The Government’s 10 Year Health Plan promises to reinvent the NHS through three radical shifts – hospital to community; analogue to digital; and sickness to prevention.
Back in July, the Government set out the long-awaited 10 Year Health Plan for England.
The 10 Year Health Plan is part of the government’s health mission to build a health service fit for the future. It sets out how the government will reinvent the NHS through three radical shifts: hospital to community; analogue to digital; and sickness to prevention.
The government will ensure that the NHS is ready to deliver these three shifts through a new operating model, by bringing in a new era of transparency, by creating a new workforce model, delivering a reshaped innovation strategy and by taking a new approach to NHS finances.
But what does this all mean in practice? Since July, the NHS and the government have published a few updates that answer some of our questions.
At the time of the plan’s launch, it was pointed out that patients were struggling to get appointments with their GP, waiting lists were long, staff demoralised and patient outcomes behind other countries. 250,000 ideas were submitted to the Change NHS website.
The NHS’s founding principles remain in place, universal care, free at the point of delivery, based on need and funded through general taxation, but the NHS will be reimagined so that patients can have choice and control over their care.
The NHS will be reinvented with science and technology at its centre and will be equipped to narrow health inequalities.
From hospital to community
The first shift is from hospital to community. The Neighbourhood Health Service offers an alternative to a hospital-centric, detached, fragmented system. This will bring care into the community and bring professionals into patient-centred teams. Access to general practice will be revitalised, enabling hospitals to focus on providing specialist care. Over time, the Neighbourhood Health Service will combine with the genomics population health service to provide predictive and preventative care that anticipates need, rather than just reacting to it.
To put it simply, care should happen as locally as possible, digitally by default and in a patient’s home if possible. Care should be delivered in a neighbourhood health centre (NHC) when needed and in a hospital if necessary.
In order to achieve this, the pattern of health spending will be altered. The share of expenditure on hospital care will fall, with proportionally greater investment in out-of-hospital care.
A key goal is to end the 8am scramble by training thousands more GPs and building online advice into the NHS App. The government has said that anyone who needs a same-day appointment will be able to get one.
Two new contracts will be introduced to encourage GPs to work over larger geographies and lead new neighbourhood providers.
Patients will be supported to be active participants in their own care with a goal of ensuring 95 per cent of people will have an agreed care plan by 2027. The government will at least double the number of people offered a personal health budget (PHB) by 2028 to 2029, offer one million people a PHB by 2030, and ensure it is a universal offer for all who would benefit by 2035.
Patients will be able to use the NHS App to book appointments, communicate with professionals, receive advice, draft or view their care plan and self-refer to local tests and services.
An NHC will be established in every community, with priority going to areas with the lowest life expectancy. These will be a one-stop shop for patient care and the place from which multidisciplinary teams operate. NHCs will be open at least 12 hours a day and six days a week.
Community pharmacy will have an increased role in the management of long-term conditions. They will also be linked to the single patient record.
There is a goal to improve access to NHS dentistry, improve children’s oral health and increase the number of NHS dentists working in the system by making the dental contract more attractive and introducing tie-ins for those trained in the NHS.
The government plans to deliver more urgent care in the community, in people’s homes or through NHCs, to end hospital outpatients as we know it by 2035.
The government has also committed to ending corridor care and restoring the NHS constitutional standard of 92 per cent of patients beginning elective treatment within 18 weeks.
Same-day emergency care services and co-located urgent treatment centres will be expanded and patients will be supported to book the most appropriate urgent care service.
Analogue to digital
In some aspects, the NHS has been lagging behind when it comes to technology. The plan is to leverage the unique advantages of the NHS’s healthcare model, including world-leading data, its power in procurement and its means to deliver equal access to create the most digitally accessible health system in the world.
By harnessing digital, the government plans to ensure rapid access for those in generally good health, free up physical access for those with the most complex needs and help ensure financial sustainability.
For the first time, patients will be given control over a single, secure and authoritative account of their data, known as their single patient record, to enable more co-ordinated, personalised and predictive care.
The NHS App will be transformed into a world-leading tool for patient access, empowerment and care planning. It is hoped that by 2028, the app will be a full front door to the entire NHS.
