LSE-Lancet Commission

on the Future of the NHS

In these politically and economically turbulent times, one of the many major outcomes is that the National Health Service is facing unprecedented scrutiny and demand. As it was only in 2018 the NHS heralded its 70th anniversary, it is imperative to take stock and objectively consider the future of our health system. In response, the Department of Health Policy at the London School of Economics and Political Science, in collaboration with The Lancet, has formed a Commission on the future of the NHS.

The commission’s main outputs will be an overarching report including a series of recommendations looking to the ‘Future of the NHS’. This will be accompanied by a series of background papers which tackle specific issues such as funding, workforce, changing health needs, improving quality, health information technology, and pharmaceuticals and medical devices.

A Lancet Commission involves working in partnership with world-renowned institutions and policy experts to focus on far-reaching issues. Each Lancet Commission is different, but all involve a panel of academics who use their collective expertise and draw on input from diverse sets of stakeholders to dissect the driving factors behind the issue at hand, produce original research where possible, and develop a series of policy recommendations.

There is a historic precedent for major commissions in the NHS. Landmark reports have contributed to the development and evaluation of the NHS: in 1980, the Black Report exposed growing health inequalities across the population, and in 2004, the Wanless Report successfully argued for increased funding for the NHS through general taxation. Moving forward, there is a well-defined need for independent and objective perspective on the NHS, and the LSE-Lancet Commission aims to provide that.

  • During a 24-month period, commissioners from a wide range of disciplines across England, Scotland, Wales, and Northern Ireland are focusing on the pertinent challenges facing the NHS, culminating in the release of a report containing a series of policy recommendations in 2020.
  • As part of this comprehensive project, we announced a Call for Evidence which offered an opportunity for individuals and organisations to submit evidence regarding their perspective on both the major challenges facing the NHS and any innovative approaches currently being utilised to address these.
  • The deadline for these submissions was 30 October 2018. The Call for Evidence attracted submissions from over 100 NHS stakeholders, such as the majority of Royal Colleges, patient organisations and public health institutes.
  • This was followed by an Evidence Hearing in September 2018 where organisations and individuals were given the opportunity to present in more detail to the Commission, allowing a wide range of viewpoints to be considered.

The Commission involves over 20 commissioners from disciplines including health policy and public health and epidemiology, and incorporates the insights of health care professions and health care managers with practical experience tackling the problems the NHS is facing. They are based across England, Scotland, Wales and Northern Ireland, to ensure that lessons from different governance structures and delivery mechanisms are explored in the Commission's work.

The Commission hopes to address the main challenges facing the NHS in both the immediate future and the next 20 years. These issues are wide-ranging, from establishing sustainable funding to securing a sufficient and skilled workforce, and addressing the conflicting incentives among a multitude of organisations wihtin the NHS. In addition, the Commission will consider the health inequalities in the population and the difficulties in accessing consistent and high-quality health and social care, while also considering changing health care needs set against the background of shifting public expectations and involvement in health care. The Commission will focus on the information needs of the NHS as well as the role of technology in this context.

Through the Commission and the partnership, the Department of Health Policy will continue a long tradition of the London School of Economics and Political Science: carrying on the legacy of distinguished LSE Director Professor William Beveridge, whose seminal Beveridge Report provided the intellectual underpinnings for the establishment of the English National Health Service. Others such as Professor Brian Abel-Smith and Professor Richard Titmuss followed, who played prominent roles in supporting the continued development of the NHS through the 1950s, 1960s and 1970s.