The environmental and financial sustainability of the National Health Service (NHS) in the UK is under threat. The Five Year Forward View set out two years ago to manage increasing activity is set to fail. Meanwhile, the NHS emitted 25 million tonnes of CO2 this year, making it the largest public sector contributor to climate change in Europe. And at the same time, clinicians are being pushed to provide seven-day services on five days’ worth of resources. Financially,
environmentally and clinically, the future for the NHS appears unsustainable. New ways of managing demand for healthcare services are desperately needed.