10-Year Health Plan: technology, operational changes, and a local focus

The Government has released its 10-Year Health Plan, promising to “reimagine the NHS through transformational change that will guarantee its sustainability for generations to come.”

The 10-Year Health Plan offers an insight into how the NHS will enact the Government’s ‘three shifts’ for healthcare – from analogue to digital, from treatment to prevention, and from hospital to community care – and how a ‘neighbourhood health service’ can be established.

This will come about through a new NHS operating model, through “ushering in a new era of transparency,” by creating a new workforce model with “staff genuinely aligned with the future direction of reform,” through a new innovation strategy, and by taking a different approach to NHS finances, the Department of Health and Social Care (DHSC) said.

The plan has come after a wide-ranging public consultation, launched in October 2024, which received over a quarter of a million submissions from the public and those working in healthcare services.

The 10-Year Health Plan notes that currently, 38% of the Government’s budget is spent on the NHS – and that this is expected to increase to 40% by the end of this Parliament.

This means the focus must be on creating value in the money that is spent, the plan said – something that was echoed by healthcare leaders on the ground during June’s NHS Confederation Expo.

New financial modelling will “incentivise innovation, support the flow of money from hospital into community, and reward best practice across the NHS,” the plan outlined, as well as increasing financial stability.

A slew of financial changes include distributing NHS funding more equally on a local basis, so it is better aligned with health needs, and breaking down block contracts so that funding can be realigned towards services being delivered by integrated care boards (ICBs).

The 10-Year Health Plan’s policy paper also notes four ‘big bets’ for ‘the NHS of 2035:’ that health data will be flow securely and seamlessly between patients and their healthcare teams, that artificial intelligence (AI) will act as a “trusted assistant” for every healthcare professional, that personalised health journeys will begin at birth, and that wearable technology will become a patients’ “personal health custodian” – allowing healthcare need to be “proactively identified and care pre-emptively organised.”

What is included in the 10-Year Health Plan?

How the ‘neighbourhood health service’ will be funded

Key to the plan is the creation of a ‘neighbourhood health service,’ designed around community health hubs that will include primary care services alongside nursing and mental health support.

Healthcare is currently “hospital-centric” and detached from communities and care is organised via “multiple, fragmented silos,” the plan says.

The aim is to bring healthcare professionals into communities, creating “patient-centred teams” and ending fragmentation.

A new ‘preventative principle’ will see care being provided as locally as it can be – in patients’ homes if possible, or in a neighbourhood health centre if required. Care will be provided “digitally by default,” and patients will only be seen in hospital if necessary, the plan said.

This will be enabled through a proportion of the NHS budget being directed away from hospitals and into the community, a shift in investment that will take place over the next three to four years, as neighbourhood health centres are established.

A neighbourhood health centre will be established in every community, the plan said. The centres will be open for 12 hours per day, six days per week.

Pharmacists will be given greater responsibility for the management of long-term conditions, whilst the dental contract will be improved to make it more attractive and encourage practitioners to stay within the NHS.

Suggestions that eye care could also be included in neighbourhood health centres have not been confirmed in the plan.

Powered by digital

The plan promises to liberate healthcare staff “from a burden of bureaucracy and administration” through the use of “AI scribes,” and to utilise the large amount of data that the NHS holds to create a digitally accessible healthcare system.

The aim is to ensure quick access to care for those in good health, and to “free up physical access for those with the most complex needs.”

This will “help ensure the NHS’s financial sustainability for future generations,” the plan says.

This will be enabled through the use of a single patient record, which patients will have full access to. The single patient record will place responsibility on every health and care provider to make the information they record about a patient available, the DHSC said. Every provider involved in a patient’s care will have access to the record, avoiding repetition and important information being missed.

The NHS App will offer advice for non-urgent care, allow patients to choose their preferred providers, book their own tests where “clinically appropriate,” and manage their own medicines as well as the care of their children.

Audiology has been confirmed as one of the services that patients will be able to self-refer for through the app.

