The NHS Assembly: NHS@75 – An invitation to have your say survey guide (accessible version)

The NHS Assembly

The NHS Assembly brings together a range of individuals from across the health and care sectors at regular intervals to provide independent advice to the board of NHS England.

Its members include NHS clinical and operational leaders, frontline staff, patients, and representatives from several charities and community organisations. The NHS@75 project is being led by the NHS Assembly

Introducing NHS@75

On 5 July 2023, the NHS celebrates its 75th birthday. Since it was founded in 1948, it has evolved and developed into one of the largest and most respected healthcare systems in the world. It provides a wide range of services to millions of people that are free at the point of use for everyone.

This 75th anniversary is a significant milestone; an opportunity for all of us to appreciate and reflect on its importance in providing healthcare services to everyone.

However, it’s also important to acknowledge the challenges that the NHS currently faces, and how the NHS will inevitably shift and develop over time to meet these difficulties as effectively as possible.

The NHS today is very different from its early days of 75 years ago, just as our society is also very different from how it was three generations ago.

The NHS of tomorrow will continue to adapt to meet the emergent new challenges, as well as the ones we are currently facing. These include increasing demand for services, higher levels of chronic long-term ill-health, workforce shortages, and the need to make the best use of new technologies and treatments.

NHS@75 is all about working together to help shape our future NHS. It’s a collaborative conversation, in which we hope to include everyone who would like to take part. We would welcome your thoughts, ideas, insights, and suggestions, and we hope you’ll want to join in with this.

There are three big areas that we’d like to ask you about:

  1. How far has the NHS come in 75 years?
  2. Where is it now?
  3. What would like from it in the future?

Your contributions to this conversation, no matter how brief or in-depth, are important. We want an honest discussion: recognising what is difficult, as well as celebrating what is going well.

We welcome anything you’d like to share with us, and we have deliberately asked broad questions to invite a wide selection of experiences, thoughts, and insights from you. The more you can tell us, the more we can learn at this very important time.

Your contributions will help inform findings that will be shared with the NHS in England and its partners, including Amanda Pritchard, the Chief Executive of the NHS.

Over the last few months, the NHS Assembly has already been considering some of the ambitions for the NHS beyond the 75th birthday. These include:

  • Prevention: supporting people to live longer, healthier lives.
  • Personalisation: giving people power to control their own care and have shared responsibility for achieving better health.
  • People: caring for those who care for us, including those who work in the health service and unpaid carers of family and friends.
  • Participation: involving patients and their families at every level of decision making and service design.
  • Primary and community care: focusing on strengthening these local services which are the foundation for most care and treatment.
  • Partnerships: the NHS working better with other organisations to improve health and care for all.

Now, it’s your turn – please let us know what you think.

This engagement will be presented to the NHS Assembly, with the aim of seeking consensus on the future development of the NHS as it advises the NHS England Board.

Thank you for your participation in this vital conversation.

Clare Gerada and Chris Ham
Co-chairs, NHS Assembly

How to respond

While the Assembly will continue to discuss these themes, the NHS@75 engagement will run from Tuesday 2 to Friday 26 May 2023. Please respond to this guide’s questions using our Citizen Space online response form as soon as you can, but the deadline is 23.59 Friday 26 May. You can find more information, including the link to the response form and the survey at

Please feel free to answer all the questions, or just answer one or two of them, whichever feels most relevant to you.

For queries, or to submit a response directly, email

What this work will build from

This exercise is not starting from scratch; it builds on learning from work and consultations such as the forthcoming Long Term Workforce Plan, the Fuller Stocktake of Integrated Primary Care and recent local NHS plans.

It will also have access to the latest insights on patient and staff experiences. Royal colleges, patient, carer and public voice representative groups, and other organisations who sit on the Assembly have produced valuable reports upon which to draw.

How far has the NHS come in 75 years?


The NHS was born from the principles that access to healthcare should be based on need, not ability to pay and delivered fairly to the whole population. The principles, rights and responsibilities of patients, citizens and staff are enshrined in the NHS Constitution and backed by legislation.

Across all services, around 2 million people use the NHS every working day. They are served by over 1.4 million staff, covering more than 150 roles, drawn from every community in the country.

Some things have stayed the same, or very similar, since 1948. The service is still almost entirely funded through national taxation. Services are still delivered largely through a similar mix of organisations, from general practice to hospitals.

Where things have changed dramatically is through advances in healthcare and technology, such as medicines, diagnostic tests, and surgical interventions. We also offer more in terms of preventative care, such as national screening programmes and vaccinations. The NHS workforce and their roles have also changed with the number of doctors, nurses and other healthcare professionals increasing substantially.

These advances have led to people living longer, averaging 14 years more than in 1948. Survival from heart disease, cancer and other conditions has improved considerably, although we often now live with multiple long-term conditions.

The question:

1. What features, developments or services of the NHS are most important to celebrate and strengthen as we approach the 75th anniversary?

You are welcome to include any personal experiences or contributions you’ve made, with insights into why they were successful.

Where are we now?


Reaching its 75th anniversary highlights much to celebrate about the NHS. However, it’s also essential to acknowledge that it is currently facing significant challenges. Waiting lists are at a record high; many who work in the NHS are under considerable pressure and industrial action is being taken by different groups.

For many years we have seen a sustained improvement in people’s life expectancies, with people not just living longer lives, but remaining healthy and well for longer as well. However, we are now seeing these improvements plateau, and even begin to decline. There are also significant inequalities in health outcomes and accessing care.

In 2019 the NHS published the NHS Long Term Plan.

It outlined changes in how to deliver care and to improve health, including improvements in the prevention, detection, and management of long-term conditions. It also outlined improvements in access to and the quality of mental health care and other major health conditions. Our aim is to go further in the years ahead, working to reduce health inequalities, to prevent ill health where possible and to increase the number of healthy years that people live.

Recently, the NHS faced its greatest challenge ever in the COVID-19 pandemic. The pandemic exacerbated many of the challenges the NHS was already facing.

However, there is an enormous amount to be proud of in our response to COVID-19, not just within the NHS but across our partners – from community groups to those at the leading edge of scientific research. Many of the rapidly adapted ways of working and new team structures, particularly in the use of digital care, show us what the future of the NHS might look like.

The questions:

2. Today, in which areas do you think the NHS is making progress?

Please feel free to include more than one area.

3. Today, in which areas do you think the NHS most needs to improve?

Please feel free to include more than one area.

4. What are the most important lessons we have learnt from how the NHS has been changing the way it delivers care in the last few years?

What would you like from the NHS in the future?


The 75th birthday of the NHS is a time to look forward. We want to hear your views on the most important ways the NHS should develop services in the coming years.

These will be delivered in the context of changes in our population. There will be a continued rise in the number of us living into advanced old age, with more people living with chronic diseases and an increase in health risk factors such as obesity.

Technology is transforming how we communicate and consult with health providers. Research into our understanding of disease, better diagnosis and new treatments create significant opportunities.

The NHS is a people business. Without the staff, volunteers and unpaid carers that deliver it, it wouldn’t exist, and they are vital to the future of the NHS. We know that we must improve the experience of Black, Asian and Ethnic Minority staff, and create careers and patterns of work that people want and need.

The questions:

5. What do you think should be the most important changes in the way that care is delivered, and health improved in the coming years?

6. What would need to be in place to achieve these changes and ambitions?

7. And finally, do you have one example of a brilliant way in which the NHS is working now which could be a bigger part of how we work in the future?

Please describe this example.

Thank you for taking part in this – together we can shape an NHS that is better for everyone.