RT Journal Article SR Electronic T1 Is it time for a paradigmatic shift in relation to healthcare in the UK? A reflection JF BMJ Leader JO BMJ Leader FD BMJ Publishing Group Ltd SP 251 OP 254 DO 10.1136/leader-2023-000762 VO 7 IS 4 A1 Karen Saunders A1 Mohamed Sakel A1 Cary L Cooper YR 2023 UL http://bmjleader.bmj.com/content/7/4/251.abstract AB Context Conflict is a driver of change and unions representing professional groups across the National Health Service (NHS) are currently engaged in direct conflict with the government. For the first time in the history of the NHS, healthcare professionals have taken industrial strike action. Junior doctors and consultant physicians are currently engaged in their respective union ballots and indicative poll surveys regarding potential strike action in the future. In the wake of such widespread industrial action, we have taken time to think deeply about the confronting challenges and issues and offer this reflection as an opportunity to redefine and re-frame an unsustainable healthcare system into one that is the best it can be in terms of fit for purpose.Insights and resource signposting We present the current context with a reflective framework table focused on ‘What do we do well? What is not done so well? What could some possible ideas and solutions be? and How could this change be supported?’We outline how a culture of well-being could be strategically and operationally introduced into the NHS workplace using research-based evidence and practical tools supported by expert guidance.No data are available. There are no data associated with this reflective article.