New report identifies five necessary steps to transform the UK’s health and care systems

A new report co-authored by the Bevan Commission, the leading health and care thinktank in Wales and Arup, a global sustainable development consultancy, has identified five key steps needed to transform how the UK’s health and care systems are designed. The aim is to provide solutions to the profound challenges that currently exist.

The report – titled “People, place, health: constructing a health and care ecosystem for Wales” – combines health and built-environment expertise and expert testimony from a broad range of stakeholders. It highlights both the response to the pandemic and the climate emergency as catalysts for change. While the report draws on research in Wales, its findings provide a blueprint for transformation across the UK and beyond.

It found that health and care systems cannot remain remote from the rest of daily lives, given that 90 per cent of good health comes from factors outside of these systems. Instead, health and care should be integrated into the planning and design of places and should support and be supported by communities, the economy and the environment.

Based on analysis of the scale of the current health challenge, current drivers of change affecting people and places, and best-practice case studies, the report identifies five key ingredients for an ecosystem that puts health and care at the heart of place. These consist of:


  1. Investing in a preventative model
  2. Driving a culture shift
  3. Considering people and place
  4. Embracing technology to bring about change
  5. Changing models to embrace a shift from hospitals to community-based health and social care

Immediate next steps outlined in the report include setting up pilot projects across Wales and using the 75th anniversary of the NHS as a turning point to draw support from new stakeholders. Longer-term, it identifies the need for a shift in the roles of government and policymakers that reconnects the mechanisms for shaping and improving places with measures to prevent ill-health.


Jamie Tucker, Associate Designer, Arup, said: “A new model of health and care is urgently needed if we are to meet the ever-growing challenges the current system faces. A people-and-place-based approach will be essential to this model, given the fact that health and care are now inextricably intertwined with all aspects of our lives.”


Helen Howson, Director, Bevan Commission, said: “Our society has shifted drastically since the NHS was founded and technology has advanced, meaning it is vital that our approach to the planning and design of our health and care systems adapts to keep pace. A radical rethink is required, and this report provides a unique combination of expertise and invaluable insights, from both a health and care and built-environment viewpoint, necessary to challenge, change and champion thinking and practise.”


The full report can be downloaded via this link.