Policy Round-Up: What Healthcare Leaders Should Focus on Now

The NHS runs on goodwill. Except much of that goodwill has been withdrawn bt staff in response to pressures on pay, working conditions and trust. In this keynote from the Connected Health & Care Summit 2026, Andy Cowper, a journalist who has covered NHS politics and policy for 26 years, examines what the arrival of Prime Minister Andy Burnham means for health and social care, dissects three broken psychological contracts with staff, the public and future generations, and argues that the system’s tendency to cover up and lawyer up remains its most dangerous cultural failure. 

Watch Andy Cowper examine what Andy Burnham’s premiership means, why three psychological contracts are broken, and why trust, the word on the lectern, is the only thing the NHS cannot afford to lose. 

What the keynote covers and the central argument

This keynote covers political change, social care reform, devolution, culture, regulation and trust. The central arguments were: 

• Andy Cowper argues that Andy Burnham has so far made limited substantive policy commitments, giving himself maximum room to manoeuvre. He questions his political consistency has not been his strong point, and points to Greater Manchester’s devolution record including significant financial overspend during his time as mayor. 

• Three psychological contracts are broken: with staff whose goodwill was withdrawn after austerity, COVID and the Hadiza Bawa-Garba case; with the public whose confidence in the NHS is at historic lows; and with future generations who will not accept funding social care from housing wealth they do not have 

• The NHS needs a chief anthropologist more than it needs any chief inspector, in Andy Cowpers view. 

• Just accountability is far better than no-blame culture, but Andy Cowper argues that the system needs stronger root-cause analysis and human-factors capability 

• Andy Cowper argues the duty of candour is too often absent when things go wrong