The most comprehensive assessment to date of the unprecedented levels of funding invested by the government in the NHS over the past five years is published today by the King’s Fund. It concludes that the increases in funding have delivered notable improvements – more staff and equipment; improved infrastructure; significantly reduced waiting times and better access to care; and improved care in coronary heart disease, cancer, stroke and mental health.

However, it finds the additional funding has not produced the improvements in productivity assumed in the original 2002 review. And, more crucially, progress on lifestyle behaviours has been slower than predicted. In particular, dramatic rises in adult and child obesity are of great concern with the UK now with much higher levels than even the least ambitious predictions of the 2002 review, says Sir Derek Wanless, former chief executive of NatWest Bank.

Five years on from his seminal report for the Treasury which paved the way for the 50% real terms increases in NHS spending since 2002, Wanless’ latest review for the King’s Fund examines how the extra money has been spent; what the NHS has achieved; whether the pace and direction of government reform has delivered value for money; and considers what lessons can be learned for the future.

However, costs of providing hospital and other services have increased. Activity has improved, but the biggest increase has been in emergency, rather than elective, admissions which - says Wanless - raises doubts about how demand is being managed across the health service. In addition, the problems and delays that have beset the National Programme for IT also have the potential seriously to undermine future productivity gains.

Sir Derek Wanless said: “The political decision the government took at the turn of the century to invest so heavily in the NHS after decades of under investment marked a once in a lifetime opportunity to improve the health of the nation. The extra resources, accompanied by fundamental reform, have undoubtedly improved patient care over the past five years. This is to be commended."

“But what is equally clear from this review is that we are not on course to deliver the sustainable and world class health care system, and ultimately the healthier nation, that we all desire. Without significant improvements in NHS productivity, and much greater efforts to tackle obesity in particular, even higher levels of funding will be needed over the next two decades to deliver the comprehensive, high-quality services envisaged by my original review. Such an expensive service could undermine the current widespread political support for the NHS and raise questions about its long-term future.”