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It is time to think differently about health and social care. Although good progress has been made in improving NHS performance in the past decade, the health and social care system faces unprecedented funding pressures and significant future challenges. Fundamental change is needed to respond to the needs of an ageing population, the changing burden of disease and rising patient expectations.

Time to Think Differently is a programme of work from The King's Fund aimed at stimulating debate about the changes needed for the NHS and social care to meet the challenges of the future. By engaging others and promoting discussion, we hope to generate new thinking about innovative ways of delivering high-quality care and support health and social care leaders in their decision-making.

Project content

  • The future is now

    Featuring the voices of patients, volunteers, clinicians and managers, our new digital report explores future ways of changing health and health care for the better.

  • NHS buildings: obstacle or opportunity?

    The first in a series of four papers that aim to crystallise ideas for change in the future of health and social care. This paper re-thinks the way that the NHS could use its estate to c...

  • The NHS workforce: how do we balance cost-effectiveness with safety?

    Professor James Buchan explores how NHS reforms have affected the health and social care workforce, and the importance of maintaining the balance between safety and cost-effectiveness.

  • Could NHS buildings become tools not temples?

    In a guest blog for our Time to Think Differently programme, Barrie Dowdeswell gives an international perspective on how the NHS could be utilising one of its prime assests - its buildin...

  • Being an Active Patient

    Havi Carel shares how she became an 'active patient' by harnessing her own resources and those of health professionals to live well despite – or rather, with – her illness.

  • How can we deliver the fundamental change needed to meet the challenges of the future?

    For our Time to Think Differently blog, Mark Newbold proposes six changes to help us meet the challenges of the future, as we move away from an acute care model to one based on the manag...

  • It's crept up on us

    As part of our Time to Think Differently programme, writer and commentator Roy Lilley considers the impact that technology has on our lives, and asks why health care is still lagging beh...

  • Breaking down the boundaries in health and social care

    How can breaking down professional barriers help us to deliver better care in the future? Viv Bennett, Director of Nursing, Department of Health and Public Health England, blogs for our ...

The second phase

In 2012/2013 we had an incredible response to our Time to Think Differently work, with thousands of visitors to our comprehensive analysis of the trends that will influence the way health and social care is delivered in future, hundreds of comments on our guest blogs and a far-reaching debate that explored the future of health and social care in England.

The next phase of the programme focused on crystallising the ideas for change. We produced perspective pieces focusing on NHS estates and the workforce and spoke to commentators to gain new perspectives on the issues facing the future health and care system.

In 2013, we set up the independent Commission on the Future of Health and Social Care in England. The commission, which was born out of the Time to Think Differently programme, carried out a fundamental review of the way that health and social care entitlements, benefits and funding are currently organised and assessed the scope for better aligning them to meet the needs of 21st-century patients and service users. The commission published its final report in September 2014.

The second-to-last publication in our Time to Think Differently programme of work, Reforming the NHS from within: Beyond hierarchy, inspection and markets, challenges the dominant approaches to NHS reform over the last 20 years. It draws on experience from high-performing organisations here and abroad to analyse how best to meet the challenges facing the NHS. Rejecting top down approaches to change, it makes the case for ‘reform from within’ - investing in staff, encouraging innovation and establishing the continuity of leadership needed to develop new models of care.

With testimony from patients, volunteers, clinicians and managers, our Future is now report draws to a close two years of work under our Time to Think Differently programme, generating ideas, debate and hope about the future of health and social care.

What next?

We are committed to using the learning from our Time to Think Differently programme to undertake longer-term work to support the NHS and social care in making change happen. This will involve The King's Fund working with teams, organisations and whole systems to develop their clinical and health care delivery strategies. We will help boards frame the key strategic questions that they should be asking themselves, drawing on the insights and learning from the Time to Think Differently programme.