The NHS is at a crossroads, on a precarious path to a future yet unknown

Niall Dickson CBE, chief executive of the NHS Confederation, gives NHE readers an exclusive preview of what to expect at this year’s edition of Confed18 – where high-profile speakers and deep-dive workshops and seminars will ensure delegates leave the conference brimming with inspiration and new ideas.

It is hard to think of another period of such uncertainty in the history of the NHS, with unprecedented workforce and funding challenges, and unprecedented levels of demand. And alongside this, Brexit, the outcome of which is also uncertain in spite of soothsayers on either side claiming to know what the future will bring.  

We do know the next decade will require some fundamental changes in our delivery systems. The creation of new integrated models of care will move us further away from the 2012 Act and arguably a delivery model which has prevailed in various forms since 1948. The risks are apparent, principal among them operational pressures that threaten to overwhelm strategic aspirations.

Charting a course over the next few years will require different ways of working, which challenge traditional mindsets and the vested interests which have driven so much in the NHS over the years.  The question is whether commissioners and providers, NHS and local government, independent and voluntary sectors, primary, secondary and community care can operate together to develop new pathways and interventions which meet patient rather than system or organisational need.  

That is the central question facing us all now, and it is one we will address at Confed18, the NHS Confederation’s annual conference and exhibition on 13 and 14 June. Our ambition is to bring together the whole system to explore practical ways forward, to exchange audacious ideas and to create the vision that will enable NHS to thrive, not just survive, over the next 10 to 15 years.

Themed ‘Celebrating the past, shaping the future,’ the conference will feature masterclasses, workshops and talks intended to equip senior leaders with the tools to confront today’s challenges, as well as those of tomorrow. Hard-hitting sessions will question narratives on mental health and regulation. And speakers from across the UK, and beyond, will share their experiences, tools and solutions on digital, transformation, integration, efficiency and productivity, workforce, and leadership.

Our hope is that everyone leaves with at least one new idea that will save them money, drive quality or both.

Yet those who run the service will only be able to go so far without support from the political class. It is therefore encouraging that we are now seeing signs of movement on the most pressing domestic issues: funding, workforce and social care. With keynote addresses from the secretary of state, Jeremy Hunt MP and his shadow Jon Ashworth MP, there must at least be the hope of new thinking and a new narrative on health and social care.

Our NHS 70th Birthday Zone will host a programme on preserving the NHS’s heritage, and our NHS 7Tea party will gather the service’s oldest and newest staff members. Main stage sessions featuring former health secretaries and NHS employees will look back at the NHS of yesteryear.

Three other exhibition zones will spotlight innovation, developments in mental health and public health, and a fourth will provide a platform to debate the latest thorny issues.

With the NHS at this critical juncture, at the intersection between yesterday and today, we aim to bring the system together to secure a brighter future.


Confed18 takes place in Manchester on 13 and 14 June. To find out more, visit:


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