Covid-19 is one of the biggest shocks in modern peacetime history. It has caused huge loss of life, and severely impacted both our society and our economy. It might be tempting to see the outbreak as a case of bad luck – a one-off event from which we should return to normal, as soon as possible. This would, however, be a mistake.

The evidence is clear that global disease outbreaks are a growing threat. We should, therefore, approach Covid-19 like a natural disaster. When flooding or earthquakes occur, it is always important to build back with flood defences and resilient construction. We need to do the same in the health and care system.

The next few months will not just be about rebuilding our healthcare system to its previous state, but about building it back better. Of course, that does not mean preparing retroactively for an identical crisis. The next health shock, when it comes, is likely to look quite different. Instead, the onus is on the government to consider how the healthcare system could be if it were given the capacity, resources, and flexibility to adapt to shocks when they emerge.

This report argues that the UK government should take the opportunity to create a system where resilience is considered efficient, where long-term thinking is encouraged, and where resources are allocated to deliver on it. To this end, we recommend that English health policy might borrow from economic policy’s ‘fiscal rules’, and introduce six ‘health and care resilience rules’.