Healthcare spending in the United Kingdom stood at 317 billion British pounds in 2024. When looking at real healthcare expenditure*, spending already exceeded this amount in 2021, where it reached 324 billion British pounds in 2024 prices. Health expenditure in the UK compared to Europe In 2024, the UK spent almost 11 percent of its GDP on healthcare. In comparison to other European countries, this ranked the UK fifth in terms of health expenditure. At the top of the list was Switzerland, which spent 12 percent of its GDP on healthcare that year.  Performance of the NHS in the UK Waiting times have been getting worse in the A&E department over the years. The NHS has been falling behind the target that 95 percent of patients should be seen within four hours of arrival. As a result, the primary reasons for dissatisfaction with the NHS among the public are the length of time required to get a GP or hospital appointment and the lack of staff.

National health expenditure in the UK amounted to *** billion British pounds in 2024. Of this, **** billion British pounds were private expenditure through out-of-pocket spending and voluntary health insurance schemes. Meanwhile, the majority of healthcare expenditure in the United Kingdom is publicly funded through the NHS.

Next Steps (also known as the Longitudinal Study of Young People in England (LSYPE1)) is a major longitudinal cohort study following a nationally representative group of around 16,000 who were in Year 9 attending state and independent schools in England in 2004, a cohort born in 1989-90.

The first seven sweeps of the study were conducted annually (2004-2010) when the study was funded and managed by the Department for Education (DfE). The study mainly focused on the educational and early labour market experiences of young people.

In 2015 Next Steps was restarted, under the management of the Centre for Longitudinal Studies (CLS) at the UCL Faculty of Education and Society (IOE) and funded by the Economic and Social Research Council. The Next Steps Age 25 survey was aimed at increasing the understanding of the lives of young adults growing up today and the transitions out of education and into early adult life.

The Next Steps Age 32 Survey took place between April 2022 and September 2023 and is the ninth sweep of the study. The Age 32 Survey aimed to provide data for research and policy on the lives of this generation of adults in their early 30s. This sweep also collected information on many wider aspects of cohort members' lives including health and wellbeing, politics and social participation, identity and attitudes as well as capturing personality, resilience, working memory and financial literacy.

2019 Web Survey
The Next Steps 2019 Web Survey took place between August and September 2019, in between the Age 25 and Age 32 Surveys. It was conducted by CLS. CLS conducts annual 'keeping-in-touch' exercises in which Next Steps participants are asked to confirm or update their contact details. The 2019 Web Survey was conducted as part of the 2019 keeping-in-touch exercise. The data and documentation are available under SN 5545, and were added as part of the nineteenth edition .

Next Steps survey data is also linked to the National Pupil Database (NPD), the Hospital Episode Statistics (HES), the Individualised Learner Records (ILR) and the Student Loans Company (SLC).

Polygenic Indices
Polygenic indices are available under Special Licence SN 9438. Derived summary scores have been created that combine the estimated effects of many different genes on a specific trait or characteristic, such as a person's risk of Alzheimer's disease, asthma, substance abuse, or mental health disorders, for example. These polygenic scores can be combined with existing survey data to offer a more nuanced understanding of how cohort members' outcomes may be shaped.

There are now two separate studies that began under the LSYPE programme. The second study, Our Future (LSYPE2) (available at the UK Data Service under GN 2000110), began in 2013 and will track a sample of over 13,000 young people annually from ages 13/14 through to age 20.

Further information about Next Steps may be found on the CLS website.

Secure Access datasets:
Secure Access versions of Next Steps have more restrictive access conditions than Safeguarded versions available under the standard Safeguarded Licence (see 'Access' section).

Secure Access versions of the Next Steps include:

• sensitive variables from the questionnaire data for Sweeps 1-9. These are available under Secure Access SN 8656.
  
• National Pupil Database (NPD) linked data at Key Stages 2, 3, 4 and 5, England. These are available under SN 7104.
• Linked Individualised Learner Records learner and learning aims datasets for academic years 2005 to 2014, England. These are available under SN 8577.
  
• detailed geographic indicators for Sweep 1 and Sweep 8 (2001 Census Boundaries) are available under SN 8189, geographic indicators for Sweep 8 and 9 (2011 Census Boundaries) are available under SN 8190, and geographic indicators for Sweep 9 (2021 Census Boundaries) are available under SN 9337. The Sweep 1 geography file was previously held under SN 7104.
• Linked Health Administrative Datasets (Hospital Episode Statistics) for financial years 1997-2022 held under SN 8681.
• Linked Student Loans Company Records for years 2007-2021 held under SN 8848.

When researchers are approved/accredited to access a Secure Access version of Next Steps, the Safeguarded (EUL) version of the study - Next Steps: Sweeps 1-9, 2004-2023 (SN 5545) - will be automatically provided alongside.

