NHS Assembly: Developing NHS@75


The NHS’ 75th birthday provides an opportunity to reflect on where the NHS has come from, and what we have learnt collectively. The milestone is also a chance to consider how the NHS can best serve our patients, our staff, our society and economy in the future.

The NHS Assembly has developed an independent report called The NHS in England at 75: priorities for the future (NHS@75), ahead of the NHS’s 75th birthday. Supported by discussions held at the NHS Assembly, this work summarises key learning from the NHS’s recent past and highlights the service’s future challenges and opportunities.

The Assembly’s work was informed by an engagement and insight gathering exercise to capture the views of thousands of patients, carers and staff.

The NHS Assembly

The NHS Assembly brings together individuals from across health and care. It serves as a “guiding coalition” that advises the NHS England Board through its broad insight and frontline experience.

Its membership is drawn from stakeholder groups including royal colleges, health system leaders, frontline staff and clinicians, patients and unpaid carers, and the voluntary and community sector. Its co-chairs are Professor Sir Chris Ham, and Professor Dame Clare Gerada.

Building NHS@75

Over recent meetings the NHS Assembly considered learning and opportunities for the future development of the NHS beyond the 75th birthday. Over the last five years, the NHS and its partners have responded to unprecedented need. There is still much to do to address the disruption left by the pandemic.

Looking further ahead, the NHS and its partners must realise opportunities to improve health and deliver outstanding care, including better tackling health inequalities. The NHS’ long history of change and innovation tells us that it can continue to take advantage of these emerging opportunities, combining local improvement and the benefits of scale as a national service to transform care and people’s lives.

To support this work, an NHS@75 rapid engagement exercise was launched on 3 May 2023 with a conversation guide and online survey inviting patients, carers, staff, and the wider health and care community to share their thoughts to inform the Assembly. This work was supported by:

  • direct engagement with NHS trust and ICS chief executives usually informed by staff discussions, and clinical leader roundtables.
  • insights and analysis from Healthwatch England, National Voices, the Patients Association, the NHS staff survey team and the Race Equality Foundation, using accessible and translated materials.
  • engagement sessions to gain lived patient and carer insights including from Carers UK, the Patients Association, National Voices, the NHS Citizens Advisory Group, and NHS England’s Learning Disability and Autism Advisory Group.
  • a focus on tackling inequalities led by NHS Assembly members.

The response to NHS@75

The Assembly received over 700 responses to the rapid engagement exercise, representing thousands of individual views. Feedback told us that many people have valued taking the time to think broadly about the history and future of the NHS, sharing insights including:

“Universal access to free healthcare is HUGE and still to be celebrated and protected”

“The NHS has great resilience, shown in COVID-19 when staff thought creatively around problems they are facing, Staff rarely give up!”

“… the NHS is beginning to break through on issues like patient doctor shared decision making but it still has a mountain to climb …”

“We must improve caring for its own frontline staff, including all the ancillary staff”

“The huge importance of effective social and community care has been even further highlighted during COVID and afterwards”

“We need to try and get individuals to buy into their responsibilities in relation to health and the NHS – can we harness (technology) to help people live well and enjoy good health”

“Healthcare provision is a co-operative endeavour. Many parties need to work together”

What we heard

Building on insights received through the engagement, the Assembly considered the following emerging shifts in how care is delivered and enablers of change. They also heard overriding messages of continuous system learning, innovation and improvement, creating the right conditions for change and making use of a compact to help renew the relationship between the NHS and the public.

As a regular topic in NHS Assembly meetings, tackling inequalities is an essential theme that is at the heart of what the NHS strives to achieve.

Preventing ill healthThe NHS has a vital partnership role to play to support people remaining healthy, through better and earlier intervention and supporting partners to address the wider determinants of ill health like housing, education, employment and environment.
Personalised careGiving people more control of their own health by determining what is important for them and supporting their involvement in managing it.
Coordinated care closer to homeA shift in where we deliver care, taking account of both the rapid growth of our older population, as well as opportunities including remote monitoring, enabling more effective care.
 Enablers of change
Valuing staff and carersNHS staff are the heart of good care and the engagement was clear that they need more support. Unpaid carers are unsung heroes and supporting them is essential.
Building partnershipsICSs have a key role in building partnerships to improve health outcomes and people’s experience of care, and VCSE partnerships ensure best use of community assets.
Harnessing digital and dataDigital and data are key to pandemic recovery and must be at the heart of how the NHS and its partners prevent ill health and meet people’s health and care needs.
Investing in infrastructureTo deliver required shifts, for example by supporting the facilities and equipment that will bring care closer to home.
Maximising valueIn line with the NHS’ commitment to efficiency an ongoing focus on maximising value and tackling variations in care, for example by involving patients in decision making.

Next steps

Thank you to all those who participated in the engagement on NHS@75, with the final report The NHS in England at 75: priorities for the future now published.
An accessible summary version of the report is also available.

The issues covered and other key challenges and opportunities will continue to be discussed at regular Assembly meetings to ensure the NHS England Board continue to hear the voices of staff and patients.