In order to understand the relative strength of UK healthcare, it’s best to assess it through three lenses—the public, the workforce and the systems that underpin it. That was the task presented to those who attended the sixth roundtable in Prospect’s series exploring the UK’s most urgent challenges.
Practitioners, policymakers, economists and other interested experts were invited to explore potential remedies for a service confronting an array of challenges. These include workforce burnout and retention, social care bottlenecks, post-pandemic backlogs, an ageing population and hospital bed occupancy that routinely approaches capacity.
Patients and prevention
“Think about health and wellbeing in the communities where we spend our time”, offered one roundtable voice when considering efforts to avoid unnecessary strain on the health service. To this end, workplace initiatives and those in third spaces such as community centres and libraries—examples include flu vaccine provision, social prescribing, and NHS health checks—can prove highly effective. Even relatively small interventions, such as reducing falls among the elderly in their own homes, really matter.
Meanwhile, advice shared within trusted groups can have an outsized effect on behaviours. For example, those behind a project aimed at improving breastfeeding practices found that “familial dynamics” trumped the most informative leaflets. “God help anyone trying to get past the mother-in- law”. Similarly, a WhatsApp group for new mothers can “set norms from day one of pregnancy”.
Affecting behavioural change can prove more difficult in some areas than others. Compare, for example, vaccine uptake which requires “a single point of decision” with combatting obesity. The latter requires a far more complex series of decisions, incentives and nudges. This is particularly the case in a nation where 2.8 million adults in the UK are economically inactive because of health problems profoundly influenced by obesity. Change demands more than individual willpower.
Workforce pressures
“Good workplace health comes back to line management nine times out of ten”, noted one roundtable attendee building on an argument that the health service needs to reconsider its approach to leadership. Research indicates that the NHS spends more on external consultants than on staff training, while another attendee noted that “there are more managers per head in any business of comparable size”. The result? Fewer high-quality interactions with senior staff and fewer training opportunities.
These challenges are underscored by data from the 2025 NHS Staff Survey. Accordingly, 42 per cent of NHS staff report feeling physically unwell because of workplace stress, often exacerbated by an inability to effect change because of hierarchical structures.
In search of an antidote to poor management, one attendee offered a study of 911 dispatchers in the United States. Working on the basis that most are incentivised less by money and more by a desire to help people in moments of crisis, a bank of positive stories—written by the dispatchers themselves—were shared weekly. “We saw staff wellbeing increase exponentially”.
Systems challenges
The link between workforce pressures and workplace deficiencies is clear. Regular systems change since the creation of the NHS in the 1940s has intensified the problem, sometimes leading to silos and fragmentation, sometimes to central government overreach and a lack of sensitivity to local needs. The net result, according to one attendee, has been “pockets of progress” without addressing system-wide needs.
Artificial intelligence might offer a means of improving processes and bringing much-needed interoperability to a sprawling system. Yet, it should be adopted with caution. Beyond issues of governance and privacy protection, there are cultural issues to consider, too. Existing norms—such as reliance on the physical whiteboard—might run counter to a digital future. Nevertheless, front-line staff, with an attachment to existing processes, are likely to resist immediate and wholesale change. A blended approach of the old and new might work better.
In that spirit, electronic rostering offers an example of a quick, effective and scalable way to introduce service-wide efficiencies. Yet resistance to change prevails, as does prevailing bureaucracy which amplifies the burden of compliance through “multiple governance structures, multiple forms, multiple procedures, multiple assessments”. In a similar spirit, healthcare leaders were urged to remove the barriers preventing the more effective use—and sharing—of data. “We need to give decision-makers the space and permission to share and use data”.
Building Resilient Healthcare for the Future, a roundtable jointly hosted by Prospect and Behavioural Insights Team (part of Nesta), took place on Wednesday 10th June 2026
A new vision for healthcare is taking shape across the UK. Short-term crisis management is no longer sufficient; now we see calls for a modern, sustainable NHS built on proactive prevention, community-led care, and long-term system renewal. This momentum offers a vital opportunity to deliver a healthcare service that does not merely survive ongoing pressures, but operates sustainably for the future.
We were delighted to partner with Prospect to host this roundtable as part of their landmark Resilience Series. We see real potential in this moment of reform, but structural changes only succeed when paired with a deep understanding of human behaviour. Resilience—across the public, our front-line workforce, and system infrastructure—comes from designing practical solutions that work with the grain of human nature.
The insights shared outline a constructive path forward grounded in real-world experience. We explore how trusted local networks can power disease prevention far more effectively than top-down mandates, especially for complex public health challenges like obesity. Within our workforce, we see how restoring front-line autonomy, belonging, and a sense of shared contribution can relieve daily pressure and support staff. Finally, we examine how human-centred technology and smarter data sharing can eliminate bureaucratic friction, empowering clinicians to focus on care.
A resilient healthcare system isn’t beyond our reach. It’s entirely achievable, provided we have the discipline to design around the real human beings who deliver and depend on care every day.
Helen Brown
Managing director, BIT
