On its landmark 70th anniversary, profound questions are being asked about the NHS. Can we afford it? Is it receiving enough funding? How can the recruitment crisis in general practice and other parts of the service be addressed? Are we really training doctors fit for 21st-century medical practice? One thing is certain, and that is the NHS will change, and it is possible that we will not recognise it as it is transformed over the coming decades. We interviewed four influential leaders in general practice, internal medicine, and health policy to learn their views on the challenges facing the NHS and what they see as possible solutions in the short and long term. Despite overwhelming pressures and a system under constant strain, reportedly on the brink of collapse, those leading the way are hopeful, maybe even truly optimistic. And it is good to know that their visions for an NHS fit for the future appear well aligned. With new challenges in a changing environment we have to develop novel and innovative ways of working, and perhaps revisit and redefine the public’s relationship with the NHS and health care in the future. Significant commitment to future spending on the NHS is fundamental to its survival and for that we wait with bated breath: it is possible that an announcement will be have been made by the time you read this article. Public support for the service remains as strong as ever, and, with such enthusiastic and committed professional leaders, we hope that it is not tempting fate to say that the future looks relatively bright.The Royal College of General Practitioners (RCGP) First5 Committee represents and supports over 10 000 GPs in their first 5 years after qualification. It is led by Dr Jodie Blackadder-Weinstein, an RAF doctor who also works …
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