Evaluating the financial sustainability of English NHS trusts: a research proposal to the Big Pitch Event 2026

This paper overviews an overlapping generations financial cash flow valuation model that evaluates the financial sustainability of English NHS Trusts. It quantifies the financial sustainability constraints related to societal demographic shifts that affect their ability to maintain service delivery quality. The financial model computes a new long-term financial sustainability performance metric based on the notion of the Social Return on Investment (“SROI”). The measure evaluates the financial sustainability of two English acute care hospital foundation Trusts. Significant generational imbalances are identified for both sample NHS Trusts, both within different cohorts of existing generations, and between existing and future generational cohorts. Suggestions are provided for implementing these ideas and expanding actuaries’ expertise and skill sets.