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Views And Reviews Provocations

The NHS at 80? How it might look in 2028

BMJ 2018; 361 doi: (Published 14 May 2018) Cite this as: BMJ 2018;361:k2106
  1. Jan Filochowski, CEO for 20 years at six NHS trusts, lastly Great Ormond Street
  1. London
  1. jan{at}

Jan Filochowski imagines what the future NHS might look like and where it is heading

As the NHS approaches a key anniversary it is important to take stock and look back, not only on its first 70 years but particularly on the 10 since then—the period in which it has thankfully moved from dire peril to rude health.

What was the turning point as the NHS headed into its eighth decade? Everything came to a head, of course, in 2019, after the NHS signally failed to cope with the big increase in demand of every sort, prompted by the most severe flu outbreak for years, combined with a very long, harsh winter. The cross party inquiry into those failures pinpointed the clear increase in mortality, disability, and suffering, plus a doubling of waiting times by summer 2019 as most hospitals became emergency-only for several months.

This was despite what the inquiry described as an “outstanding flat-out performance in all the circumstances.” It concluded that the NHS could never cope with real …

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