Lord Darzi’s report states the NHS is in a ‘critical condition’ with rising waiting lists and declining population health, leading to serious access issues and widening health inequalities. The NHS is on the brink of collapse, but is there hope?
This winter has seen unprecedented critical incidents, reminiscent of the COVID-19 pandemic. Health Secretary Wes Streeting expressed shame over long waits and unsafe care, with exhausted, and under-resourced staff struggling to meet demand.
NHS bosses reported a difficult start to 2025, with high flu rates and adverse weather causing a surge in demand. Dr. Fiona Hunter from the Royal College of Emergency Medicine highlighted the unacceptable and unsafe care patients are receiving:
“We are running on hard work and goodwill, and our patients are receiving unacceptable, undignified and unsafe care in corridors and in the back of ambulances.”
The government is committed to urgent NHS reform, with plans to tackle the backlog through increased surgical and diagnostic hubs, private sector capacity, and longer opening hours. As well as launching the biggest national conversation in October last year about the future of the NHS since its birth (July 5, 1948) (Change.NHS), dubbed “a rallying cry to the nation to help fix the NHS”. This public engagement aims to shape a 10-year plan for transformation.
NHS England Chief Executive Amanda Pritchard emphasised the need for innovation and adaptation to address record demand, an aging population, and outdated infrastructure:
“NHS staff are facing an unprecedented number of challenges – with record demand for care, alongside growing pressures from an ageing population, rising levels of multiple long-term illnesses and patients with more complex needs. And they are often hampered by working in crumbling buildings with outdated tech, meaning too many patients are waiting too long for care they need. So, it is vital the health service innovates and adapts – as it has always done throughout its 76-year history – to design and deliver an NHS fit for the future”.
Change is on the horizon, and MPM Health has identified 10 key challenges and focus areas for transforming the UK health service in 2025.
Top 10 Challenges and areas of focus for the UK Health service in 2025.
1. Insufficient funding
Rising demand for health services has outpaced funding, leading to longer waiting times, limited access to treatments, and challenges in maintaining high-quality care. Without adequate funding for preventive care, this cycle will continue, straining future budgets and potentially reducing funding for other sectors like education, social care, and transport. This could further widen health inequalities by not addressing key determinants of health such as living conditions, work environments, and community growth.
💡 Additional Insights:
The Health Foundation: Joint letter to the Chancellor to address spending on prevention
Investing more in prevention could deliver £11 billion return on investment | NHS Confederation
2. Staff shortages and workforce issues
There is a significant shortage of healthcare professionals, including doctors, nurses, and allied health professionals. High turnover rates and staffing shortages, especially in underserved areas, lead to increased workloads, burnout, and compromised patient care. The working conditions in the NHS have been well documented and staff at all grades and across all professions are leaving in droves, with a projected short fall of up to 360,000 staff by 2037.
Short term fixes, inflationary pay deals and overseas workers are not the solution, not only do we deplete the precious resources of low and middle income countries with the latter, we are plugging a gap instead of driving through long term and sustainable solutions.
We at MPM Health think that one solution to high turnover and burnout is to address the recruitment freezes that hit hard in the engine room of the NHS, the administration and support services function which keeps patients moving through the system. Further, digital transformation, automation and patient-clinical team integration is one solution that can reduce the burden on an over-stretched staff resource, as well as provide patient choice and allow for self-help and proactive self-management.
💡 Additional Insights:
Tackling workforce challenges through digital transformations
Bridging the staffing gap for better care for more people
3. Backlog of patients:
The COVID-19 pandemic worsened an existing backlog of patients awaiting treatment, leading to longer waiting times, poorer patient outcomes, and additional strain on healthcare providers. Winter pressures, social care system issues, and economic challenges further exacerbate this backlog, with many discharge-ready patients unable to leave due to a lack of care packages.
Long wait times can lead to patient deterioration, requiring more complex and costly treatments. This impacts the overall capacity and cost within the health system.
A proactive preventative approach, including services like ‘staying well’ and ‘pre-habilitation,’ can help maintain good health and prevent deconditioning. This allows urgent and complex cases to be treated more quickly, while other patients manage their health in the community, leading to faster recoveries and reduced complications.
💡 Additional Insights:
The cost of keeping patients waiting
4. Ageing population
The UK’s ageing population increases health service demand, with older adults often having multiple chronic conditions. MPM Health believes that with a focus on prevention and adequate resources, we can help older adults live longer, healthier lives.
