EDITORIALS
cross-cutting themes such as technology and partnership with patients, public, and civil society. The national health and care crisis we are facing requires an urgent, robust, and values based response. It requires new thinking and old values. It requires a clear long term vision and long term planning. It requires the voices of health professionals and patients to be heard. It requires a recognition of the inequalities and wider social determinants that drive health outcomes. It requires prioritisation of health and care, of people and the planet. Above all, it requires us to recommit to the founding principles of the NHS, to put the health and wellbeing of our population first, and to revive the spirit of Aneurin Bevan and a nation that came together in the hope of creating a better, fairer, healthier world.
Competing interests: We have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.
Provenance and peer review: Commissioned; not externally peer reviewed.
The BMA, which owns TheBMJ , grants editorial freedom to the editor in chief of TheBMJ . Theviews expressed in this editorial, and in the papers of the BMJ Commission on the Future of the NHS, are those of the authors and may not necessarily comply with BMA policy. The BMJ convened this commission, which was chaired independently by Victor Adebowale, Parveen Kumar, and Liam Smeeth. TheBMJ was responsible for the peer review, editing, and publication of the papers of the commission. 1 Bevan A. A message to the medical profession. BrMed J 1948;2:. doi: 10.1136/bmj.2.4565.1 pmid: 20787364 2 Office for National Statistics. Mortality in England and Wales: past and projected trends in average lifespan. Jul 2022. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmar- riages/lifeexpectancies/articles/mortalityinenglandandwales/pastandprojectedtrendsinaveragelifes- pan 3 Liberati E, Richards N, Ratnayake S, Gibson J, Martin G. Tackling the erosion of compassion in acute mental health services. BMJ 2023;382:e073055. doi: 10.1136/bmj-2022-073055 pmid: 37402535 4 Salisbury H. The NHS is not unsustainable. BMJ 2023;381:. doi: 10.1136/bmj.p991 pmid: 37130604 5 McKee M, Hiam L, Dorling D. Weakened by a decade of austerity: why the UK ’ s covid-19 inquiry is right to look at policies since 2010. BMJ 2023;381:. doi: 10.1136/bmj.p1288 pmid: 37279988 6 Health Foundation. The continuing impact of COVID-19 on health and inequalities. 2022. https://www.health.org.uk/publications/long-reads/the-continuing-impact-of-covid-19-on-health- and-inequalities?psafe_param=1&gclid=CjwKCAiA5L2tBhBTEiwAdSxJX8lxZhgB_ZJK-BGx- AIPDJ5N0UCNfZP8UWtO8Ms3t3q_7c_61Lm6NphoCQ9sQAvD_BwE 7 Aburto JM, Schöley J, Kashnitsky I, etal. Quantifying impacts of the COVID-19 pandemic through life-expectancy losses: a population-level study of 29 countries. Int J Epidemiol 2022;51:-74. doi: 10.1093/ije/dyab207 pmid: 34564730 8 Oliver D. “ If youdon ’ t like it, just leave! ” won ’ t solve the NHS workforce crisis. BMJ 2023;380:. doi: 10.1136/bmj.p4 pmid: 36599477 9 Nuffield Trust. Health and Brexit: six years on. 2022. https://www.nuffieldtrust.org.uk/re- search/health-and-brexit-six-years-on 10 WHO. Universal health coverage. 2023. https://www.who.int/news-room/fact-sheets/detail/uni- versal-health-coverage-(uhc) 11 Schneider EC, Shah A, Doty MM, etal. Mirror, mirror 2021: reflecting poorly. health care in the us compared to other high income countries. Commonwealth Fund, 2021. 12 Cooksley T, Clarke S, Dean J, etal. NHS crisis: rebuilding the NHS needs urgent action. BMJ 2023;380:. doi: 10.1136/bmj.p1 pmid: 36596578 13 Abbasi K. The BMJ ’ s Commission on the Future of the NHS. BMJ 2023;381:p1000.doi: 10.1136/bmj.p1000 14 The BMJ Commission on the Future of the NHS. https://www.bmj.com/nhs-commission 15 Crisp N, Bamrah JS, Morley J, etal. NHS founding principles are still appropriate and provide a strong foundation for the future. BMJ 2024;384:e078903. doi: 10.1136/bmj-2023-078903. 16 Office for Budget Responsibility. https://obr.uk/
the bmj | BMJ 2024;384:q187 | doi: 10.1136/bmj.q187
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