10 Year Health Plan for England: fit for the future
Learn more about the Government's 10 year health plan for England
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10 Year Health Plan for England: fit for the future
The Government’s 10 Year Health Plan for England has been launched, setting out a bold, ambitious and necessary new course for the NHS.
The plan fundamentally reinvents our approach to healthcare so that we can guarantee the NHS will be there for all who need it for generations to come.
It has been shaped by the experiences and expectations of members of the public, patients, our partners and the health and care workforce across the country, reflecting the changes that people wanted to see.
The plan includes three ‘shifts’:
- from hospital to community
- from analogue to digital
- from treatment to prevention
Through these shifts we will personalise care, give more power to patients, and ensure that the best of the NHS is available to all.
Understanding more about the chapters of the plan
Chapter 1: From Hospital to Community
The Neighbourhood Health Service will bring care into the places people live and abolish the default of a ‘one size fits all’ care. It will also transform access to general practice and prevent unnecessary hospital admissions.Key ambitions in this area include:
An end to the 8am rush through the training of thousands more GPs and embedding of AI technology /digital telephony to improve patient access
New GP contracts to create single and multi-neighbourhood providers (from next year) and multi-professional neighbourhood teams organised around groups with most need (in the next 3 years).
On the high street with Neighbourhood Health Centres in every community, pharmacy offering more clinical services and prevention, increased numbers of NHS dentists and improving access to dental care for children and a focus on prevention through genomics technologies, diagnostics and predictive analytics.
A patient initiated follow up as a standard approach (by 2026); embedding ‘advice and guidance’ in many more specialities (over the next 10 years) to reduce the need for patients to travel for appointments; as well as expanding the use of AI-enabled digital diagnostic tools across specialties.
Enabling patients to self-book into A&E (via the NHS App or 111) before attending, enabling clinical triage in advance and redirection if appropriate (by 2028) and Mental Health Emergency Departments co-located or close to 50% existing Type 1 A&E units (over the next 5 years).
Working with NHS providers, universities, and community groups to co-develop research that addresses real-world needs.
Chapter 2: From Analogue to Digital
We will create the most digitally accessible health system in the world, where patients have a ‘doctor in their pocket’ to provide 24/7 advice and guidance and staff are liberated from the NHS’ archaic systems. Key ambitions in this area include:
We will transform the NHS App to become the front door to the NHS, and the tool to organise care around patient needs, choices and schedules. Through the app, patients will be able to get 24/7 AI-enabled advice, book appointments, leave feedback, choose their provider, manage their medicines and their children’s health (by 2028/29).
We will build a ‘HealthStore’ to enable patients to access approved health apps to manage or treat their conditions, enabling innovative SMEs to work more collaboratively with the NHS and regulators.
We will give patients real control over a single, secure account of their data and enable more coordinated, personalised and predictive care. It will improve clinical outcomes, make decision-making more informed and speed up the delivery of care.
We have identified three areas of proven technology that are already in use in some areas of the NHS, can be scaled quickly, and have a specific promise in boosting clinical productivity. These areas focus on improving the quality of patient interactions through more accessible information, embracing ambient AI to release time to care, and building a new platform for proactive, planned care.
Chapter 3: From Sickness to Prevention
People are living too long in ill health, the gap in healthy life expectancy between the rich and poor is growing, and we have an obesity epidemic with nearly one in five children leaving primary school obese. Key ambitions in this area include:
The Tobacco and Vapes Bill will mean that children turning 16 this year or younger can never legally be sold tobacco, we estimate that the benefit of this policy will reach £6.6 billion in NHS savings, and we will go further by introducing deterrents to prevent young people from taking up vaping.
We will tackle the obesity epidemic, for children we will update school food standards and reduce junk food advertising aimed at children. We will move to a smarter regulatory landscape by setting new mandatory targets to increase the healthiness of sales in all communities and work with the Food Strategy Advisory Board on sequencing. We have established a pioneering industry collaboration to test innovative models of delivering weight loss services and treatments to patients and will launch a national campaign aimed at encouraging people to move more.
We will support people to make healthier choices by giving consumers more information about the health risks of alcohol consumption.
Expansion of the Mental Health Support Teams in schools and new Young Future Hubs will provide additional support for children and young people’s mental health.
Patient employment goals will be part of care plans and local NHS services targets will be set for reducing unemployment and economic inactivity.
We will do far better at taking the immediate opportunities available to deliver prevention: vaccination, screening and early diagnosis. Second, looking to the longer-term, we will create a new genomics population health service, to harness the potential for predictive analytics to support more personalised and precise prevention in the future and thirdly we will tilt NHS incentives towards population health outcomes.
