Conclusion

The findings from this year’s survey highlight a sector under sustained pressure yet demonstrating resilience and adaptability in the face of complex challenges. Trust leaders remain deeply concerned about winter pressures, workforce burnout, and financial sustainability, with many, but not all, expecting the coming months to be more difficult than last year. Despite these concerns, there are signs of cautious optimism, particularly in perceptions of care quality and confidence in delivering financial plans.

Workforce issues continue to dominate, with high levels of concern around morale, discrimination, and the impact of industrial action. While there is some improvement in optimism around skill mix and retention, trust leaders are less confident about this in the future. Mental health services also remain a particular area of concern, with limited confidence in investment, capacity, and integration into the 10-year health plan.

The future landscape presents both opportunities and uncertainties. While most trust leaders understand their role in delivering the 10-year health plan, confidence in the impact of new models such as IHOs and multi-neighbourhoods remains mixed. Financial and capital constraints are the most cited concerns around delivery of the 10-year health plan, alongside integration and workforce.

However, the sector continues to innovate and collaborate. Examples of digital transformation, neighbourhood health initiatives, and integrated care models show promising strides toward the ambitions of the 10-year health plan already taking place. These achievements underscore the importance of sustained investment and cross-sector collaboration to support meaningful transformation and improve outcomes for patients and communities.