Children born today will be taking their first steps into adulthood in 2040. What will life in the UK be like for them, according to current trajectories? What policy options do we have now that can influence or change that trajectory for the better?

When we started UK 2040 Options in June 2023, a year out from the General Election, we asked health and social care experts two simple questions: what are the greatest issues facing the health and social care systems; and what interventions might best help to improve them by 2040? As health is devolved, we asked experts to consider these issues in relation to England. 

The results highlighted the myriad of challenges that are facing England’s health and adult social care systems and sparked a year-long dialogue with experts, emerging thinkers and practitioners about both where there is established consensus on the issues and way forward, and where there is fertile ground for new ideas. 

With The Health Foundation, we assessed the fundamental facts that underpin the NHS and adult social care systems. We then highlighted the big choices that the new UK Government faces as a result. This report focuses on some of the interesting, innovative policy ideas that emerged.

It is well established that between now and 2040 the UK Government will need to grapple with the funding, structures and big workforce challenges that the NHS and social care systems face. Others, such as The King’s Fund, The Health Foundation, and Nuffield Trust are looking at those questions in detail. The ideas set out here are intended as additive – highlighting some policy ideas that, in a new, mission-driven government, have the potential to improve outcomes, regardless of the path taken on the big structural and funding questions. They’re not a set of recommendations, and nor do they represent a ‘strategy’ to ‘fix’ the NHS, but they should serve as food for thought for policymakers looking to innovate. 

The eight ideas that follow in this report: 

• Overhaul the policy approach to obesity: tackling poor diets upstream by introducing mandatory health targets for supermarkets

• Tackle alcohol-related harm head-on: through the introduction of minimum unit pricing 

• Reform the Treasury’s fiscal framework to prioritise prevention: introducing a new category of public spending for prevention
• Make NHS staff wellbeing a strategic priority: improving data collection and transparency, testing wellbeing interventions, and scaling the ones that work 

• Pave the way for an AI health revolution: standardising patient records, and establishing a new National Data Trust

• Ramp up the use of digital mental health services: through expanding access to, and effectiveness of, internet-delivered cognitive behavioural therapy (eCBT) and other digital tools 

• Stem rising demand in social care by slowing ageing: through preventing falls and improving physical activity in older people
• Proactive and streamlined support for unpaid carers: through targets and incentives

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Children born today will be taking their first steps into adulthood in 2040. What will life in the UK be like for them, according to current trajectories? What policy options do we have now that can influence or change that trajectory for the better? 

Almost all of the UK Government’s options to improve outcomes by 2040 will be shaped by our economic fortunes. Economic growth is a lynchpin for improved standards of living and social progress, and bolsters the tax receipts that fund better public services. Policy that secures higher productivity and growth enables governments to pursue ambitious policies elsewhere to keep our citizens healthy and look after those who are not, provide good educational opportunities, to both resist and build resilience against a changing climate, and more. 

But growth has been elusive for the UK in recent years, and particularly since the financial crisis of 2007-2008. The consequences of this continue to reverberate across the economy; the gap between where we are headed and where we could have been, based on pre-Global Financial Crisis trends, is stark. 

We’ve convened the brightest and best economists and thinkers in the UK and beyond to discuss the issues, trade-offs and ideas for reversing the trend. We’ve already examined the fundamental facts and choices and here we highlight some of the many ideas raised by those at the forefront of growth economics.

Focusing on four areas that came up time and time again – our institutions, land use, labour markets, and business productivity – some of the ideas are big, and some are small. Some aim to add to the literature on well-trodden ground, and some are more novel. They don’t aim to provide a comprehensive strategy for ‘fixing’ growth, but we hope all are thought provoking.

The nine ideas that follow in this report are:

• Establish an enduring new independent growth institution
• Empower functional economic areas by establishing regional and local governments in England with a route to devolution and fiscal agency 
• Tackle the housing crisis by moving to a zone-led planning system that simplifies the rules for developers
• Improve land use efficiency by introducing a land value tax
• Reduce labour market inactivity by harnessing data and AI to proactively support individuals
• Improve the transparency of the labour market to improve job quality
• Introduce regionally-specific migration routes
• Create ultra-low-cost energy zones to support industry
• Embrace experimentation by developing a productivity innovation fund to understand the most effective interventions

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Children born today will be taking their first steps into adulthood in 2040. What will life in the UK be like for them, according to current trajectories? What policy options do we have now that can influence or change that trajectory for the better?

