Executive summary and recommendations

The NHS is one of the UK’s most treasured institutions, providing universal healthcare to millions and widely regarded as a symbol of quality care internationally.

However, as the healthcare landscape evolves, the NHS faces growing challenges: rising patient demand, workforce shortages, deteriorating infrastructure and constrained financial resources. These pressures come at a time when the NHS’ potential to attract high-quality inward investment remains largely untapped. 

The UK healthcare sector has long been a destination for foreign investment. With the NHS recognised as one of the world’s most respected healthcare brands, there is significant opportunity to engage international partners to address systemic issues such as long waiting times, unsuitable infrastructure, and an ageing population. Strategic inward investment could help bridge resource gaps, stimulate innovation and create new care delivery models. However, to date, concerns about profiteering and privatisation, bureaucratic complexity, and fragmented procurement pathways have hindered the ability to capitalise on these opportunities.

Inward investment could fuel NHS 10 Year Plan

In the NHS 10 Year Plan, the Government committed to evolve its infrastructure finance models. This is a welcome acknowledgement of the potential of inward investment to address the challenges faced by the NHS. To do this, the Department of Health and Social Care (DHSC) and the NHS should consider a ‘smart investment strategy.’ This should go beyond financial contributions, leveraging expertise, innovation, and social impact to ensure sustainable and mutually beneficial partnerships. Foreign investment, often referred to as ‘smart money,’ focuses on mutual benefits, such as shared revenue, social impact, and reinvestment into national priorities. Sustainable collaboration requires investors to bring added value to enhance the NHS’ capacity and outcomes, aligning with broader national objectives.

This strategy involves balancing responsibilities between the UK and investors to achieve meaningful returns that benefit both parties. Emphasis is placed on ensuring investments address social and economic goals, including technological advancement and improved healthcare systems. A collaborative and accountable approach encourages investors to strengthen domestic infrastructure and organisations, prioritising sustainable, long-term improvements over immediate profit. This ensures that foreign investments contribute to the NHS resilience and ability to deliver high-quality care. It means the investment will contribute to the Government’s three aims of: hospital to community, sickness to prevention and analogue to digital.

How we compiled recommendations

The recommendations outlined in this report support the implementation of a ‘smart investment strategy’ and are closely aligned with the openness to inward investment signalled in the NHS 10 Year Plan and Life Sciences Sector Plan. They are the result of extensive discussions held during two roundtable sessions focused on unlocking the potential of inward investment in UK healthcare. These sessions brought together diverse stakeholders, including NHS leaders, policymakers, legal experts, and representatives from the private sector, to examine the opportunities and challenges associated with attracting international investment in the UK healthcare system.

The discussions explored key themes, such as leveraging the NHS’ global reputation, addressing structural inefficiencies, and fostering innovative partnerships to strengthen the health system while ensuring public benefit. Participants shared insights on creating a supportive investment framework, improving regulatory and procurement pathways, and aligning inward investment with NHS priorities. These collaborative conversations provided the foundation for the actionable recommendations:

Recommendations

Recommendation 1: Centralised repository of information

Establish a comprehensive centralised repository of information to guide overseas suppliers on how to navigate the UK healthcare market and supply the NHS effectively. This should be easily accessible and understood, and promoted at international conferences and events, highlighting the unique assets of the UK, such as universal health coverage and extensive health data resources.

Recommendation 2: A unified ‘NHS Front Door’ for investment

Develop a unified ‘NHS Front Door’ for investment to act as a single, centralised entry point for foreign investors to streamline engagement with the NHS. This platform should be designed to provide clarity and efficiency for international investment while addressing longstanding challenges in navigating the system.

Recommendation 3: A dedicated central business development unit

Develop a dedicated central business development unit within the NHS to consistently manage trade and investment conversations and bridge knowledge gaps in international commercial operations. This could provide the necessary structure to address these gaps, streamline trade and investment efforts, and align them with the NHS’ operational needs and global opportunities. It will also reduce fragmentation caused by individual NHS bodies making arrangements with international investors, in effect it would present a unified NHS approach.

Recommendation 4: Enhance regulatory agility

Enhance regulatory agility to attract MedTech and digital health innovation with a focus on investment in the health sector. The UK should leverage post-Brexit regulatory freedoms to streamline approval pathways for low-risk and emerging technologies. To achieve this, the Medicines and Healthcare products Regulatory Agency (MHRA) must be adequately funded and empowered to expedite approvals, foster international collaboration, and maintain high safety standards. 

Recommendation 5: A structured framework for international investment

Establish a structured framework for international investment to ensure private sector investment delivers tangible public benefits. A structured framework for international investment should be established, similar to the Voluntary Scheme for Branded Medicines Pricing, Access and Growth (VPAG) agreement with the Association of the British Pharmaceutical Industry (ABPI), to ensure private sector investment delivers tangible public benefits. Public-Private Utilisation (PPU) models and risk- and gain-sharing agreements should be introduced to incentivise investment. These contracts must be straightforward, transparent, and aligned with NHS priorities, ensuring investor goals are balanced with public needs. 

Recommendation 6: A comprehensive healthcare workforce strategy

Develop a comprehensive healthcare workforce strategy that simplifies qualification recognition, ensures high professional standards, and supports cultural integration for international practitioners. Foreign-trained healthcare professionals play a critical role not only in addressing workforce shortages but also in contributing to the NHS' broader operational and strategic goals. By viewing these practitioners as a form of inward investment integrating ‘people as investment’ into workforce strategies, the NHS can enhance its capacity and tackle systemic gaps in service delivery. The NHS presents an opportunity to develop a global sustainable clinical workforce. 

Recommendation 7: Simplify NHS procurement processes

Simplify NHS procurement processes between NHS organisations to attract and streamline investor engagement. Simplifying and standardising NHS procurement processes across trusts and Integrated Care Systems is essential to improve accessibility for investors, reduce inefficiencies, and streamline decision-making. 

Recommendation 8: Align inward investment with a UK health data strategy

Align inward investment with a UK health data strategy to unlock the value of NHS data assets and attract global investors. In addition to implementing the recommendations from ‘Data Saves Lives’, the Government must accelerate the aggregation and integration of primary, secondary, community, and social care datasets for the benefit of patient care and to unlock the potential of UK health-data assets while protecting patient privacy and ensuring ethical data use. Alongside this, steps must be taken to address the regulatory and legal barriers to international data sharing with countries not perceived to have sufficient data security adequacy. 

A clear strategic approach

The NHS stands at a pivotal moment, with immense potential to unlock inward investment that can support it with its current challenges while enhancing its long-term sustainability. By leveraging its global reputation, unique offerings and extensive footprint, the UK can position the NHS as a premier destination for foreign investment. However, for this potential to be realised, structural reforms and a clear, strategic approach are essential.

The recommendations outlined in this report provide a comprehensive framework for attracting international investment in a way that strengthens the health system while ensuring that the NHS remains true to its core mission: providing high-quality, equitable care to all. With bold aspirations and targeted actions, the NHS has the opportunity to transform its capacity and innovation potential, driving better outcomes for patients, empowering healthcare professionals, improving the prevention of ill health and securing the future of the healthcare system for generations to come.