NHS urged to rethink models for prevention by 2035

Senior health leaders have called for a rethink of NHS operating models to support a prevention-first system by 2035. The call emerged from a roundtable in Leeds involving figures from the NHS, health technology and academia.

The discussion focused on structural barriers that participants said could hinder any shift towards earlier intervention and prevention. While digital tools were seen as important, they argued that changes to incentives, service design and data governance will be just as critical if the health service is to move away from a model largely built around treating illness after it appears.

The debate covered decentralisation, community care, interoperability between services and greater patient control over health data. Participants also examined how earlier diagnosis could ease pressure on the NHS, with one figure cited at the roundtable suggesting that about 20% to 30% of UK adults have an undiagnosed condition.

Prevention was also discussed in broader terms. According to figures raised at the meeting, only around 12% of health determinants in the UK are linked to medical care, while genetics, behaviour and lifestyle account for much of the rest. That balance has increased interest in care models that identify risk earlier and intervene outside acute settings.

Data focus

Much of the conversation turned to the NHS data ecosystem and whether it is equipped to support preventative care at scale. Options discussed included moving towards a single data system, giving patients more direct control over how their data is shared, and retaining data over a person's lifetime to reduce duplication in areas such as genomic medicine.

Leaders at the session also highlighted the use of population health digital twins, virtual models designed to mirror real-world systems, as a way to test interventions and simulate patient journeys. A West Yorkshire pilot focused on kidney disease was cited as an example of how such models could be used more widely.

AI focus

Artificial intelligence in primary care was another theme. Participants discussed its potential role in earlier detection, automated diagnostics and more targeted testing pathways, while noting that any wider use of AI would depend on public trust and clear oversight of data use.

Community-based prevention also featured strongly. Attendees identified digitally enabled screening and self-testing as ways to expand preventative services beyond hospitals, alongside greater investment in community care and more connected pathways between providers.

Adrian Stanbury, director and co-founder of Axiologik, said the central challenge was not simply technical. "The NHS is a globally recognised pinnacle of healthcare but becoming prevention-first while it is still structurally designed around sickness represents a challenge. Technology is a critical enabler, but the real challenge is operational and cultural: changing incentives, redesigning pathways, shifting care into communities, and building public trust around the use of data and AI," he said.

System reform

He added that the session suggested many of the tools needed for change are already present in parts of the system. "What emerged from this roundtable is that the solutions already exist in pockets across the system. The question now is whether we have the collective bravery to scale them and fundamentally rethink how the NHS operates by 2035."

Rob Walker, head of health and social care at techUK, said technology and organisational reform would need to move together. "If the NHS is serious about becoming truly prevention-first by 2035, technology is essential to this transformation. However, this needs to be alongside a fundamental shift in culture and operating models across the health system - including the bravery to rethink how care is delivered, how organisations collaborate, and how patients are empowered to take greater control of their own health."

Harry Armstrong, managing director of Opencast, focused on the role of data and connected services in moving care upstream. "Technology can enable the NHS to transition from a system that primarily reacts to illness to one that actively prevents it. Better use of data, digital platforms and connected services can help clinicians identify risks earlier, intervene sooner and support people before conditions become acute. Prevention-first healthcare is not just about reducing pressure on hospitals; it is about improving the quality of life for millions of people."