Advancing healthcare foresight: insights from the ‘National Ambulance Service 2040’ project

Abstract Healthcare systems face escalating long-term uncertainty due to technological advancement, demographic shifts, and heightened social demands, yet foresight is still insufficiently employed within mission-critical healthcare institutions. This article contributes to futures studies by providing a comprehensive empirical case of applied, participatory, and normative foresight conducted within a national ambulance service. Drawing on the ‘National Ambulance Service 2040’ project in Hungary, the findings indicate how classic foresight methods – STEEP analysis, scenario development, futures wheel, and visioning – can be systematically combined and embedded in organizational decision-making under real-world constraints. The case demonstrates how foresight enhances anticipatory capacity building, strategic sensemaking, and normative alignment within a high-pressure public service context. Methodologically, the article advances applied futures studies by evidencing the complementarity of foresight tools and by highlighting the performative role of visioning as a governance and mobilization mechanism. Substantively, the findings show that foresight can be both cost-effective and impactful in publicly funded, resource-constrained healthcare systems. By extending healthcare foresight into the largely unexplored domain of emergency medical services, the article positions healthcare as a fertile site for methodological advancement in futures studies. The article also offers policy-relevant insights into anticipatory governance, workforce readiness, and the ethical incorporation of artificial intelligence in healthcare.