Using the app, patients will be able to get instant advice for non-urgent care, and help finding the most appropriate service first time. Through the My Choices section, they will be able to choose their preferred provider looking at outcomes, feedback or distance from home.
Patients will be able to use the My Specialist section to book directly into tests where appropriate and hold consultations with My Consult.
Through My Medicines, they will be able to manage their medicines and through My Vaccines, they will be able to book vaccines.
My Care will enable patients to manage long-term conditions and My Companion will provide extra care support.
Patients will be able to upload health data through My Health and manage a loved one’s care through My Children or My Carer.
Elsewhere, patients will be able to leave feedback on the care they have received which will be compiled and passed back to providers.
There will be a single sign on for staff and technology like AI scribes will be scaled to free staff from bureaucracy and administration, so they have more time to focus on patients.
A ‘HealthStore’ will be built which will enable patients to access approved digital tools to manage or treat their conditions, enabling innovative businesses to work more collaboratively with the NHS and regulators.
Sickness to prevention
The government has a plan to halve the gap in healthy life expectancy between the richest and poorest regions, while at the same time, increasing it for everyone. The key to this is prevention.
The government plans to work with businesses, employers, investors, local authorities and mayors to create a healthier country.
The Tobacco and Vapes Bill means future generations of children will never be able to legally buy tobacco and restrictions have been placed on the advertisement and sale of vapes.
There are restrictions on junk food advertising targeted at children and a ban on the sale of high-caffeine energy drinks to children.
Healthy Start will be restored from the 2026 to 2027 financial year and free school meals expanded to all children with a parent in receipt of Universal Credit.
Other initiatives include weight loss medication, alcohol standards, expanded mental health support and increased uptakes of the HPV vaccine.
There are also plans to create a new genomics population health service by the end of the decade. Universal newborn genomic testing will be introduced, alongside population-based polygenic risk scoring and other diagnostic tools, enabling early identification and intervention for individuals at high risk of developing common diseases.
New operating model
Perhaps one of the most well-known changes is the abolition of NHS England. NHS England will be combined with DHSC, reducing headcount by 50 per cent.
ICBs will be built up and commissioning support units closed so that ICBs become the strategic commissioners of local healthcare services.
New standards have been introduced for trusts and leaders, with pay tied to performance and good work rewarded.
Workforce
Central to plans to save costs are cuts to staff. In November, it was announced that 18,000 administrative posts will be cut across the NHS. The government plans for staff to be better treated and more motivated, with better training and development. Every member of staff will have their own personalised career coaching and development plan.
Innovation
A key part of the goal to transform the NHS is innovation. Five transformative technologies have been identified – data, AI, genomics, wearables and robotics – which will be harnessed to personalise care, improve outcomes, increase productivity and boost economic growth.
A Health Data Research Service will be launched, backed by £600 million. This will transform the access to NHS data by providing a secure single access point to national-scale data sets, slashing red tape for researchers.
There are plans to make the NHS the most AI-enabled health system in the World, with AI integrated into clinical pathways.
Wearables will be standard in preventative, chronic and post-acute NHS treatment by 2035 and surgical robot adoption will be expanded.
Productivity
The NHS has a target to deliver a 2 per cent year-on-year productivity gain.
The practice of providing additional funding to cover deficits will end. The government has set a target for the NHS to move into surplus with the majority of providers achieving that by 2030.
Organisations will be asked to prepare robust five-year plans to break the cycle of short-term planning.
The 10-Year Health Plan sets out a comprehensive programme to reshape the NHS over the next decade. At its core are three major shifts: moving care from hospitals into communities, embedding digital tools across the system, and focusing on prevention to improve healthy life expectancy and reduce inequalities. To support these changes, the plan introduces a new operating model that streamlines leadership and governance, alongside workforce reforms designed to improve training, motivation and career development. It also places innovation at the centre of healthcare delivery, harnessing technologies such as data, AI, genomics, wearables and robotics to personalise care and boost productivity. Financial reforms aim to ensure long-term sustainability, with a focus on efficiency, transparency and surplus planning. Together, these measures are intended to modernise the NHS while preserving its founding principles of universal, free care, ensuring patients have greater choice, access and control over their health.