Continuous monitoring that will allow practitioners to “reach out [to patients] at the first signs of deterioration to prevent an emergency admission to hospital” will also be a focus of the app.

A new Health Data Research Service will also be created, in partnership with the Wellcome Trust.

The use of surgical robots will also be expanded, in line with National Institute of Clinical Excellence Guidelines.

Prevention: smoking, obesity, and a ‘health rewards scheme’

The Government’s third healthcare shift, from treatment to prevention, aims to “halve the gap in healthy life expectancy between the richest and poorest regions, while increasing it for everyone.”

Businesses, investors and local authorities will be key to this effort, the plan said.

The focuses are on tackling smoking, vaping and obesity through greater regulation, and through a rewards scheme to incentivise the public towards healthier outcomes.

Mental health teams in schools will be expanded, and there will be a push to increase the uptake of human papillomavirus vaccinations.

As had previously been reported, a new “genomics population health service” will see all newborns tested for genetic conditions as default.

A new operating model for the NHS

ICB capability will be increased as part of the NHS’ new operating model, in order to make them “the strategic commissioners of local healthcare services.”

A high level of autonomy across local areas is the ambition for the next 10 years, the plan said.

The Foundation Trust model for hospitals will also be updated, with the creation of ‘integrated health organisations’ (IHOs) for the most successful trusts. IHOs will “hold the whole health budget for a defined local population” and are expected to become operational by 2027, with the first trusts being designated next year.

Private sector collaboration with the NHS will continue, the plan confirmed, and will be expanded in the most deprived areas of the country.

As noted by those close to the plan during the NHS Confederation Expo, there will also be a focus on creating closer partnerships with local services as part of the development of the neighbourhood health service.

A focus on transparency in care will see league tables rank healthcare providers against key quality indicators, reform of the complaints process for patients and of the National Quality Board, and the ability for providers to make additional financial payments to clinical teams that have high clinical outcomes and excellent patient feedback.

Optometry in the 10-Year Health Plan: best practice highlighted

The use of Ophthalmic Community Link in Gloucestershire was highlighted in the 10-Year Health Plan as an example of best practice in terms of innovation.

Community Ophthalmic Link allows optometrists in the community to seamlessly share digital images, including any optical coherence tomography or visual fields that a patient might previously have had taken, with secondary care. The ICB-commissioned service has been in place in optometry practices in Gloucestershire since late 2022.

“The NHS in Gloucestershire has significantly advanced the shift of eye care from hospitals to neighbourhood settings,” the 10-Year Health Plan recognised.

“Hospital eye care records and images are shared with primary care optometrists, such as those working in Specsavers. This has reduced unnecessary hospital referrals, led to a 14% reduction in waiting lists, and improved convenience for patients.”

The plan added: “Where there is such rapid innovation taking place today in how services can be transformed through advances in science and technology, we want to broaden the eco-system of providers.”

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Community Ophthalmic Link

Karen Gennard, optometrist at Norville Independent Eyecare, on an ICB-commissioned software that is revolutionising digital image sharing in Gloucestershire

What is missing from the 10-Year Health Plan?

The Health Service Journal (HSJ) noted that a previous draft of the plan has included a chapter on delivery, which had been written by former health secretary, Alan Milburn.

The chapter was not included in the version of the plan that was published today (Thursday 3 July).

The chapter was likely to have “focused heavily on the immediate tasks,” the HSJ reported.

The publication suggested that the delivery of the plan could be outlined in NHS England planning guidance for 2026–2027, which could be published as early as September.

The AOP view: “Optometry may finally get the recognition and investment it deserves”

The AOP welcomed the 10-Year Health Plan’s ‘neighbourhood-led shift,’ but emphasised that investment in primary care will be needed in order to deliver results for patients.

Adam Sampson, chief executive of the AOP, called the plan an “essential reset,” and asked the Government to prioritise the public’s access to eye care as part of its commitment to delivering a neighbourhood health service.

“Reform of the NHS is critical to its survival – and to ensuring the public get the care they need, when they need it,” Sampson said.

