We peruse the priorities for 2024 – innovation, partnerships and a focus on unmet clinical needs. Meanwhile, we focus on the healthcare horoscope of politics, tech, data, public health and the rise of the patient. Hop on for the ride as we ask how the NHS will be reconstructed, if the success in hepatitis C elimination can be repeated in HIV, why gene therapy challenges must be embraced and if we can realise the potential of real-world data throughout industry.