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Kieran Brett

Bending the Curve

It is often overlooked but the NHS and Local Government are amazing at change. We often see negative headlines but the truth is that both parts of the public sector have overseen huge transformations in performance and have been at the cutting edge of innovation. I have been lucky enough to work in and with the public sector for over 30 years and I’ve lived it at the operational level and as a policy wonk. I worked on national delivery at the Prime Minister’s Delivery Unit, then as Special Advisor to the Prime Minister and later to the Secretary of State for Health.

During that time, I have witnessed impressive changes. Think about the days when it took 18 months to get an operation in hospital. It now takes weeks. Recall how Councils helped to liberate half a million people to manage their own care with an individual budget. Mortality from cancer, heart disease and stroke slashed. Local partnerships between health, the criminal justice system and local authorities leading the way on issues like antisocial behaviour and domestic violence.

Each time, the challenge looks too complex, too challenging and too big. Each time, the public sector steps up to innovate, to change but most of all to deliver. Health and social care, along with partners in the third sector are being asked to step up again to meet the interlinked challenges of a growing and ageing population; a fixed NHS budget; declining social care budgets and new medical interventions.

Our new paper outlines how we see this challenge, and what needs to be done.

Download the Paper

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The sceptics will say ‘no they can’t’ but we will say ‘yes we did’ BUT we need to be smart to get there.

To discuss this paper, on iMPOWER’s wider work in healthcare, please contact me on

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