“That’s why we welcome the Government’s Plan. It is a necessary starting point to address the waiting lists, the postcode lottery of care, and the health inequalities that are collectively eroding the public’s trust in the NHS.”

He added: “Greater emphasis on prevention and community-led care is not only essential – it is the right direction for delivering better outcomes for patients and future-proofing our healthcare system.”

Sampson emphasised that “a neighbourhood-led approach must be the cornerstone of change” and is “the only way to ensure hospitals can focus on the services only they can offer, while ensuring patients receive specialist, timely care.”

Eye care has strong potential to embody this change, Sampson noted.

“Nowhere is this shift more evident – or has more potential – than in eye care,” he said.

He added: “The transition of services from hospital clinics to community optometry has already proven its value in Wales, Scotland and in parts of England, including Gloucestershire.

“The plan needs to be the firing gun for an essential reset, ensuring eye care services are available everywhere in England: a fairer system, based on need, not postcode.”

Investment in existing primary care services is essential in “supporting community-led optometry and our colleagues across pharmacy, dentistry and GPs – to deliver essential care for patients, closer to home,” Sampson said.

The plan needs to be the firing gun for an essential reset, ensuring eye care services are available everywhere in England: a fairer system, based on need, not postcode

He also noted that a large amount of work needs to be done “to ensure the plan transitions from theory into the practical steps of delivery.”

“We look forward to working with the Government, NHS leaders, and other stakeholders to ensure that community-led eye care plays a leading role in this transformation,” Sampson said.

Dr Peter Hampson, AOP policy and clinical director, added that there is strong evidence that moving eye care services into the community works, and that this is seen through reduced waiting times and less pressure on secondary care.

He also noted that moving eye care into the community is cost-effective for the NHS, and delivers high-quality care for patients.

“As a sector with a proven track record of delivering care closer to home, we believe community optometry must be the first port of call for the public’s eye health and eye care,” Hampson said.

“If the Government is serious about real transformation, connecting community optometry with neighbourhood health teams must be a priority.”

He added: “We will be closely reviewing the Government’s Plan in detail to assess its impact on eye care. This includes evaluating any areas of concern for members.”

These considerations will include how commissioning responsibilities for community services are organised in order to reduce ‘postcode lotteries.’

Hampson emphasised that: “Without national consistency, there is a risk that patients will continue to face fragmented care depending on where they live. We need a solution that looks forward, with primary care services front and centre – not backwards, reinventing old systems that did not work.”

However, Hampson noted that “there is also much to be positive about” in the 10-Year Health Plan.

“The plan’s emphasis on digital innovation and prevention presents real opportunities for primary eye care,” he said.

“The explicit reference to integrating community-based professionals is a welcome sign that optometry may finally get the recognition and investment it deserves.

“Optometry is ready to play its part in delivering a modern NHS where care is closer to home, and patients come first.”

A fundamental rewiring of the NHS

Speaking about the release of the 10-Year Health Plan, Prime Minister Keir Starmer said that the UK healthcare system currently has a “sticking plaster” approach that is “unable to face up to the challenges we face now, let alone in the future.”

“That ends now. Because it’s reform or die. Our 10-Year Health Plan will fundamentally rewire and future-proof our NHS so that it puts care on people’s doorsteps, harnesses game-changing tech and prevents illness in the first place,” Starmer said.

Patients will have access to GPs, nurses and other healthcare services “all under one roof in their neighbourhood – rebalancing our health system so that it fits around patients’ lives, not the other way round,” he added.

Starmer acknowledged that the 10-Year Health Plan does not represent “an overnight fix,” but emphasised that NHS waiting lists are at their lowest level for two years under the current Labour government.

Health and social care secretary, Wes Streeting, added that the 10-Year Health Plan would help to shift care from hospital to community, reducing waiting lists and stopping patients “going from pillar to post to get treated.”

The aim is “keeping patients healthy and out of hospital, with care closer to home and in the home,” Streeting said.