NHS Health Education England

Welcome to health and care in the South West in 2035

Scenario Planning

In 2020 HEE SW commissioned a “Scenario Planning” project to allow us to take a look 10 to 15 years forward in time, providing ideas of what the future of health and social care might look like in South West England.

What’s emerged is four divergent versions of health and social care systems set in 2035. These are not predictions, but plausible versions of the future.

It is our goal that these scenarios will be utilised to inform workforce planning, inspire debate and innovation, and aid us in developing shared vision and purpose across the 7 Integrated Care Systems (ICSs) of the South West.

Facing an uncertain future in health and care

Now is a good time to work with these materials. The impact of Covid-19 has certainly changed the nature of health care in the short term and, although it is too early to know what the long-term impact of the pandemic will be in the South West, these scenarios provide insights, and clues to some of the possible intended and unintended consequences of the pandemic.


We hope you will find the scenarios and associated material a useful framework for your team and partners. The scenarios are intended to be used to:

  • bring people together to reimagine what you want health care in the South West to look like.

  • provoke debate and use the detailed toolkits to consider, for example, workforce development and workforce planning and the role of leadership.

The four divergent futures

National Wellbeing Service

The ‘National Wellbeing Service’ scenario imagines a future where the systems of health and social care have become integrated into one wellbeing system.

Treadmill Health and Care System

A future based on ever-increasing need being put on the NHS and ever-decreasing funding being available.

Two-Tier Health and Care System

A decade of increased health, economic and social inequalities in the South West coupled with a surge in private health care provision through technology. Those with the means do well.

Networked Health and Care system

This is a smart, technology-led integrated health service which is networked, uses big data effectively to target treatment developments and is led by the central government.