Modern diseases are of the mind and the body. Most of the things that cause us trouble and pain today were either unknown or unrecognised when our health services were designed. Diabetes for example was virtually unheard of when the NHS was founded but now someone is diagnosed with diabetes every two seconds. 15 million people suffer from diabetes or other chronic conditions. These modern illnesses absorb 70 percent of health expenditure but they cannot be cured, managed or prevented within our medical systems – we need a very different approach. Over more than a decade I have been exploring ways that we could design new systems. I collaborate with GPs, with specialist networks, with mental health services and with communities, learning how we can make a measurable impact on people’s lives and on our health systems. Growing these new approaches within existing health systems is difficult work but change is possible.