From AI to personal responsibility: Experts debate what the NHS could look like at 100

As part of our celebrations for the NHS’s 75th birthday, we gathered a panel of local and national health experts, hosted by our Chair, Jacqui Smith, to discuss what the health service could look like when it reaches its centenary.

The panel was made up of:

Mohamed Omer, from the Gardens of Peace, the largest dedicated Muslim cemetery in the country
Alastair McLellan, editor of the Health Service Journal
Helen Balsdon, interim Chief Nursing Information Officer, NHS England
Dr Narinderjit Kullar, Clinical Director, Havering Place Based Partnership, an integrated care partnership across north east London
Max Geraghty, Operations Manager for the Care Quality Commission, London region
Deborah Sturdy, Chief Nurse Adult Social Care at the Department of Health and Social Care.
In response to the first question: will the NHS be the main provider of healthcare at 100?, Max said “the model will still be here, but it might look different in how care is delivered” and Helen added “there will be a plethora of providers as we move forward, but the NHS will remain the bedrock of what we do, and it will evolve and change”.

Though Alastair agreed the NHS would still exist, pointing out “in my 21 years as editor of the HSJ people are always telling me the NHS is being privatised, if it is, they’re taking a long time about it”, he did say he believes more people will be paying for private healthcare to top up what the NHS delivers.

When asked whether there should be a national care service the panel were quick to point out the importance of social care in supporting the NHS. Narinderjit said: “social care is critical, without it, healthcare falls over. You can’t look at one without the other.”

On the issue of what artificial intelligence could mean for human interactions in healthcare. Alastair thought “in 25 years, the majority of healthcare will be delivered digitally”, however, Deborah argued “when people are frightened and vulnerable, they need a person – human, emotional contact is really important”.

Discussing the recently published NHS Long Term Workforce Plan, panel members welcomed the plan being in place, but agreed there were still gaps. “Is it deliverable? The short answer is no,” said Alastair. “The modelling it’s based on is ropey. It will lead to some new medical schools and training places, which is a good thing, but other than that it’s nonsense.”

Helen, who is passionate about the role of technology in improving healthcare, particularly digital patient records, wanted it to go further in equipping staff with digital skills. She added: “We have a great opportunity to use technology to break down barriers, so information moves with people. Clinicians having all the information about their patients at their fingertips means they can provide smarter, faster care that’s safer.”

For the future, everyone agreed on the need for the NHS to become a more proactive service, working to prevent disease. That led to a discussion on how responsible we should be for own health in the choices we make, and the socio-economic issues at play.

Max said: “While 25 years from now it will be a different landscape, we still make choices. There are socio-economic issues here which are bigger than healthcare, such as deprivation and inequalities. Health promotion is essential in the prevention of chronic diseases, and surely we need to take responsibility as well.”

For the final question, Jacqui asked the panel what their biggest hope and fear is for the next 25 years in the NHS. Mohamed didn’t hesitate: “An efficient service with no waiting lists, but I fear there is not enough funding or manpower to fulfil this.”

Deborah added: “I hope we can recruit the people we need to meet the growing demands, and have the head space to think and do things differently.”

Narinderjit helped the debate finish on a lighter note when it came to the difficulty of predicting the future. After hoping for “a more proactive than reactive service which acts as one organisation”, he added: “I hope this doesn’t end up like the film Back to the Future with hoverboards and flying cars!”