‘Three Horizons’ is a tool for building a long term vision for a system and the steps required to get there. It shows how different pieces of work can help make long-term changes.

The Three Horizons model describes three distinct focal points of activity. They all have their own benefits but it's important to see how they fit together to become ‘greater than the sum of their parts’.

This tool can help you look at and improve the current ways of working with ongoing improvement. It can also help you change from one way of working to another, opening and closing different paths.

One challenge in making changes is knowing if something is really changing how things are done or just making small tweaks. The Three Horizons tool can help you think about what changes are required. It shows you how to shift away from things that are not working. It also helps you move towards a more integrated model of care.

This will enable better alignment of workstreams and a more planned approach to system-wide change. Through this approach you can:

• Plan for change across a range of services and workstreams.
• Explore what needs to happen in the medium term to start to move towards the ideal state.
• Help distinguishing between transformational and incremental change to clarify assumptions regarding progress towards the third horizon.

To use the Three Horizons with your stakeholders, find a PowerPoint with the core Three Horizon's graphics you can use in your presentations and workshops.

To find out more about Three Horizons, register for our October 2025 webinar here.

To read more widely about Three Horizons, you can access a paper from Public Health Wales that enhanced our content and graphics.