Download“What do you think is the biggest challenge facing the NHS?” is one of the most common interview questions in medicine and dentistry. It is not a politics test. The interviewer wants to see that you follow what is happening in the system you want to work in, and that you can discuss a complicated issue fairly, with balance, and with the patient in mind.
A structure for any NHS question
- Pick one issue and name it clearly. Depth beats a list.
- Explain the causes, briefly. Most NHS problems have several.
- Explain the effect on patients and on staff.
- Give both sides of any proposed solution, including its trade-offs.
- Give a reasoned view, and connect it to the doctor or dentist you want to be.
Avoid party politics, and avoid quoting numbers unless you are sure of them and know where they came from. A wrong statistic does more harm than no statistic.
Topics that come up again and again
These themes have been part of the NHS conversation for years and are likely to keep coming up. Read about two or three of them properly, from reputable sources such as the King’s Fund, the Nuffield Trust, the BMJ and the BBC, and check for news in the weeks before your interview.
Workforce: recruiting and keeping staff
Shortages of doctors, nurses, GPs and dentists, staff leaving or reducing their hours, burnout, and training places. The NHS Long Term Workforce Plan, published in 2023, set out plans to expand training. A good answer connects this to retention: training more people helps less if experienced staff keep leaving.
Industrial action
Resident doctors (the BMA’s term, since 2024, for what used to be called junior doctors) and other staff groups have taken strike action in recent years over pay and conditions. Expect a question such as “Is it ever right for doctors to strike?” Show both sides: the duty to patients and the arguments about pay, morale and retention, and the steps taken to keep emergency care safe.
Waiting lists and urgent care
Long waits for planned treatment, pressure on A&E and ambulances, and delays discharging patients who are medically well but have nowhere safe to go. That last point links the NHS to social care, which is funded and run separately and is one of the most useful connections to understand.
Prevention and public health
Obesity, smoking and vaping, alcohol, and inequalities in health between different areas and groups. Prevention questions often test ethics too: how far should the state go in shaping people’s choices? The soft drinks levy and restrictions on smoking are useful examples to think about.
Where the NHS is heading
The government’s 10 Year Health Plan for England, published in 2025, describes three shifts: from hospital to community care, from analogue to digital, and from treating sickness to preventing it. You do not need to know the details, but understanding those three ideas gives you a frame for many other questions.
AI and digital health
AI that reads scans, writes notes or helps with triage; the NHS App; remote consultations. Good answers weigh the benefits (speed, access, freeing up time) against the risks (safety, bias in data, privacy, and patients who are less confident online).
Changing roles in the team
Physician associates, pharmacists prescribing, nurses in advanced roles, and how responsibilities are shared. The role of physician associates has been debated publicly, and a 2025 independent review (the Leng review) recommended changes, including to their title. Be fair to everyone involved, and focus on patient safety and clear roles.
For dentistry
Access to NHS dentistry, how the NHS dental contract affects that access, oral health inequalities, children’s tooth decay, and prevention such as water fluoridation and sugar reduction. If you are applying for dentistry, know these well.
An example answer
“I think one of the biggest challenges is keeping experienced staff. Training more doctors and nurses matters, but it takes years, and it helps less if people leave because of burnout. Patients feel that directly through longer waits and less continuity of care. There are things that help, like flexible working and protected time for training, but they cost money in a system that is already stretched. My view is that retention deserves as much attention as recruitment, and as a doctor I would want to contribute to a team culture where people feel supported enough to stay.”
Questions to practise
What is the biggest challenge facing the NHS?
One issue, causes, effects, balance, your view.
Should doctors be allowed to strike?
Duty to patients against fair pay and conditions; how emergency care is protected.
Should people who smoke or drink heavily be treated differently?
Justice, autonomy, the causes of behaviour, and the NHS’s founding principles.
How could AI change the work of a doctor?
Benefits, risks, and what stays human.
What do you know about the relationship between the NHS and social care?
Delayed discharge is the clearest example.
Should the NHS charge for missed appointments?
Cost and waste against fairness to people who struggle to attend.
Frequently asked questions
What NHS topics should I know for a medicine interview?
Know two or three well rather than many superficially. Workforce and retention, waiting lists and social care, prevention and public health, AI and digital health, and industrial action come up often.
Do I need to quote statistics?
No. A clear, balanced argument is worth more than numbers. Only use a statistic if you are sure it is accurate and know its source.
Can I give my own opinion on the NHS?
Yes, and you should, as long as it is reasoned and you have shown the other side. Avoid party politics.