In the summer of 1998 the National Health Service (NHS) Confederation in the UK used the opportunity provided by the celebrations marking the 50th anniversary of the NHS to engage in an exercise designed to stimulate thinking about the future of health services in Britain. A key part of this involved the creation of two possible future environments of the NHS. These became known as “the Madingley Scenarios”. In this article, the context of this work is briefly outlined before describing the main drivers that are shaping this environment (technology and information, new power structures, the changing relat ion ship with the living environment, and the effect of social and cultural change). The scenarios themselves are then outlined followed by some reflections on the value of this work in healthcare and beyond.
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