Health Foundation and Nuffield Trust longitudinal study of the four home nations health services that finds:

• There have been significant improvements in the performance of the four UK health systems over the past two decades. Each country has substantially increased investment in their health systems between 2000/01 and 2012/13. Each has invested in more hospital and community health services doctors and dentists, with reductions in inpatient admissions per doctor/dentist. But spending has slowed in response to austerity
• Finds few indicators on which a devolved country does better than England or its North East region, the performance gap between England and the rest of the UK has narrowed in recent years. There is little sign that one country is moving ahead of the others consistently across the available indicators of performance.
• Improvements are seen in all four countries in reducing long hospital waiting times, in shortening ambulance response times to immediately life-threatening emergency (category A) calls and in the quality of stroke care. There have been reductions in MRSA-related mortality. In addition, there are no material differences in performance for breast screening, immunisation and survival following renal replacement therapy between the four countries.
• Overall, this research suggests that despite hotly contested policy differences between the UK health systems since devolution on structure, competition, patient choice and the use of non-NHS providers, there is no evidence linking these policy differences to a matching divergence of performance, at least on the measures available across the four UK countries.

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