Chapter 4: A devolved and diverse NHS: a new operating model
The new operating model will devolve power from the centre to local providers, frontline staff and patients.
Integrated Care Boards will be strategic commissioners of local health services, including neighbourhood health services, with a focus on population health outcomes and financial sustainability.
Where local providers perform well, they will have greater autonomy and flexibility to develop services free from central control. Our ambition over a 10-year period is for high autonomy to be the norm across every part of the country by authorising a new wave of NHS Foundation Trusts (FTs) in 2026. By 2035, we want every NHS provider to be an FT.The most mature, high performing organisations will be designated Integrated Health Organisations, taking responsibility for the health (and budget) of a whole population.
We will use multi-year budgets and financial incentives to enable investment in population health outcomes, not just into inputs and activity. Resources will be tied to outcome-based targets, which all commissioners and provides will have a responsibility to help meet.
ICBs will be supported to shape the provider landscape to encourage innovation, including the use of the VCSE and Independent sectors.
A new partnership with local government to develop neighbourhood health along with other local partners and a stronger role for Strategic Authorities as ICB board members.
An end to bureaucratic planning process with a much simpler set of requirements – a strategic commissioning plan for ICBs and a neighbourhood health plan for local partners at single or upper tier level. We will also see the abolition of Integrated Care Partnerships.
A rules-based approach to managing failure with targeted support and an emphasis on supporting organisations to manage their own sustained improvement as quickly as possible. For our leaders, good work will be rewarded and NHS providers should be able to reward clinical teams that provide high quality care.
A new Choice Charter for patients will be introduced to put power in the hands of patients. This will start in the areas of highest health need.
Chapter 5: A new transparency of quality of care
The plan will usher in a new era of transparency, a focus on high-quality care for all and a renewed focus on patient and staff voice to prevent the worst cases of neglect, drive up quality and support our mission to make progress on the biggest killers.
Publish easy-to-understand league tables, ranking providers against key quality indicators. Improve response times to patient safety incidents and complaints by expanding use of AI tools to support faster collection of complaints data. Pilot rapid response teams in 2026/27 to act quickly and decisively for those who have concerns about the care they are receiving. We will set up a national investigation into NHS maternity and neonatal services to provide accountability for impacted families and drive urgent improvements to care and safety
Revitalise the National Quality Board (NQB) in 25/26 and task it with developing a new quality strategy, overseeing quality measurement. All providers will be given flexibilities to make additional financial payments to clinical teams that have consistently high clinical outcomes and excellent patient feedback or are significantly improving care, under a new framework.
Moving CQC’s operations to an intelligence-led model and giving it expansive new access to data. CQC will provide verbal feedback at the end of inspections, with written feedback within 2 days outlining any significant concerns. A reformed DHSC will also incorporate the functions of Healthwatch England to put patient voice at the heart.We will introduce new tools on NHS.uk and through the My Choices tool in the NHS App to make it easier for patients to access and interpret quality measures. The new Maternity Outcomes Signal System (MOSS) system for maternity will be in place across trusts from November and will use near-real time data to indicate higher than expected rates of stillbirth, neonatal death and brain injury. And we will establish a national AI-led warning system building on the capabilities in the Federated Data Platform (FDP) to analyse data to identify where quality issues are emerging in parts of the NHS
Chapter 6: Workforce
The plan will create a more realistic size and shape of the workforce, that enjoy and feel valued at work and are well equipped to care for patients in 21st century.
- The 10 Year Workforce Plan will set out training, education and retention of the workforce and the general shape of the workforce that will deliver our new models of care.
- Minimum standards for modern employment in the NHS will be developed with the Social Partnership Forum, covering access to nutritious food and drink, reducing violence against staff, tackling racism and sexual harassment, standards of ‘healthy work’ and occupational health support, and support for flexible working.
- Reduce the dependence of the NHS on international labour to less than 10% of new recruits by 2035.
- Prioritise UK medical graduates for foundation training and UK medical graduates and other doctors who have worked in the NHS for a significant period for foundation and specialty training by 2035.
- Working with trade unions and employers to maintain, update and reform employment contracts and start a conversation on significant contractual changes that provide modern incentives and rewards for high quality and productive care (by 2035).
- NHS employers will have new duties by 2035 to consider how they employ those in the local area, including employing and training those in poverty or unemployment to take up appropriate roles.
- By 2030 regulators will review curricula to ensure that those joining the workforce have the skills to deliver the three shifts and drive our new model of care.
