Building the health of the nation: priorities for a new government

The NHS remains one of the UK’s most valued institutions and its staff are among the most trusted. But a decade of underinvestment in the 2010s, compounded by the impact of an unprecedented pandemic, rising demand and an ageing population, has left NHS and social care services under extreme pressure.

This manifesto draws on the views of our members – health and care leaders across England, Wales and Northern Ireland – and sets out the changes that whoever is elected at the next election will need to make if the health and care system is to be placed on a sustainable footing. 

Our starting point is that a well-resourced NHS is vital to the running of the economy, including supporting people to work. It should be regarded as a key driver of growth. Our analysis shows that for every £1 invested in the NHS, the economy gets £4 back in gross value added (GVA). The next government should target investment in the NHS and social care as an explicit tool of economic development and prosperity. 

To build the health of the nation and a more prosperous UK, as well as creating a more sustainable NHS given constrained resources, health and care leaders are ready to work with partners and patients to make tough and explicit choices on how local services are configured, what care should be prioritised and how best to transform services. 

With NHS and other departmental budgets likely to be squeezed further in 2025 and beyond, this will require health and care leaders to ensure every healthcare pound is spent as effectively as possible. 

It will require a concerted effort across the NHS, wider public services and the government to tackle critical areas of care that are in danger of going backwards, particularly when it comes to the state of children and young people’s health and care services where there are increasing pressures.

But to do that they need the new government to provide them with the tools, support and investment they need and to move away from the short-termism that has impeded progress. In so doing, the new government should back health and care leaders to make hard decisions on how best to serve their local communities. 

Health and care leaders are also ready to grasp the opportunities presented by biomedicine, artificial intelligence and other new technologies that have the potential to transform health and care, including through more personalisation and empowering people with long-term conditions to effectively manage their own care. They stand ready to do this while holding fast to the NHS principle that the public cares most about – equity – which lies at the heart of the health service.

Health and care leaders want to see the new government prioritise the following five areas:

1. Put the NHS on a more sustainable footing, with no top-down structural reform in England for the next parliament. Commit to a short-term stabilisation plan during the first 12 months of parliament to help get performance in the English NHS back on track.
2. Increase NHS capital spending across the UK and reform how the capital regime operates. Specifically in England, capital funding needs to increase to at least £14.1 billion annually, a £6.4 billion increase from the current level of £7.7 billion. This is vital if we are to increase productivity and reduce waiting lists.
3. Commit to fund and deliver the NHS Long Term Workforce Plan for England, alongside an equivalent plan for social care.
4. Provide more care closer to home by enabling local health systems to proportionately increase investment upstream into primary care and community-based services, mental health and social care.
5. Deliver a strategy for national health given that most policy that impacts people’s health is made outside the NHS. The Prime Minister should lead a cross-government national mission for health improvement to shift the focus from simply treating illness to promoting health and wellbeing, reducing inequalities and tackling the wider determinants of health, and supporting the public to be active partners in their own health.