England has a number of new health and care leaders, who stand at a defining crossroads.

The pandemic has rapidly accelerated an existing trend of decline in access and outcomes. This is creating the conditions for an ‘opt-out’ by those who have the means – embedding a two-tier system.

There is near-universal public support for retaining a universal, free, comprehensive and tax-funded NHS. Our polling shows a consensus in public support for the basic principles of the NHS as a system that universalises the benefits of the best healthcare and shares the cost across the population.

We propose policies designed to better live with Covid-19, to help build back better and to help prepare for the future. Our proposals are based on three aims: recovery, building back better and increased sustainability facing an uncertain future.