From permacrisis to possibility: Research and innovation in the NHS and life sciences

Reported by Meg Groom, Policy Engagement Themes Coordinator, Centre for Science and Policy

From permacrisis to possibility: Research and innovation in the NHS and life sciences

In a time of mounting economic and social pressure, the 2025 CSaP Annual Conference opened with a pragmatic discussion of the UK health system’s challenges and the role of research and innovation in tackling them. Professor Lucy Chappell, Chief Scientific Adviser at the Department of Health and Social Care (DHSC), and Lord James O’Shaughnessy, former Parliamentary Under Secretary of State for Health, offered a timely perspective - just one week before the publication of the Government’s new 10 Year Health Plan for England.

Listen to a recording of the panel discussion:

Download a copy of Lord O’Shaughnessy's presentation.

A system under pressure

Both speakers illustrated the huge challenge facing the national health system. Other leaders, including the Secretary of State for Health and Social Care, Wes Streeting, and Lord Ara Darzi, have described the NHS as “broken” - a diagnosis supported by historic lows in public satisfaction, deep health inequalities, and troubling productivity figures. NHS output has declined sharply since 2019, despite an increase in public funding. Lord O’Shaughnessy noted that structural inefficiencies and rising economic inactivity due to ill health - especially among working-age people - are driving up demand and lowering tax revenues. The health of the nation, he argued, is becoming a drag on wider economic performance.

Underlying these issues is a set of intersecting drivers: a growing and ageing population, more people living with complex long-term conditions, and significant social and geographic disparities in healthy life expectancy. This convergence of pressures - described by some as a ‘permacrisis’ - requires more than incremental improvements. It demands system-wide transformation.

Turning challenge into opportunity

Despite the bleak assessment, both speakers saw a window of opportunity to leverage the UK’s science and innovation base in support of the Government’s mission to transform the NHS.

Professor Chappell emphasised that the NHS holds a unique set of interconnected assets - science, patients, workforce and systems - making it an ideal platform for research-enabled transformation. The UK’s life sciences sector, spanning academia, industry, NHS Trusts and charities, offers an estimated return of £13 for every £1 invested by NIHR. This provides a compelling economic argument for embedding innovation into the heart of health system reform.

A framework for NHS innovation

Lord O’Shaughnessy proposed three criteria to evaluate any future proposals: does it improve efficiency and productivity? Does it reduce input costs? And does it help reduce demand for sickness care?

With these criteria in mind, there are opportunities within each of the NHS’s 3+1 assets:

1. Invest in science and technology: Tools such as AI-assisted radiology and robotic surgery are already embedded but not yet scaled in the NHS. With the right frameworks for adoption, they can offer significant productivity gains especially in diagnostics and outpatient services.
2. Empower patients: Innovations must enhance - not replace - patient agency. Professor Chappell underscored the ethical obligation to protect patient data. In conjunction with this, there is an opportunity to increase patients’ agency and access to personalised preventative care through the NHS app.
3. Build the right workforce: If NHS staffing remains static, there must be a dramatic shift in productivity and continuous professional learning. Supporting health professionals to participate in and lead research will create a workforce that is research-active and research-aware.
4. Fix the system: System-level reform is required to unlock the full potential of innovation. This includes focussing on outcomes rather than activities, centralising assurance, and transparent data flows.

Enabling scalable prevention and innovation

A related theme of the discussion was the importance of scaling preventative approaches across the wider health system. Currently, many preventative services sit outside the NHS mandate, and key determinants of health - such as housing, education and employment - lie beyond the DHSC’s direct remit. This creates a challenge for the Department, which remains responsible for delivering the Health Mission and its prevention goals.

Speakers noted that increasing access to personalised preventative programmes, could support this shift. The NHS app could offer access to both public and private preventative care, but expanding digital access must not unintentionally deepen existing health inequalities.

Both speakers also emphasised the need for policies that enable - rather than prescribe - innovation. Clinician-led innovation is essential to ensure new technologies are both useful and usable. Updating regulatory and funding pathways could create a more agile life sciences sector. Reforms to evaluation processes, such as those used by NICE, could help capture wider benefits alongside traditional cost-effectiveness measures.

From vision to delivery

As the conference opened, there was cautious optimism that this moment could mark a turning point for the nation’s health and care systems. The challenges facing the NHS are well understood, and political commitment to reform is clear. With the tools, technologies and partnerships already in place, this plenary session underscored the role of research and innovation in the life sciences sector in seizing this opportunity.