The UK has a strong track record of leadership on net-zero targets, but this is a country that is veering substantially off-track for future carbon budgets unless it massively accelerates the pace and breadth of its decarbonisation. 

Through Delphi exercises, workshops and interviews, we’ve asked experts two questions: what are the biggest priorities facing the UK Government as it seeks to deliver on climate targets, and what interventions could deliver on these priorities and get the UK back on track by 2040, ahead of the Government’s target to reach net zero by 2050? It’s worth being explicit that targets are a proxy – a necessary one – for the things we really care about. In this case, stabilising the impacts of global warming to reduce global harms, and making the UK better off, greener, more comfortable and healthier as we do so.

We’ve already distilled the challenges and priorities into the fundamental facts and the big choices for Government to grapple with. This paper is the third in our series, and focuses on the ideas that could help deliver that better, greener, healthier UK by 2040, and beyond. 

The ideas presented here are not intended to form a comprehensive strategy across all priority sectors, nor are they a clear-cut set of recommendations. Instead, they are intended to be practical, thought-provoking policy ideas which could support the trajectory to net zero.

The ten ideas that follow in this report are:

• Bring citizens into the key issues: launch a national engagement campaign on net zero
• Support an effective market for green products and services: increase information transparency for consumers using green subsidies
• Explore an alternative delivery model for home retrofit: coordinate household decarbonisation street-by-street
• Increase centralised planning for major infrastructure: make NESO a system architect
• Increase efficacy of land use for environmental outcomes: develop a national rural land use framework and use it to underpin farming payments 
• Make better use of carbon pricing mechanisms: expand the scope of the UK Emissions Trading Scheme (ETS)
• Harness the market power of state funding: amend government procurement to require net-zero carbon construction materials to reduce embodied emissions
• Change incentives and increase innovation in energy markets: reform the structure of the energy retail market to support household decarbonisation
• Incentivise households to decarbonise when they’re moving house: reform Stamp Duty Land Tax to become an energy-saving stamp duty
• Show leadership on the impacts of climate change: develop and legislate adaptation targets

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Children born today will be taking their first steps into adulthood in 2040. What will life in the UK be like for them, according to current trajectories? What policy options do we have now that can influence or change that trajectory for the better? 

When we started UK 2040 Options in June 2023, with 12 months to go before the general election, we asked more than 60 education experts two simple questions: ‘what are the greatest issues facing the education system?’ and ‘what interventions might best help to address them by 2040?’ As education is devolved, we asked experts to consider these issues in relation to England. 

The results highlighted the range of challenges facing England’s education system, some well-known, some more surprising. 

It sparked a year-long dialogue with experts about where there is consensus on the issues and way forward, and where there is fertile ground for new ideas. 

With the Education Policy Institute, we set out the fundamental facts about the education system that policymakers need to know. We then worked with experts to dig into the big choices the new UK Government would face. This report focuses on 10 of the most interesting, innovative policy ideas that have emerged during this process.

What follows is not intended as a set of Nesta recommendations, but exciting ideas from some of education’s brightest minds, offering food for thought for policymakers looking to innovate in an area of policy that is vital for improving outcomes between now and 2040. 

The 10 ideas in this report are:

1. Build a professional development system for the early years: raising the quality of training and development early years practitioners receive throughout their careers. 
2. Reshape school structures: a single system to run and improve schools: blending the best of the maintained system and the trust-led system together. 
3. Make teaching a 21st-century career: backing innovation in working practices to increase flexibility and reduce workload. 
4. Decouple the process of mainstream Education Health and Care Plans from special school admissions: enabling mainstream schools to understand and meet a wide variety of learning needs.
5. Develop the next generation of integrated family support services: building on Sure Start and Family Hubs, and testing, learning and iterating to continuously meet the needs of users. 
6. Protect young people’s mental health: introducing legislation to create ‘safe phones’ for under 16s. 
7. Expand enrichment to all young people: opening schools from 8am to 6pm. 
8. Make kinship care the first port of call: allowing children who cannot live with their parents to stay in their family networks wherever possible. 
9. Revive youth apprenticeships: targeting apprenticeships at young people, and offering a different approach for adults upskilling and reskilling.
10. Increase the supply and demand of sub-degree qualifications: introducing exit qualifications after each year of university study

