Lord Ara Darzi’s probe has concluded the service is in a ‘critical condition’ amidst surging waiting lists and a deterioration in the nation’s underlying health, identifying serious and widespread problems for people accessing services.

The report describes [the 2010s] as “the most austere decade since the NHS was founded”. Crumbling buildings, decrepit portacabins, and mental health patients accommodated in Victorian-era cells infested with vermin.

Key findings from Lord Darzi’s 142-page report include:

• Deterioration: The health of the nation has deteriorated over the past 15 years, with a substantial increase in the number of people living with multiple long-term conditions. 

• Spending: Too great a share of the NHS budget is being spent in hospitals, too little in the community, and productivity is too low.

• Waiting times: Waiting lists have swelled and waiting times have surged, with A&E queues more than doubling from an average of just under 40 people on a typical evening in April 2009 to over 100 in April 2024. 1 in 10 patients are now waiting for 12 hours or more.

• Cancer care: The UK has appreciably higher cancer mortality rates than other countries, with no progress whatsoever made in diagnosing cancer at stage one and two between 2013 and 2021.

• Lasting damage: The Health and Social Care Act of 2012 did lasting damage to the management capacity and capability of the NHS. It took 10 years to return to a sensible structure, and the effects continue to be felt to this day.   

• Productivity: Too many resources have been being poured into hospitals where productivity had substantially fallen, while too little has been spent in the community. 

In the PM's speach, the 2010s were described as a lost decade for the NHS…which left the NHS unable to be there for patients today, and totally unprepared for the challenges and opportunities of tomorrow.

As well as recognising the cost to people’s health, the PM will also address the inextricable link between the state of the NHS and the nation’s economy:

'It’s not just the state of our National Health Service in crisis - it’s also the state of our national health.

There are 2.8 million people economically inactive due to long term sickness, and more than half of those on the current waiting lists for inpatient treatment are working age adults.

Getting people back to health and work will not only reduce the costs on the NHS, it will drive economic growth – in turn creating more tax receipts to fund public services.'

Rooted in Lord Darzi’s diagnoses of the challenges facing the NHS, the PM will outline three fundamental areas of reform and the imperative to work with staff and patients throughout this process. He said:

'This government is working at pace to build a Ten-Year Plan. Something so different from anything that has come before.

Instead of the top-down approach of the past, this plan is going to have the fingerprints of NHS staff and patients all over it. 

And as we build it together, I want to frame this plan around three big shifts - first, moving from an analogue to a digital NHS. A tomorrow service not just a today service.

Second, we’ve got to shift more care from hospitals to communities… And third, we’ve got to be much bolder in moving from sickness to prevention.

Only fundamental reform and a plan for the long term can turn around the NHS and build a healthy society. It won’t be easy or quick. But I know we can do it.

The challenge is clear before us; the change could amount to the biggest reimagining of our NHS since its birth.'

Lord Darzi is an independent peer and practising surgeon with 30 years’ experience in the NHS. He examined over 600 pieces of analysis from DHSC, NHS England and external organisations during his investigation. His report will inform the government’s 10-year plan to reform the health service.

Lord Darzi said:

'Although I have worked in the NHS for more than 30 years, I have been shocked by what I have found during this investigation - not just in the health service but in the state of the nation’s health.

We need to rebalance the system towards care in the community rather than adding more and more staff to hospitals. And we need a more honest conversation about performance - the NHS is now an open book.'

In carrying out the review, Lord Darzi brought more than 70 organisations together in an Expert Reference Group and sought input from NHS staff and patients through focus groups and frontline visits.   

Stephen Sorrell MBE, social partnerships director at Preferred Homes Limited, a provider of extra care housing who exclusively develop affordable rental homes for society’s most vulnerable older people, commented: 

'While social care is out of Lord Darzi’s scope, he has rightly highlighted it as a root cause of pressures in our health system. A big part of the problem is that retirement housing is seen by many as a last resort. This isn’t a baseless fear – the dearth of affordable or appealing older people’s housing is what causes people to stay in their own homes for as long as possible. Rather than making a pre-emptive move to specialist accommodation, they often end up in hospital. Some 13% of NHS beds are occupied by people who should be in more appropriate settings – creating a backlog and inefficiency in the system.

 'To ease this blockage and foster the community care that the Health Secretary has championed, the government must back the development of affordable and fit-for-purpose housing for older people. Homes which promote accessibility and autonomy improve health and wellbeing, while accommodation that is not suitable leads to increased care needs and diminished independence. Poor housing is currently causing major health issues – for individuals and for the country. Good quality, care-focused accommodation can act as a powerful prevention and ease the NHS’ burden.'