The 10 Year Health Plan for England

The UK Government's 10 Year Health Plan for England, “Fit for the Future” was published on Thursday 3 July 2025. At the heart of the plan are three strategic “shifts”:

• from delivering care in hospitals to delivering care closer to home, in communities and in primary care
• to digital transformation of service delivery
• from a service treating sickness to one focused on preventing illness occurring in the first place

The plan details how the £29 billion real terms increase in day-to-day spending for the NHS, over the next 3 years (as announced in the Spring 2025 Spending Review) will fund reforms, service improvements and new technology. 

Neighbourhood health services

When announcing the plan the government focussed on the ‘left shift’ to the community, and the plan’s aims to create “a neighbourhood NHS” (see Gov.uk, PM launches new era for NHS with easier care in neighbourhoods, 3 July 2025).

Neighbourhood health centres are expected to house GPs and a range of other healthcare professionals, offering a range of services, and open at evenings and weekends. The plan states these centres will also offer services like debt advice, employment support and stop smoking or weight management services. The government has said neighbourhood health centres will be established in every community, beginning with places where healthy life expectancy is lowest.

The plan also commits to support a return to the family doctor model, make it easier for patients to access GP and dental services, and to increase the role of community pharmacy in the management of long-term conditions.

The plan sets out how the move to a neighbourhood NHS will also provide personalised care plans for all those with complex needs, and introduce access to 24/7 mental health support.

Digital services

The plan states the shift from analogue to digital “will transform the NHS from being a bricks and mortar service to a digitally led one, where patients can access care online and offline 24 hours a day, 365 days a year.” At the core of this shift are proposals for an expanded NHS App, which the plan states will be a full front door to the entire NHS by 2028.

The government state the app will allow patients to book and schedule appointments with their choice of provider, and rate their experience. It is envisaged that the NHS App will also improve communication with healthcare professionals, so patients can receive advice, view their health records, draft care plans, and self-refer to local tests and services. These developments will also include AI ‘virtual assistants’, described as a “doctor in your pocket”.

The 10 Year Health Plan sets out how new technology will liberate NHS staff from administrative tasks, and outlines there will be a new single patient record so patients will not have to repeat their medical history at each interaction with a different part of the NHS.

Prevention

The plan sets out the government’s goal to halve the gap in healthy life expectancy between the richest and poorest regions, while increasing it for everyone, and “to raise the healthiest generation of children ever.”

The government aims to make it easier for people to make healthy choices by introducing:

• healthier sales reporting for large food retailers along with targets for healthier sales
• updated restrictions on the advertising and promotion of less healthy foods
• new information on alcohol labels

The plan also states the NHS will:

• open up access to new weight loss services and treatments to tackle obesity
• introduce new screening programmes

A new operating model for the NHS

The 10 Year Health Plan sets out a new NHS operating model, with a redesigned centre of the system, at the Department of Health and Social Care and other national bodies. The government has said integrated care boards (ICBs) will be smaller and re-focussed on strategic commissioning and population health outcomes, with a new system of “earned autonomy” for providers. This will include a new failure regime to address poor performance, and systems to reward the best performers, at individual and organisational level.

Under this new operating model, the plan envisages greater use of multi-year budgets and financial incentives to enable investment in preventative services, and to achieve better outcomes. The government state that transparency, data and choice will be used to drive performance, with providers and commissioners to be measured against clear metrics and ranked on performance, with that information then provided to patients. Patient reported outcomes, experience and feedback will also be used as key measures of performance, and a new patient choice charter will be introduced.

Other measures included in the 10 Year Health Plan

Measures aiming to improve patient experience and choice are a key theme running through the plan. There is also a focus on several other areas, including workforce strategy and wellbeing, tackling health inequalities, improving quality of care, technological innovation, and the efficiency and productivity of services. Underpinning this, the plan describes a new “financial foundation” for the NHS, with reforms to the way resources are allocated.

The document outlines major changes to local and national health and care organisations, with plans to abolish or relocate a number of bodies involved in planning, regulating and assessing services. Many of these structural changes build on previous announcements to abolish NHS England and reduce running costs of ICBs. Some of these changes to statutory bodies, including the transfer of NHS England functions and changes to ICBs, are expected to require legislative change.

The plan proposes that ICBs re-align boundaries alongside local government changes, with the aim they should cover the same area as strategic authorities “wherever feasibly possible”. It further proposes the abolition of integrated care partnerships, noting that the multitude of local plans and committees have resulted in confusion.

Under the proposed “earned autonomy” for NHS providers, the government says it will "reinvigorate and reinvent the NHS foundation trust (FT) model", with a return to the freedoms for FTs to reinvest surpluses and borrow for capital investment. The plan states the first ‘new FTs’ will be approved in 2026, with an ambition that, by 2035, every NHS provider should be a FT. The government further proposes that the highest performing new FTs will be able to manage the entire healthcare budget for a local population. These FTs will become "integrated health organisations" or IHOs.

Implementation

The publication of the 10 Year Health Plan was not accompanied by a specific implementation plan and further details are expected to emerge in subsequent strategies and guidance, including NHS planning guidance and a new NHS Workforce Plan.

The Secretary of State for Health and Social Care and the chief executive of NHS England have addressed plans for implementation in a number of speeches since the publication of the plan, and in appearances before the Health and Social Care Select Committee. The government has also made a number of further announcements relating to commitments to the plan, including details of 43 areas that will pilot neighbourhood health services (see Gov.uk, Our shared commitment to creating a healthier, fairer Britain, and Millions of people to benefit from healthcare on their doorstep, 9 September 2025).

Initial response to the 10 Year Health Plan

The government’s press release for the plan quoted supportive comments from representatives of several medical royal colleges, associations and charities. Matthew Taylor, chief executive of the NHS Confederation, commented that “our members… are eager to work with the government to help turn this bold vision into lasting change.” He said moving more care into the community is a vital step towards a more preventative, community-based NHS. He also noted the importance of building on successes in local services, and investing in digital and estates (Gov.uk, PM launches new era for NHS with easier care in neighbourhoods, 3 July 2025).

Health and social care think tanks have generally welcomed the ambitions of the plan, and many of its specific policy proposals. However, they have also asked why this plan will succeed when other similar policies under previous governments have not. They also want to know how soon reforms are likely to improve patient experience, given the challenging context of demand and financial pressures, organisational change, and ongoing workforce issues.

Organisations representing NHS staff have raised questions about who will run the new neighbourhood health services and how they will be funded.

In September 2025 the Health Foundation and the BMJ Commission on the Future of the NHS published separate analysis of the government's reform plans. Both share some similar conclusions, welcoming the government’s broad vision for change but noting a lack of detail on how this will happen, and the limited resources to deliver reform. The authors highlight the importance of continuing to engage patients, the public, and the workforce in implementation. The Health Foundation and the BMJ Commission both note improvement to population health will also depend on a cross-government approach to addressing wider structural determinants of health.