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Sam Freedman is a political journalist, author and former policy adviser at the Department of Education. He has conducted an analysis of the UK 2040 Options reports on economic growth, health, education, tax and public finances, wealth and income inequality, and power and place. In this report, he draws out the cross-cutting themes that span the UK government’s most pressing challenges.
 

 
The UK is in a bad place – stuck in a loop of low growth and productivity, with underfunded and inefficient public services, record low levels of trust in politics and a general sense of frustration from across the political spectrum, regardless of ideology.

But there is nothing stopping us from turning it around by 2040. That’s the timeframe that the UK 2040 Options project is looking to: it has commissioned analysis in topic areas that will be critical to deciding what our future will look like.

There’s a long list of things we could do, it’s just that the nature of our political system makes it so hard to do them. Only by tackling head on these broader cross-cutting political challenges can politicians steer us through our current problems to a more optimistic future. And they need to get on with it, because the list of demands on the state is only going to grow.

• By 2040, there will be much higher healthcare, social care and pensions costs due to an ageing population. Chronic health conditions are projected to affect a substantially greater number of people.
• Decades of underinvestment in capital and infrastructure risk driving future costs in acute crisis management even higher. We can already see this playing out in the NHS and the criminal justice system, among other examples.
• There is a growing number of external risks, including worsening global security following the Russian invasion of Ukraine, growing tensions in the Middle East, and concerns about China. The effects of climate change will increase and we have learned the hard way the need to be prepared for pandemics.
• The rise of the ‘regulatory state’ has meant a big, and largely undiscussed and unplanned, increase in regulatory costs for public and private institutions. There is ongoing pressure for further regulation across multiple sectors – often with good cause.

The UK isn’t unique in this regard. Countries across the world are facing similar challenges, but there are elements of the UK’s political set-up that make them particularly difficult for us to deal with.

• The UK is uniquely centralised. This puts huge operational pressure on the centre, while leaving local government weak and unable to raise its own funds. There are major regional disparities in wealth and productivity that are, in part, driven by this lack of power at regional or local level.
• The UK has a constitutionally extremely powerful executive combined with weak central institutions that struggle to use this power effectively. Government ministers rarely last more than a year or two. Attempts to reform the civil service have been half-hearted at best and it has been left largely as originally designed.
• The Treasury is unusually powerful for a finance ministry and essentially holds veto power over everything that happens in government, meaning it sets the de facto strategy.
• The UK has a highly centralised political culture that is caught up in a super-fast media cycle. This leads to a focus on communications at the expense of policy, which paradoxically creates a loss of trust with the public.

Managing demand for services will require the state to spend more upfront. Some of this can be achieved through better taxation but mostly it requires growth through improved productivity. It will also need more efficient public services through greater investment in infrastructure, technology, and prevention. This is well known and has been for a long time. There isn’t a shortage of ideas about how to do these things, but our structural constraints keep getting in the way. To tackle them effectively, politicians need to confront the ‘meta’ cross-cutting challenges of the way our state works.

The UK needs:

• more effective central institutions that are able to support ministers in decision-making, rather than the haphazard collection of structures that have evolved over centuries
• more capacity at regional and local level, with more operational functions devolved to them and more ability to decide strategy for regional economies and services
• more effective engagement around democratic trade-offs, through greater transparency and accountability, as well as exploring new ways to assess the public-preferred routes through difficult trade-offs
• a clearer framework for regulation, risk and prevention, rather than the entirely arbitrary and poorly evaluated and costed approach we take at the moment.

There are many different approaches politicians could take to create a new political settlement. But we will only get to 2040 in good shape if we have one. What we have now isn’t up to meeting the challenges we face.
 
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