More Money Isn’t Enough: In 2026, the NHS needs to rethink how it spends it

The NHS is facing a productivity puzzle. The government pours increasingly large sums of money into it, but it is still struggling on key indicators. And yet waiting times have increased over the last decade and health outcomes have not improved enough.

Part of this is of course due to factors out of the NHS’ control: demographic factors like an ageing population and the increasing complexity and range of things the health service is asked to deal with. But it is also about an outdated way of delivering care.

Let’s start with the obvious: The main focus of the NHS is on treating patients when they come to the hospital. Of course we need to do this, but focusing too much on  this overwhelmingly reactive approach means the NHS is too often behind the curve.

What if instead of just focusing on treating patients that come through the door, the NHS also focused on stopping it ever reaching that point? What if it adopted an approach that is as proactive as it is reactive.

By intervening further upstream, we can identify risks earlier to support patients to proactively manage conditions before they ever need to be admitted. Think of it as getting a vehicle serviced rather than waiting for it to break down on the motorway.

The kind of chronic conditions this tech would be used for include illnesses such as heart failure, chronic lung disease, and diabetes. These conditions often follow a relapsing-remitting pattern with periodic flare-ups or hospitalisations.

The burden on the healthcare system of chronic illness is stark. Just 5% of patients account for more healthcare spending than the remaining 95% combined.

Among this high-cost group, 70 to 90% live with at least one chronic condition, and managing these conditions consumes 70–80% of NHS expenditure. By 2040, the number of people living with major long-term illnesses is expected to rise by 37% - nine times faster than the working-age population.

A focus on proactive care would see the NHS monitoring patients’ vital signs and symptoms while they are at home, enabling early detection of any concerning changes. This gives patients peace of mind and allows hospitals to make decisions about who needs to come in.

The good news is, we’ve never been more capable of implementing a system that is proactive as much as reactive.

Technology allows the NHS to predict who is most likely to need care and to use common devices like mobile phones and wearables to identify deterioration.

The digitalisation of records allows patient data to be accessed and shared easily. The integration of A.I. into the health service means that the system can flag up at-risk patients in need of proactive care.

And these changes won’t just save a small amount of money. Proactive care could save up to 40% of total healthcare costs. Put simply, it could deliver savings to the NHS of £34 billion nationally.

NHS funding is one of the hottest political topics there is. But too often the conversation is focused just on how much, rather than how to spend it.

For the NHS to endure for another 100 years and provide the people of the UK with value for money, a radical rethink of how it approaches care is sorely needed.

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Dag Larsson is the CEO and Co-Founder of proactive healthcare company Doccla

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