A proactive preventative approach can benefit older adults through early intervention, addressing issues that increase disease burden and disability. Key measures include:
- Access to financial support
- Addressing fuel poverty through uptake of energy schemes like ECO4
- Home adaptations for independent living
- Home repairs to improve living conditions
- Signposting and referrals to reduce social isolation
- Increasing health literacy around falls prevention
- Regular health assessments and seasonal vaccines
A population health management approach can improve overall health and wellbeing, enhance patient care, and provide a person-centred approach. Benefits include:
- Improved system capacity by redirecting patients
- Reduced demand in urgent and planned care
- Narrowing health inequalities through proactive identification
- A sustainable workforce
- A responsive, safe, and effective system
- Reduced per capita healthcare costs and improved productivity
- Reallocation of funding to preventive measures, like active travel and community enterprises
💡 Additional Insights:
A population health approach to fuel poverty
Taking a data driven approach for proactive preventative care
5. Evolving healthcare needs
The health service landscape is constantly evolving, with new diseases emerging and existing conditions becoming more prevalent. This requires the NHS to adapt quickly and efficiently. As the world becomes more interconnected, the risk of disease and mutations increases due to closer proximity between humans and animals and greater genetic diversity. Changing demographics also present unique challenges, necessitating a flexible NHS that can expand and contract with population health needs.
An ageing population, particularly in areas like Wales and rural communities, will drive much of the change in health needs. Without intervention, chronic conditions such as diabetes, cardiovascular disease, and respiratory conditions could increase by nearly 50% by the decade’s end, with cancer incidence rising by up to 20%.
These projections demand significantly greater health service provision, leading to higher costs for prescriptions, appointments, hospital admissions, treatments, and staffing. This also diverts resources from other patients and disease groups, highlighting the need for a responsive and adaptable health system.
💡 Additional Insights:
The changing health needs of the UK population
Incident and trends with 10 year projections
6. Complexity of diseases and diagnostic errors
Many diseases, like cancer, have complex presentations that can mimic other conditions, making accurate diagnosis challenging. Misdiagnosis or delayed diagnosis can result from atypical presentations and cognitive biases. With the NHS facing a depleting workforce, overstretched resources, and burned-out staff, the likelihood of errors and delays in diagnosis increases.
MPM Health collaborates with global health innovators and international government bodies to identify solutions for Europe. We believe reducing human error and improving service delivery through digital technology and AI can support capacity and enhance clinical management. By adopting a model closer to home, supported by digital technology, resources can be allocated to community-based diagnostic hubs with the right resources and specialist skills, acting as advanced centres of excellence for treatment and research.
💡 Additional Insights:
Complexity of disease presentation
7. Technological integration and Section 251 of the NHS Act 2006
Incorporating new diagnostic technologies and ensuring system interoperability is challenging due to data sharing issues, different systems across trusts, and the lack of a unified patient record system.
Digital illiteracy among healthcare staff and inadequate digital capabilities across the system are major challenges. Digital solutions, including AI, augmented and virtual reality, and automation, are essential for the future. Smaller technologies, like generative AI, are already improving productivity and patient safety.
However, simply introducing technology won’t fix the system. The workforce must grow and adapt, with the necessary skills, training, and buy-in to ensure successful implementation. As well as infrastructure arrangements and solution focused Information Governance Frameworks that support an integrated data sharing solution for proactive population health and enhanced care provision. Cross-sector and partner data sharing is fundamental to realise the full potential of a digitally enabled healthcare system.
MPM Health welcomed the Government announcement this week that talked about bold and ambitious plans to integrate AI innovation and for the NHS to realise the full potential of data sharing for the development and advancement of treatment, drugs and diagnostic tools.
💡 Additional Insights:
Technology adoption in the NHS
8. Patient diversity
Ensuring diagnostic tools and protocols are effective across diverse populations requires continuous adaptation. As global connectivity increases, so must our health services to address issues like global warming, food security, disease eradication, and treatment advancements.
Greater collaboration and shared research funding can support developing countries in advancing their workforce and expertise in life sciences, AI, automation, telemedicine, and remote clinical reporting. Initiatives like Twinning Partnerships and particularly ‘open science’ demonstrated during COVID-19 highlight the benefits of global cooperation in medical and technological advancements (COVID-19 vaccine R&D partnerships).
