As with most healthcare systems, the COVID global pandemic of 2020 left major scars and significant cross sectoral challenges for the NHS, not least in terms of leadership challenges [1], crumbling infrastructure, outdated IT, rapidly falling productivity, increasing levels of staff sickness; and importantly, extensive major backlogs in elective care waiting lists, significant shortages in community services and, in many parts of the country difficulties in accessing a GP.

The Darzi Report ‘Independent Investigation of the National Health Service in England‘ [2] of September 2024 gives a helpful overview of the challenges facing the NHS as it emerges from the global pandemic. It is essential reading to debunk some of the myths surrounding healthcare in the UK. For example, as Darzi emphasises, for all the talk of ‘joined up’ integrated care and ‘moving care closer to home’, patients have become less satisfied with the co-ordination of care and healthcare resourcing has shifted away from the community and into hospitals. Notably:

"since the 2006 commitment to shift care towards the community, the share of NHS spending on hospitals increased from 47 per cent to 58 per cent in 2021" (Darzi page 76).

As a result, other budgets have been squeezed in relative terms with primary care falling from 28% to18%; mental health falling from 13% to 8%; and community services falling from 8% to 7%; other making the difference and rising from 3% to 8% in the same period.