NHS ConfedExpo 2026: Designing for the future, delivering today

I have been attending NHS Confed Expo (and its predecessors) for nearly 25 years now and this year felt important! Nearly 10,000 leaders in health and care gathered in Manchester across two days, and the central question hanging over everything was one that the NHS has been circling for some time: How do we genuinely improve care today and transform the system for tomorrow, at the same time, under real financial pressure?  The tone from speakers was less “here is the plan” and more “here is what we are learning as we go.”

Lord Victor Adebowale set the agenda on day one with a phrase that stuck with me: “leadership is the treatment.” His central point was clear, the NHS has spent years reorganising itself, redrawing boundaries, creating new bodies, renaming functions; and yet, patients still fall through gaps. His warning was that structural change only counts if it reaches the person who most needs care.

Responding to this, the neighbourhood health agenda dominated the conference.  A year on from the 10-Year Health Plan, the conversation has moved slowly but meaningfully from what the “left shift” (i.e. the shifting of healthcare out of hospital settings and into local communities) means in theory to what it actually takes to deliver it. The highlight of the conference for me was a session featuring our clients from Greater Manchester and Coventry: Shifting left: A route to improved UEC performance, better outcomes for people and a more financially sustainable future.

What made it stand out was the honesty: two very different systems, with very different local contexts, speaking openly about what it actually took to make progress under pressure.

Both systems are fundamentally changing the way urgent and emergency care (UEC) is delivered as part of a longer-term shift towards out-of-hospital models of care. They have each taken a distinctly different approach, shaped by their own populations, relationships and starting points. But the core message was the same, and it is one I believe deeply: improving day-to-day acute performance and investing in community and neighbourhood models are not sequential steps. You do not fix UEC first and transform later. The transformation is the route towards the fix, and to Victor’s challenge, in my opinion, this leadership is the treatment.

Taken together, the examples from both systems are a powerful demonstration of what is possible when partners align around a common purpose, build the right capabilities across the system and crucially sustain the commitment needed to see it through. That last part is often underestimated.

You can watch a recording of the session here to hear more: watch the session here

There is, of course, plenty that still feels extremely challenging for health and care systems: financial pressures remain and the gap between the ambition of the 10-year plan and the reality of day-to-day operational pressure is no small step.

However, reflecting on ConfedExpo 2026, what I experienced was a committed sector that is beginning to find its footing, with a continuity of purpose and pace expressed by the new Secretary of State. There is more practical knowledge in the system than ever before about what good looks like, and the ambition around the event to deliver change was palpable.

I left NHS ConfedExpo energised by the conversations I had, proud of the work our clients are doing, and more committed than ever to our role as a strategic delivery partner to health and care systems.