The Next Steps: Linked Health Administrative Datasets (Hospital Episode Statistics), England, 1998-2023: Secure Access study includes data files from the NHS Digital HES database for those cohort members who provided consent to health data linkage in the Age 25 sweep. The HES database contains information about all hospital admissions in England. The following linked HES data are available:

1) Accident and Emergency (A&E)
The A&E dataset details each attendance to an Accident and Emergency care facility in England, between 01-04-2007 and 31-03-2023 (inclusive). It includes major A&E departments, single specialty A&E departments, minor injury units and walk in centres in England.

2) Admitted Patient Care (APC)
The APC data summarises episodes of care for admitted patients, where the episode occurred between 01-04-1997 and 31-03-2023 (inclusive).

3) Critical Care (CC)
The CC dataset covers records of critical care activity between 01-04-2009 and 31-03-2023 (inclusive).

4) Out Patient (OP)
The OP dataset lists the outpatient appointments between 01-04-2003 and 31-03-2023 (inclusive).

5) Emergency Care Dataset (ECDS)
The ECDS lists the emergency care appointments between 01-04-2020 and 31-03-2023 (inclusive).

6) Consent data
The consents dataset describes consent to linkage, and is current at the time of deposit.

CLS/ NHS Digital Sub-licence agreement
NHS Digital has given CLS permission for onward sharing of the Next Steps/HES dataset via the UKDS Secure Lab. In order to ensure data minimisation, NHS Digital require that researchers only access the HES variables needed for their approved research project. Therefore, the HES linked data provided by the UKDS to approved researchers will be subject to sub-setting of variables. The researcher will need to request a specific sub-set of variables from the Next Steps HES data dictionary, which will subsequently make available within their UKDS Secure Account. Once the researcher has finished their research, the UKDS will delete the tailored dataset for that specific project. Any party wishing to access the data deposited at the UK Data Service will be required to enter into a Licence agreement with CLS (UCL), in addition to the agreements signed with the UKDS, provided in the application pack.

CLS Hospital Episode Statistics data access update July 2025

From March 2027, HES data linked to all four CLS studies will no longer be available via the UK Data Service. For projects ending before March 2027, uses should continue to apply via UKDS. However, if access to a wider range of linked Longitudinal Population Studies data is needed, UKLLC might be more suitable. For projects ending after March 2027, users must apply via UKLLC.

Latest edition information
For the third edition (January 2025), the data have been updated to include linked data the financial years 2017-2022. In addition, a new dataset for Emergency Care (ECDS) episodes has been added, along with a dataset detailing the consent for linkage. Furthermore, the study documentation has also been updated.

The National Diet and Nutrition Survey (NDNS) Rolling Programme (RP) began in 2008 and is designed to assess the diet, nutrient intake and nutritional status of the general population aged 1.5 years and over living in private households in the UK. (For details of the previous NDNS series, which began in 1992, see the documentation for studies 3481, 4036, 4243 and 5140.)

The programme is funded by Public Health England (PHE), an executive agency of the Department of Health, and the UK Food Standards Agency (FSA).

The NDNS RP is currently carried out by a consortium comprising NatCen Social Research (NatCen) (NatCen, contract lead) and the MRC Epidemiology Unit, University of Cambridge (scientific lead). The MRC Epidemiology Unit joined the consortium in November 2017. Until December 2018, the consortium included the MRC Elsie Widdowson Laboratory, Cambridge (former scientific lead). In Years 1 to 5 (2008/09 – 2012/13) the consortium also included the University College London Medical School (UCL).

Survey activities at the MRC Epidemiology Unit are delivered with the support of the National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre (IS-BRC-1215- 20014), comprising the NIHR BRC Nutritional Biomarker Laboratory and NIHR BRC Dietary Assessment and Physical Activity Group. The NIHR Cambridge Biomedical Research Centre is a partnership between Cambridge University Hospitals NHS Foundation Trust and the University of Cambridge, funded by the NIHR.

Further information is available from the gov.uk National Diet and Nutrition Survey webpage.

The survey of young people aged 4 to 18 years aimed to collect data on diet through a questionnaire and a 7-day weighed intake record for a nationally representative sample living in private households in Great Britain. The study also included a 7-day bowel movement record, a 7-day physical activity diary, anthropometric and blood pressure measurem ents, a spot urine sample and a blood sample. The survey consisted of two parts: Part 1, the Diet and Nutrition Survey, and Part 2, the Oral Health Survey.

In addition to the aims of the survey series as a whole, the survey of young people was designed to:

• provide data to assist in the development of dietary guidelines for young people, including dietary guidelines for food provided by schools
• determine the frequency of bowel movement in this age group
• provide baseline and comparative data for blood pressure and some anthropometric measurements in this age group
• provide baseline and comparative data for some haematological and biochemical indices in blood and urine in this age group