The United Kingdom’s National Health Service (NHS) was established under the founding principles that health care should be comprehensive, universal, and free at the point of access. However, it now faces a dual crisis: an aging population and increasing rates of disease. The rising demand for its services and budget constraints have limited the care it has been able to provide.

As part of the debut of the Milken Institute’s Project Prevent initiative in 2024, the Institute conducted a series of interviews with 35 key stakeholders and experts in health, finance, philanthropy, pensions, and public policy to explore sustainable additional sources of funding, particularly in these times of fiscal strain, as well as new financing mechanisms to reinvent early-stage prevention services. The exploration centered around three topics, each focused on a critical aspect of the challenge:

• What financing mechanisms could overcome traditional barriers to public- and private-sector investment in community-level preventive care?
• What would it take to attract the capital to finance such interventions? These conversations focused on identifying the conditions and assurances that would enable asset owners to feel confident in allocating capital to prevention projects.
• What would constitute an example of a compelling, investable, and adaptable community-level prevention intervention that would satisfy these conditions?

Stakeholders also shared insights on design and implementation strategies for effective, scalable, community-based prevention that could reduce the burden on the NHS. From those conversations and interviews, we found a consensus that reinforces emerging thinking about the need for a radical shift to a prevention-focused, community-based system. According to the experts interviewed, the real issue confronting the new government is not whether to pivot the system toward prevention, but how to do so. We hope our report contributes to the growing calls for this pivot while providing recommendations that make new sources of investment capital possible.