Future hospitals must be able to adapt in many ways to the changing demands on their roles and functions within evolving healthcare delivery infrastructures. These include changing population structures and needs, new models of healthcare provision, technological advances, and innovations in design, all while enhancing their environmental sustainability. This article sets out the issues that those determining healthcare policy and designing future hospitals must consider if they are to become and remain fit for purpose within the wider health and social care system. It also examines the need for, and challenges to, strategic healthcare planning, creating future hospitals that are sustainable, net-zero carbon organisations, and ensuring resilience in the face of a range of potential shocks. Future hospitals play a crucial role in healthcare worldwide, regardless of the country's income level. Hospitals cannot be viewed without broader health system changes, infrastructure, community and cultural factors, staffing and other considerations. We anticipate that future hospitals will enhance population health in all settings and support the move towards more consumer-centric healthcare. We urge clinical and policy planners to consider the factors discussed carefully to maximise the benefits.