Decolonising health and medicine by supporting non-traditional countries in science and engineering can lead to innovative solutions and treatment advances that reduce health inequalities. We believe decolonising and ending the dominance and supremacy of knowledge advancement, typically the North v South, East v West nexus, can improve the lives of marginalised groups and reduce morbidity and mortality rates by using empirical evidence from similar demographics and belief systems.
💡 Additional Insights:
What next for decolonising health and medicine? | The BMJ
9. Paradigm and culture shift
To transform the NHS into a fit-for-purpose, free-at-the-point-of-delivery service that meets the demands of a dynamic population, a cultural shift is needed within the healthcare system and among the public and political bodies.
Continuing with the same approach will yield the same results. We have an opportunity to make lasting changes and disrupt the status quo for future generations. This requires a flexible and agile workforce, care closer to home, digitally enabled service delivery, universal integration, measurable KPIs, and greater accountability of health service leaders.
A cultural shift is also needed among staff and the public, moving from ‘doing for’ to ‘doing with.’ The NHS should facilitate health promotion and disease management, with the health of the nation being a shared responsibility. The NHS can be there for you and your family at the point of need, but it cannot be the default position.
Providing reassurance and being there when needed has been the guiding principle of the NHS since its inception. As Aneurin Bevan, the Minister for Health who launched the NHS, stated in his book In Place of Fear:
“Society becomes more wholesome, more serene, and spiritually healthier, if it knows that its citizens have at the back of their consciousness the knowledge that not only themselves, but all their fellows, have access, when ill, to the best that medical skill can provide.”
As citizens, we should bring this to the forefront of out minds. We should prioritise the sustainability of our free-at-the-point-of-delivery health service, and not rest on our laurels. The NHS faces immense pressures from fiscal constraints and an ageing population, putting its future at risk. At MPM Health, we believe in the NHS, but it requires overcoming significant challenges and transforming to meet tomorrow’s needs while upholding its founding principles.
The Health System of Tomorrow: Free at the point of delivery and capable and adaptable to the changing needs of a global Britain:
- Efficient
- Prudent
- Providing the right care, at the right time, in the right place, with the right resources
💡 Additional Insights:
The way forward: realising the vision of care closer to home | The King’s Fund
10. The changing landscape: public versus private healthcare
Our final challenge is the debate around public versus private health services. Transforming the NHS to be free at the point of need and adaptable to a growing and ageing population requires an integrated system involving the private, public, and third sectors. This system must operate with a shared vision, mutual respect, and trust.
Increasing dissatisfaction with NHS services has led to a rise in private healthcare provision and insurance, with notable increases in recent years. Younger demographics are more positive about using the private sector (The Health Foundation and GlobalData).
The shift in public opinion may stem from the significant challenges the NHS faces, but it also reflects a generational change. Those raised with broader NHS services may view it differently than those who have experienced greater privatisation in areas like dental and optometry services.
The third sector often fills gaps left by the NHS, offering holistic, patient-centred services and supporting underserved or marginalised communities. Increasingly, the third sector is partnering with the NHS to deliver integrated care, such as hospices run by charities providing end-of-life care.
The landscape is changing, and conditions are favourable for private healthcare and the third sector to gain market share and tender for service delivery. Recent government announcements aim to reduce waiting times and utilise private sector capacity. This shift suggests a more integrated system, leveraging the strengths of the private, public, and third sectors to transform the NHS and meet future demands.
💡 Additional Insights:
The NHS Refounded: Delivering a Health Service Fit for the Future
Final words
Will the healthcare system survive and continue to provide the very best diagnostic and treatment options for the UK? Who knows, but we hope so and we hope we have raised some food for thought in this article.
In conclusion, at MPM Health we believe that transforming the NHS to meet the demands of a dynamic and evolving population requires a comprehensive approach involving the private, public, and third sectors.
By addressing funding, workforce shortages, backlogs, and the integration of new technologies, we can create a flexible and efficient healthcare system. Emphasising prevention, collaboration, and digital innovation will help maintain the NHS’s founding principle of being free at the point of need; through a proactive health care delivery, reducing complexity, delaying onset, reducing the demand and leading to per capita reductions.
Working together, we can ensure the NHS remains capable and adaptable, providing high-quality care for future generations.
If you work in healthcare please share your thoughts, or if you know someone who does please share this article with them so they can. How do we, as a nation, go about solving these challenges? What other challenges do you foresee that aren't listed here?