they are treated.
4. Delivering value for money
Independent providers deliver strong value for money by preventing illness, reducing complications, and shortening waits — all of which reduce long‑term costs for the NHS. They are paid on tariff, operate highly productive services, and consistently deliver strong outcomes.
Last year, independent providers delivered just under 6 million operations, diagnostic tests and outpatient appointments removing 1.6 million patients from the NHS waiting list.
But it isn’t just about capacity – it is also about experience something that has heightened focus with the newly appointed NHS England’s National Director of Patient Experience. Patients treated in the independent sector report extremely positive experiences – 98% of NHS inpatients treated by independent sector organisations say they would recommend their provider to friends or family, reflecting high satisfaction, strong communication, and reliable care.
So, in conclusion, healthy life expectancy in the UK is declining but it does not have to. The independent healthcare sector already delivers many of the features seen in the world’s highest‑performing health systems. It expands capacity, accelerates diagnosis, supports prevention, reduces inequalities, and delivers innovative care.
The National Quality Strategy sets a clear ambition – high‑quality care that improves healthy life expectancy, provides timely access, reduces inequalities, and delivers value for money. The independent sector is essential to achieving this.
By strengthening collaboration, improving interoperability, expanding diagnostic choice, and integrating care pathways, the UK can harness the full potential of independent healthcare — and help millions of people live longer, healthier lives.