Despite there being separate health services for each country, the performance of the National Health Service (NHS) across the UK can be measured for the purpose of making international comparisons. In a 2014 report by the Commonwealth Fund ranking developed-country healthcare systems, the United Kingdom was ranked the best healthcare system in the world overall and in the following categories: Quality of Care (i.e. effective, safe, coordinated, patient-oriented), Access to Care, Efficiency, and Equity. The UK's palliative care has also been ranked as the best in the world by the Economist Intelligence Unit. On the other hand, in 2005-09 cancer survival rates lagged ten years behind the rest of Europe, although survival rates continue to increase.
In 2015, the UK was 14th (out of 35) in the annual Euro health consumer index. It was criticised for its poor accessibility and "an autocratic top-down management culture". The index has in turn been criticized by academics, however.
The total expenditure on healthcare as a proportion of GDP in 2013 was 8.5%, below the OECD average of 8.9% and considerably less than comparable economies such as France (10.9%), Germany (11.0%), Netherlands (11.1%), Switzerland (11.1%) and the USA (16.4%). The percentage of healthcare provided directly by the state is higher than most European countries, which have insurance-based healthcare with the state providing for those who cannot afford insurance.
Each NHS system uses General Practitioners (GPs) to provide primary healthcare and to make referrals to further services as necessary. Hospitals then provide more specialist services, including care for patients with psychiatric illnesses, as well as direct access to Accident and Emergency (A&E) departments. Community pharmacies are privately owned but have contracts with the relevant health service to supply prescription drugs.
The public healthcare system also provides free (at the point of service) ambulance services for emergencies, when patients need the specialist transport only available from ambulance crews or when patients are not fit to travel home by public transport. These services are generally supplemented when necessary by the voluntary ambulance services (British Red Cross, St Andrews Ambulance Association and St John Ambulance). In addition, patient transport services by air are provided by the Scottish Ambulance Service in Scotland and elsewhere by county or regional air ambulance trusts (sometimes operated jointly with local police helicopter services) throughout England and Wales.