The Bulletin

Your biweekly update on health economics, policy, and impact

From cost-effectiveness in advanced therapies to sustainable food choices, from rare disease care to climate resilience, the challenges the NHS faces are as diverse as they are urgent.

If your schedule’s tight, see you in the next Bulletin. If you have a moment, dive deeper.

Nadine Henderson, Principal Economist

Heatwaves and healthcare: Climate pressures on NHS resilience

Summer 2022 saw 2,985 heat-related excess deaths, the highest number in any given year.

Heat episodes can also significantly impact healthcare service delivery. In July 2022, extreme heat triggered a major IT failure at London hospitals, severely disrupting services. Referral rates fell to 64% of the usual volume, outpatient appointments dropped to 84% and elective procedures to 71%. The total cost of restoring operations was £1.4 million.

These events are not an outlier. At the time of writing, the temperature feels like 33°c in London. The frequency, duration and intensity of heatwaves is rapidly increasing due to climate change. The impact is disproportionately felt by older adults, people with chronic conditions, and those in poorly ventilated housing, creating equity concerns.

The NHS 10 Year Health Plan references their Net Zero Plan in passing but is missing any explicit plans to mitigate increased climate change mortality risks. The NHS is insufficiently placed to deal with increasingly frequent extreme weather events; without urgent action to accelerate sustainable healthcare, posing serious financial and health risks.

Is BIA limiting access to innovation?

Challenges and Solutions for Budget Impact Analysis of Gene Therapies

Gene therapies have the potential to transform lives but come with high upfront costs. Current budget impact analyses (BIA) focus on short-term budgets, often missing the bigger picture of long-term value and savings. Updating BIA methods is necessary to improve access to treatments.

Short 2–5 year horizons miss gene therapies’ full value

Could going vegan save the NHS billions?

Infectious disease: another reason to try Veganuary for the NHS

What if a simple change in diet could save the NHS billions and prevent millions of illnesses? Plant-based diets are linked to lower risks of COVID-19 infection and hospitalisation, adding to their well-known benefits for chronic disease. Shifting what we eat could improve health outcomes and ease the strain on healthcare systems.

£6.7 billion in potential NHS savings explained

Why we still care about rare

Advancing Rare Disease Care: Challenges and Key Issues

Rare diseases affect fewer than 1 in 2,000 people but collectively, they impact millions. This insight highlights what needs to change: data gaps that delay diagnosis, policies that limit access, and the need for stronger incentives to support innovation. A closer look at where progress is happening and where it’s still too slow.

About 85% of rare diseases have no approved treatment

Green Healthcare:
Are We Asking the Right Questions?

From the financial pressures on healthcare to the urgent fight against climate change, this discussion gets to the heart of the tough questions. Watch the recording to hear bold ideas from experts across government, healthcare, industry, and academia on building a greener, financially sustainable future.

Watch the full recording