The performance of the NHS is “middling at best” compared with its overseas peers, marred by “strikingly low levels” of clinical staff and equipment, according to an extensive analysis of international data by a leading health think-tank.

The King’s Fund revealed in a report published on Monday that the UK has fewer doctors and nurses per head than most comparable countries, and is more heavily reliant on internationally trained staff. Britain has just 3 doctors per 1,000 people, for example, while Greece has 6.3 doctors per 1,000 people.

The performance of Britain’s taxpayer-funded health system has been under particular scrutiny as waiting lists for treatment reach record levels ahead of a general election in which it is likely to be a pivotal issue for voters.

The report found that the pandemic hit treatment waiting times far harder in the UK than in other countries. While many peer countries had rising waiting lists for knee, hip and cataract operations before Covid-19, the fall in the number of these procedures was “dramatically sharper in the UK in the first year of the pandemic”.

The pressures of the pandemic compounded the consequences of more than a decade of squeezed investment in staff, equipment and wider services, said Siva Anandaciva, chief analyst at the King’s Fund and the report’s author. “This leaves the NHS delivering performance that is middling at best and the UK must do much more to reduce the number of people dying early from diseases such as heart disease and cancer,” he added.

As the NHS reaches its 75th anniversary, it stood out in having removed most financial barriers to accessing healthcare but “it trails behind its international cousins on some key markers of a good healthcare system”, Anandaciva warned. 

The independent report, which was commissioned by the Association of the British Pharmaceutical Industry, compared the NHS with 18 similar higher-income countries, including France, Germany, Italy, Sweden, Japan, Singapore and the US.

It showed that the UK had among the lowest levels of life expectancy for men and women, with falls having been particularly striking since the pandemic.

While the think-tank emphasised that life expectancy was determined by many more factors than healthcare, it found that the UK had higher levels of deaths from treatable diseases such as heart attack and stroke than the majority of similar countries, and below-average survival rates for many common cancers.

There have been suggestions by politicians and analysts that the taxpayer-funded model of the NHS should be changed — possibly to a social insurance system used by several European countries. However, the King’s Fund said it had found “little evidence that any one country’s model of health funding and delivery is inherently better than another”.

Working to improve the existing health system while providing it with the “adequate resources, political support and long-term planning” it desperately needed would give the NHS the best chance of delivering “the timely, high-quality care and outcomes it is capable of”, the report concluded.

Prime Minister Rishi Sunak said on Sunday that the NHS is poised to undergo the “largest expansion in training and workforce” in its history, as he conceded “it will take time” for the overall health service waiting list to fall.

Sunak told the BBC that the long delayed NHS workforce plan, which is set to be published in the second half of this week, would reduce “reliance on foreign-trained healthcare professionals”.

It will also “draw on the latest innovations and techniques”, he said, but admitted it could take between 5 and 15 years for benefits of the plan to be felt.

The Department of Health and Social Care highlighted the recognition of the King’s Fund report that the NHS was “one of the most efficiently run healthcare systems”. It added that it was investing up to £14.1bn to improve services and cut waiting lists, one of the government’s top five priorities.

The DHSC also pointed out that a total of 108 new community diagnostic centres had delivered more than 4mn tests, checks and scans since July 2021, and said there were record numbers of staff working in the NHS.