The NHS in 2025: A tale of targets, technology and transformation

The Labour Government, flush with a renewed mandate and a promise to ‘save the NHS’ will be under pressure to deliver in 2025, writes Graeme Currie.

Increased funding, while welcome, has been accompanied by a stern demand from Health Secretary Wes Streeting for UK taxpayers to get more ‘bang for their buck’.

So, the Government will look for a transformation of services that involves integrated and preventative care pathways, and scale up digital healthcare intervention, both of which will encompass new ways of working for staff and demand that inequalities in healthcare and outcomes are addressed.  

Plus, at long last, there seems to be a recognition that the National Health Service (NHS) is under-managed and managers are more than ‘men in grey suits’ and they can add value. Undoubtedly there will be considerable pressure on them to do so.

Alongside this, Labour will sustain the longstanding emphasis on managing organisational performance through targets. Expect politicians of all stripes to make the case for Government success or failure based on a reading of whether targets are being met or not. They will be all too ready to blame managers when failure is evident.

Digital healthcare

The Labour blueprint also calls for a digital revolution. ‘Hospital at home’ programmes and ‘virtual wards’ are touted as the ‘future’, promising to reduce the burden on hospitals and improve patient experience.

Yet the spectre of past failures looms large. The NHS, notorious for its IT woes, has a long and chequered history with digital initiatives. The recent much-publicised collapse of Electronic Patient Record (EPR) systems in several major hospitals serves as a stark reminder of the challenges that lie ahead.

It seems like an act of faith that digital healthcare will solve the UK healthcare system’s problems even though hospital at home programmes and virtual wards may well have some promise.

Despite all the doubts, expect significant investment to continue in digital healthcare, and as a patient or carer, don’t be surprised to be engaging with doctors and nurses more and more in a virtual way.

This digital push will also inevitably disrupt traditional roles and workflows. The rise of physician associates, for example, has already sparked controversy, with some fearing a dilution of patient care.

As technology reshapes the landscape, expect heated debates in the media about patients not ‘getting a good deal’ in this brave new world of virtual consultations and remote monitoring.

Of greater challenge still is moving resource and reconfiguring clinical roles away from hospitals towards preventative care delivered in community care settings. Hospitals have proved adept at retaining resource and services, and there has been considerable public outcry when hospital services have been reduced in localities.

All in all, the Government will probably struggle to deliver such transformational change over the lifetime of one parliament.

Behavioural science to promote healthy ageing

In 2025 there will be some interesting developments for healthcare, writes Ivo Vlaev. Perhaps the most intriguing development will be the burgeoning influence of behavioural science in the health sector.

By understanding the subtle psychological factors that influence health decisions, policymakers will hope to nudge the population towards healthier lifestyles.

Moreover, by integrating sophisticated theories and methodologies from psychology, neuroscience, and sociology, doctors and policymakers can develop nuanced interventions that promote healthy ageing and enhance the quality of life for those in retirement.

Like many countries the UK has an ageing population. According to the Office for National Statistics (ONS), 19 per cent of the UK in 2022 – 12.7 million people – were aged 65 and over, and the ONS predicts this will rise to 22.1 million, 27 per cent of the population, by 2072.

So, promoting healthy ageing through advanced interventions is critical to reducing demand on the NHS and its limited resources.

Using data analytics and machine learning, interventions can be tailored to individual behavioural patterns, preferences, and motivational drivers. Techniques such as adaptive goal setting, real-time feedback, and reinforcement learning can enhance engagement and effectiveness, making health interventions more relevant and impactful for each individual.

In 2025 more people will be using these tools through apps so they can stay motivated and focused with a personalised training programme.

Understanding the brain’s ability to reorganise itself, too, is leading to interventions like brain-training games, which are designed to stimulate neuroplasticity, potentially delaying cognitive decline associated with ageing. These activities can help maintain cognitive functions such as memory, attention, and problem-solving skills.

The behavioural scientist’s understanding of cognitive biases can also come into play here. Insights into how these biases affect decision-making in older adults allows for designing choice architectures that nudge them towards healthier behaviours without restricting freedom of choice.

For example, setting healthy choices as defaults and presenting information in ways that highlight the benefits of action, or the costs of inaction, can significantly influence healthier decisions, such as moving fruit and vegetables to the most easily accessible cupboard and the biscuits out of reach.

Simplifying the presentation of information to reduce cognitive overload and providing support for emotional regulation can also improve mental health outcomes.

Meanwhile, encouraging a growth mindset among older adults to embrace new skills and adapt to changes is crucial. Educational programmes that promote continuous learning and adaptability can improve cognitive function and openness to new experiences.

Technology for older adults

Technology adoption among older adults is another critical area. Advanced behavioural science emphasises the design of technologies that align with the cognitive and sensory capabilities of older adults. With eyesights fading and finger dexterity diminishing, voice-activated smart assistants can be ideal.

The development of adaptive systems that learn from user interactions to provide personalised experiences is also key. For example, voice-activated assistants that adapt to the speech patterns and preferences of older users can make technology more intuitive and engaging.

Educational workshops and peer mentoring can mitigate many old people’s fears and misconceptions about technology, making it easier for them to adopt new tools.

And incorporating game elements into technology can increase motivation and sustained use. Reward systems, challenges, and progress tracking can make using technology more appealing and enjoyable for older patients. Through personalised exercise programmes and health monitoring, interventions can also lead to better management of chronic conditions, reducing the risk of falls, and enhancing mobility.

This year, then, will see more technologies that support daily living activities to empower older adults to maintain independence and reduce the reliance on caregivers.

Healthcare resource management also benefits from these advancements if they are connected to the data apps in their community. Early detection of health issues through regular monitoring can lead to timely interventions, reducing the need for intensive medical treatments. And data collected from these apps can be used to inform healthcare providers about patient needs, enabling more efficient and targeted care.

Overall, the integration of advanced behavioural science into technological and programme interventions for the ageing population is expected to yield substantial benefits in promoting healthy ageing and enhancing the quality of life.

The influence of behavioural science as a pathway not only to extend lifespan but also to enrich the ‘healthspan’ – when additional years of life are lived with vitality and purpose – will be keenly felt in 2025 and beyond.

Further reading:

Predictions for 2025: a bleak outlook but with glimmers of light and hope

What will 2025 bring for energy and climate action?

How employee wellbeing will move up the agenda in 2025

Social economy to gain ground in 2025 as companies see the benefits

The EU will lead the way on sustainability reporting in 2025

Navigating AI in 2025: the promise and the pitfalls

Graeme Currie is Professor of Public Management. His research interests include leadership, innovation, and strategic change, with a particular focus on public service organisations in fields such health and social care.

Ivo Vlaev is Professor of Behavioural Science. He teaches Behavioural Sciences for the Manager on the Executive MBA and Full-time MBA plus Judgement and Decision Making on the MSc Finance.

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