The UK government has committed to improving the nation's health. It has set itself a 'grand challenge' of enabling people to live an extra 5 years of healthy life by 2035 while narrowing the gap between the richest and poorest. Bolder action is needed to make progress towards this goal. •The transition to a new public health system needs to be managed carefully, to ensure that the reorganisation does not disrupt the pandemic response or lead to a weaker system in future.

Public perceptions of health and social care 4Public satisfaction with the health service has fallen to a 20-year low. 6 By the end of 2021, the 'grace period' of widespread support for the NHS and its staff during the pandemic 7,8 had been replaced by a more pessimistic outlook. 9 Public satisfaction fell across all NHS services -from emergency care in hospitals to general practice and dentistry. 6 Satisfaction with social care is even lower. 6 Early in the pandemic, high numbers of deaths in care homes and the impossible pressures on care workers put the sector in the spotlight. This spotlight has dimmed, yet social care remains under extreme strain from chronic underfunding 10 and widespread staff shortages, leaving many people without the care they need. 11,12 These pressures are less visible than in the NHS, but are no less severe -and challenges in both systems interact to cause escalating problems for people using and providing services. COVID-19 has made these problems worse, but their causes are longstanding -including a decade of austerity in public spending, political neglect of adult social care, and limited health system capacity, such as staff, beds and equipment.The 2019 general election gave Boris Johnson's government a substantial majority to deliver on pledges 13 to 'level up' the UK, 'fix' social care and strengthen the NHS. These manifesto ambitions initially took a backseat to the pandemic response. But since then ministers have produced policy at frenetic pace -with white papers on the health service, 14 social care, 15 integration of care 16 and levelling up, 17 alongside the biggest shake-up 18 of the NHS in England in a decade. Yet Liz Truss inherits a health and care system in crisis and widening health inequalities. 19,20 The task facing the new prime minister and her government is significant. As the Truss government sets out its agenda on health and social care, understanding what the public thinks should inform policy.

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