Laura Ashforth, chief executive of specialist health insurer Lateral, explains that continuity matters as much as speed of healthcare as we age.
Although the latest round of junior doctor strikes has now been cancelled, it again highlighted the uncertainty many patients face around when and how they will access their healthcare. The strikes would have seen the cancellation of tens of thousands of operations, diagnostics and clinics… and the inevitable knock-on effect on patient waiting lists.
Older people are disproportionately affected because they are more likely to need diagnostics, specialist input and elective interventions to help them stay healthy, active and independent.
For many over-60s, the challenge is not just waiting. It is not knowing how long to wait, what options they have, or at what point it makes sense to seek support privately.
Faced with uncertainty, more people are turning to private healthcare as they look for greater choice and alternatives to NHS waiting lists. A 2025 YouGov survey found that 15% of Brits over the age of 65 had used private healthcare in the past year, with 71% using either disposable income or money from a savings account to pay for it.
For older adults, healthcare is also rarely a single appointment or an isolated intervention. It is often a journey involving multiple clinicians, multiple decisions and increasingly multiple health conditions. As more people move between NHS and private providers, maintaining continuity throughout that journey becomes increasingly important.
Public versus private
The debate is often framed as NHS versus private healthcare. But the right answer is not always straightforward, and beyond waiting lists, there are many other factors to consider when deciding how to manage a condition. The challenge is knowing how to navigate the different options whilst preserving continuity of care.
Different pathways have different strengths, and the best option can depend on the condition, the urgency of treatment and an individual’s wider health circumstances. Preserving continuity can be just as important as securing the earliest available appointment.
Take someone who has been referred for hernia surgery. When seeking the quickest route to treatment, it can be tempting to immediately consider private treatment if local waiting lists are long. But many people are unaware that alternative routes utilising NHS Right to Choose are available, meaning they could remain within the NHS just by travelling a bit further. The challenge is that many people are simply unaware of the choices available to them.
Additionally, for some people with existing health conditions who need surgery, the private option may not be the best option. The access to a wider multidisciplinary team and specialist services that the NHS provides may ultimately be more valuable than reducing their waiting times by a few weeks. Here, understanding the pros and cons of different routes is key to making decisions.
It also pays to be forward-thinking. Someone diagnosed with a chronic condition that is likely to require long-term management may benefit from thinking carefully about continuity from the outset. While private consultations may initially provide faster access, continuity becomes increasingly important when multiple specialists, treatments and follow-up appointments are involved. Here, having someone to coordinate care across different providers and provide advice about how to navigate the system to get the best care outcomes is often missing. GPs, historically the overseers of health journeys, are rarely versed in private options and often lack the time to talk people through options as they move between different stages. This lack of continuity means that patients are often left to navigate the system on their own, with incomplete information.
Hybrid approaches
As more people turn to hybrid approaches to healthcare, supporting patients to make the best choices for their individual circumstances and ensuring continuity becomes increasingly important. Yet these services rarely exist in either the public or private sectors.
This was why we built nurse-led navigation into the Lateral Health Plan. Rather than acting purely as claims handlers, our nurses help members understand referrals, diagnoses, treatment options and the different pathways available to them. Sometimes that means helping someone access private treatment. Sometimes it means helping them make better use of NHS services.
The goal is not to push people towards one system or another. We respect patient choice throughout. Our aim is to give people access to clear information, a consistent point of contact and the support they need to navigate important decisions along the way.
When we’re younger, speed of access often feels like the most important thing in healthcare. As we age, speed still matters. But continuity increasingly matters too.
