A brighter future is possible in 2026

A key question for all of us working in health and care as we approach the end of the year is: “How will the NHS shape up in 2026?” This matters more than ever – for our health of course and the millions of patients who rely on its services, but also for our politics, economy, and social justice. 

A quick scan of media stories posted in the run-up to Christmas offers some important clues about the challenges and concerns that will have to be tackled, and opportunities there for the taking.

One of the most immediate and pressing issues is industrial action. Yet again the NHS is picking up the pieces from another five-day walkout by resident doctors. These strikes have been disruptive and distressing for patients, divisive for staff, and have cost the health service an arm and a leg. We desperately need a fix. Not just with the British Medical Association which has walked doctors up a very high hill offering no easy route down, but with wider health unions making strong cases for pay rises and reform. 

I was particularly struck by the proposal – apparently rejected during the development of the 10 year health plan – to let staff receive part of pension contributions as pay, if they want to. I wonder if that idea will make a comeback in 2026.

Wes Streeting says he’s doing everything he can to avoid further strikes. Good, because it looks very much like the coming pay round could be a defining moment. He’ll need to be on his game.

There’s been a spate of stories recently highlighting failings in maternity care, which have persisted in the face of so many reviews and recommendations. The issues are complex and varied, but many have identified a damaging cultural divide between midwives and obstetric staff. There is more to come, with public inquiries in train, but we must hope the forthcoming Amos review results in steps to restore confidence in this key service.

I was pleased to see the government’s announcement of support for people who have grown up in care. But it was also reminder that we need to do much more for children and young people. Preventing ill health at this stage is central to ensuring the next generation are able to live well, thrive and contribute to society and the economy. That also means giving mental health the priority it deserves, while recognising, sharing and scaling up successful approaches.

This will be key to the success of the government’s 10-year health plan. As we approach the year-end the government is understandably keen to highlight progress but for me the most powerful evidence for optimism lies in the extraordinary ideas and innovation I see week-in week-out on trust visits to hospital, mental health, community and ambulance services. 

A quick scan across media health pages shows the challenges come from so many different directions. Winter pressures are taking a toll, with a long stretch to go until spring. Improved ambulance performance shows progress is possible. 2026 must be a year of headway on corridor care, same day access and investment in home and neighbourhood services. Ambition must be backed by action.

The government has placed priority on the elective target. Waiting lists are falling but not fast enough. As always, finance is a key factor. And the funding pressures keep on growing - drug prices, clinical negligence, redundancy costs and increased business rates. 

That’s hardly the ideal background for a once-in-a-generation transformation programme to reshape the NHS for future generations. But that is the challenge in 2026.

We must make the most of the many emerging opportunities. These include how to handle the deployment of tech and AI. New figures on the expansion in use of the NHS App are really encouraging. There will be further big benefits if, in the months ahead, we can make strides on building in the NHS Online Hospital and single patient record. There are exciting possibilities too for the role of weight-loss drugs, and other incredible medical advances. 

So many possibilities in the year ahead in health, good and bad. But amid the many difficulties, there’s a real chance of a better, brighter future for the NHS, its patients and its staff. 

This article first appeared in Health Service Journal