Intended for healthcare professionals

Rethinking health and care systems

Building more resilient, innovative and person-centred services

The challenge for health services in building back from the impacts of the covid-19 pandemic goes beyond simply recovering the performance of services or reducing backlogs in care to pre-pandemic levels. There is an opportunity to reorient health and care services to ensure more resilient, innovative, and people-centred health and care systems.

This BMJ Collection presents how health and care services can create lasting transformation and tackle long standing problems in the design and delivery of care. It shows that improvement efforts are needed to not only prepare for future challenges, but to fulfil long-term aspirations for health and care services. These include increasing patient and family involvement in care, supporting the workforce to build better services, and benefiting from the adoption of technological and digitally enabled care.

We hope the Collection can stimulate a sharper focus on what is needed to build sustainable and resilient health and care systems that deliver on longer-term improvement objectives but also support short-term adaptability and innovation.


People are at the heart of resilient health and care systems
We must invest to support people throughout the sector, say Helen Buckingham and Nadra Ahmed


Assessing resilience of a health system is difficult but necessary to prepare for the next crisis
Health systems responses to covid-19 can help to identify factors within and outside of the health system that affect its resilience to shocks, suggest Anna Sagan and colleagues

The power of autonomy and resilience in healthcare delivery
Russell Mannion and colleagues argue healthcare systems should learn from the good examples witnessed during the pandemic to enhance provider autonomy and resilience

Building a better understanding of adult social care
Jon Glasby and colleagues suggest short and long term measures to tackle the invisibility of adult social care

Tackling the erosion of compassion in acute mental health services
Elisa Liberati and colleagues argue that understanding the systemic and institutional forces behind lack of compassion in mental health services is key to solutions to this problem

Invisible no more: unpaid care giving in the shadow of covid-19
Miles Sibley and colleagues argue that families must be recognised and valued as partners in patient care

Data to knowledge to improvement: creating the learning health system
Paige McDonald and colleagues detail key domains, tools, and actions required to enact learning health systems for continuous intelligent improvement in healthcare


NHS innovation must value staff and inspire hope
NHS staff are well placed to invent and implement innovations in the NHS, writes Charlotte Williams

Healthcare education needs radical reform to emphasise careful and kind care
Suzie Bailey and colleagues argue for radical transformation in the curriculums for healthcare professionals and in the conditions for care in practice

The Collection was developed in partnership with the Health Foundation who also provided funding for the Collection, including open access fees. The BMJ commissioned, peer reviewed, edited, and made the decision to publish these articles. The lead editors were Rachael Hinton and Paul Simpson for The BMJ.

Thank you to the following Steering Group members who helped guide the commissioning ideas for the Collection: Kamran Abbasi, Nadra Ahmed, Helen Buckingham, Joe Home, Bryan Jones, Elisa Liberati, Martin Marshall, Erik Mayer, Tessa Richards, Krishna Udayakumar, Sally Warren and Katherine Woolf.

The Health Foundation is an independent charity committed to bringing about better health and health care for people in the UK. From giving grants to those working at the front line to carrying out research and policy analysis, the Health Foundation aims to shine a light on how to make successful change happen.

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