Chapter 7: Powering transformation: innovation to drive healthcare reform
- Signal intent on five ‘big bets’ – transformative technologies that will drive our new model of care by aligning research, investment and innovation: Data to deliver impact: Allowing data to flow seamlessly and securely to deliver better care, and supporting UK companies to apply their skills to solving health problems.
- AI to drive patient power and productivity: New regulatory frameworks for AI and software as a medical device by 2026 and significant investments in AI infrastructure.
- Genomics and predictive analytics for pre-emptive, personalised care starting at birth: Build on expertise of the NHS Genomic Medicine Service to develop a unified genomic record, integrating patient genomic data with clinical data in near real-time.
- Wearables to make care ‘real-time,’: By 2035 wearables will be standard in preventative, chronic and post-acute treatment, with data connected to the NHS App and integrated with SPR. We will make remote monitoring standard for cardiovascular disease (by 2028).
- Robotics to support precision: to transform care and service delivery and automate operational processes in and out of hospitals. We will introduce national registries for robotic surgery data and developing telesurgery networks (from 2029)
- Establish new Global Institutes to become world leading centres of excellence in research and translation and create Regional Health Innovation Zones to give systems new freedoms to experiment, test and generate evidence implementing innovation.
- Improve the research environment, speeding up clinical trial set-up times to <150 days (by March 2026), publishing monthly scorecards on site level trial performance.
- Invest in innovative medicines: we will spend more on medicines over the course of this plan, particularly those that help keep people out of hospital. we will also speed up the way NICE evaluates certain medicines used to treat multiple conditions and simplify the way the NHS negotiates prices for such medicines.
- Future proof our regulators: MHRA and NICE will launch parallel approvals for medicines, supported by joint scientific advice and information sharing to speed up patient access (by April 2026).
- Move to a Single National Formulary (by 2028), expanding to HealthTech (by 2030) to improve efficiency.
- Expand NICE’s Technology Appraisal process via a new Rules Based Pathway for MedTech (2026), create a digital marketplace to procure technologies and create an ‘innovator passport’ to reduce bureaucracy (by 2026).
Chapter 8: A new financial foundation
We will move to a system of value-based healthcare where spending and incentives are aligned to what delivers the best outcomes.
For the next 3 years the NHS has a target to deliver a 2% year on year productivity gain. Two-thirds of outpatient appointments – which currently cost £14bn a year – will be replaced by automated information, digital advice, direct input from specialists and patient-initiated follow ups as we introduce a new digital front door to the NHS via the NHS App. We will also free up more staff time to care for patients via adoption of new technologies like ambient voice technology to free staff time.
We will end the practice of providing additional funding to cover deficits and introduce a transparent financial regime.
We will dismantle block contracts, where providers receive the same money irrespective of how many patients they see. We will change this to only pay providers for effective care which has been commissioned by an ICB – and to withhold payment for poor quality care and/or pay a bonus for high quality care. To support the shift of care away from hospital settings towards neighbourhood care, we will ensure that there is a higher growth in investment in primary and community services than in hospitals. We will also test the development of year of care payments; this new payment mechanism will be calculated according to the health needs of the population being served and will allow providers to invest in high-quality, proactive, planned care for patients. We will test a new payment mechanism which give patients the power to hold back some of the payment if not satisfied with a service. These changes will be reflected in a new financial framework which will be published later this year.
We will introduce long-term strategic planning through multi-year allocations that will give people greater certainty, shifting the balance from national control to more local decision-making. We will speed up delivery through quicker and more streamlined approvals processes. And drawing on the 10 Year Infrastructure Strategy's commitment to consider the use of Public Private Partnerships (PPP), we propose a new programme to support establishing a Neighbourhood Health Centre in every community across the country.
How our north east London communities contributed to the 10 year plan
From December 2024 to February 2025, people across the country were invited to contribute to the NHS Change discussions on a 10-year Health Plan for England. You can read our report on how we engaged with north east London communities.
It was important to offer local people from north east London an opportunity to contribute to this conversation, and so we hosted seven workshops within each of our Places to ensure engagement from each borough across the area. Using the People’s Panel, we invited existing members to join workshops and invited partner organisations to promote the sessions, which saw new sign ups to the People’s Panel. Participants in the sessions were diverse in terms of ethnicity and disability, however, most participants were over the age of 45 and there was an over-representation of women, in comparison to other genders.
Workshops focussed on looking at people’s vision for health and care in the future, as well as investigating residents’ thoughts and ideas on the three focus areas or ‘shifts’ identified by the Government. Each group were asked to identify which of the following shifts they were most interested in discussing:
- Moving more care from hospitals to communities
- Making better use of technology
- Preventing sickness, not just treating it
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