The NHS 10-year plan will see ‘the majority of outpatient care’ moved outside of hospitals and into the community by 2035, the Prime Minister has announced. This will reduce pressure and demand on hospitals and allow secondary care teams to focus on specialist care, supported by technology, to improve productivity.
Sir Keir Starmer set out the details of the highly anticipated 10-year plan for the NHS – largely focusing on the Government’s ambitions for a Neighbourhood Health Service.
As part of this, he confirmed the launch of new neighbourhood health centres, which will ‘eventually’ be open 12 hours a day, six days a week within local communities.
These centres will bring ‘historically hospital-based services into the community’, including diagnostics, post-operative care and rehabilitation. They will also provide services such weight management, stop smoking, debt advice and employment support, according to the 10-year plan.
The aim is to ‘provide easier, more convenient access to a full range of healthcare services right on people’s doorsteps – stopping them from having to make lengthy trips to hospitals,’ the Government said.
‘Neighbourhood teams will include staff such as nurses, doctors, social care workers, pharmacists, health visitors, palliative care staff and paramedics.’
Community workers and volunteers will also ‘play a pivotal role in these teams’.
Supporting productive, specialist hospital care via the 10-year plan
With this shift from hospital to community, the Government aims to ‘enable hospitals to focus on providing world class specialist care to those who need it’, highlighting that ‘small amounts of community expenditure can unlock disproportionate amounts of hospital capacity’.
It is hoped that by reducing the demand and pressure on hospitals, they will ‘do less firefighting’ and ‘have greater means to boost productivity through technology and artificial intelligence (AI)’.
To this end, the ‘Fit for the future’ 10-year plan promotes healthcare digitisation, advocating for increased AI-assisted diagnosis, comprehensive digital records, consultant-led advice and guidance in more specialties, and a much bigger focus on the NHS App.
Over time patients will be able to use the NHS App to request follow-up or update their clinicians on their condition to get ‘faster, more accurate decisions’ through a virtual service, as well as being able to digitally book, move and cancel appointments.
In April, the Department of Health and Social Care announced that the NHS App had been adopted by 87% of hospitals in the UK, saving 1.26 million clinical hours since July 2024.
The 10-year plan states that the long-term ambition is for digital technology, community care, predictive analytics and greater operational efficiency to optimise patient flow and discharge and mean long waits in emergency departments ‘are no longer the assumed default’.
And when it comes to the workforce, the plan outlines the Government’s ambitions to ensure more streamlined and predictable pathways are in place for both ‘experienced specialty doctors to develop and operate at a specialist level’, as well as ‘experienced doctors to obtain the registration to become a consultant’.
‘Rewire and future-proof our NHS’
Announcing the ‘Fit for the future: 10-year health plan for England’, Sir Keir said: ‘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.
‘That means giving everyone access to GPs, nurses and wider support all under one roof in their neighbourhood – rebalancing our health system so that it fits around patients’ lives, not the other way round.’
And he pledged that patients would have ‘easier, quicker and more convenient care, wherever they live’.
‘Of course hospitals will always be important – for acute services especially. But… disease has changed and we must change with it. And not only can we do that, we can do it in a way that improves care and convenience for millions of people,’ the Prime Minister added.
‘The future of healthcare is no longer defined by top-down citadels of a central state, but is instead, in your home, in your community, in your hands.’
Clinicians respond to the NHS 10-year plan
Responding to the announcement, leaders from across acute care and beyond have welcomed many of the commitments outlined in the 10-year plan. But they warned that adequate financial and workforce investment, and robust implementation, will be required to realise the full potential.
The Royal College of Physicians (RCP) responded favourably to the Government’s commitments to expand specialist training places, improve the NHS working environment and tackle ill-health through action on tobacco and obesity, as well as the hospital to community shift.
Dr John Dean, RCP clinical vice president said: ‘The RCP has long called for a shift toward community-based care that is backed by robust policies and investment. [This] commitment to redesigning outpatient services is exactly what we called for in our Prescription for Outpatients report.
‘We welcome the introduction of neighbourhood health centres across every community in England. But this shift must not be seen as simply about buildings – it’s about how clinicians and patients work together across traditional boundaries to deliver joined-up, person-centred care. Specialists have a vital role to play in neighbourhood health, and we must ensure they are supported to work across settings as part of integrated teams.’
RCP president Dr Mumtaz Patel, added: ‘Delivering this vision will only be possible with a medical workforce that is adequately resourced to meet demand, feels supported, valued and is equipped for the future.’
And he noted that noting that ‘AI and tech alone won’t solve the problem of capacity’.
‘A vital opportunity’ to reimagine care
Giving his initial reflections on the NHS 10-year plan, president of the Royal College of Paediatrics and Child Health Professor Steve Turner, said it offers ‘offers a vital opportunity to reimagine how we deliver care to children and families’.
‘I’m really pleased to see the plan emphasise prevention, early intervention and integrated care. Embedding paediatric expertise within neighbourhood health teams, alongside mental health professionals, health visitors and community workers, could be transformative for children – especially those with complex or long-term conditions,’ he said.
‘Fundamentally, the success of this plan will also depend on sustained investment in the paediatric workforce. Children’s needs are unique, and these new models of care must be underpinned by adequate staffing, training and support for professionals working in community settings, alongside equitable funding between children’s and adult’s services.’
Just rearranging deck chairs on a sinking ship?
BMA council chair Dr Tom Dolphin said: ‘The success of the plan, and whether it will improve patients’ care and the public’s lives, will hinge on whether it genuinely addresses the workforce shortages, and values and empowers professionals on the front line, or just rearranges deck chairs on a sinking ship.’
Dr Dolphin continued: ‘The plan must demonstrate the Government truly values the clinical leaders who dedicate their lives to saving lives, and improving and protecting the nation’s health. They cannot do this on the cheap or by filling gaps with lesser qualified staff.
‘As for neighbourhoods, there’s no doubt that early intervention is better – and prevention is better than cure – but the shift from hospitals to communities cannot happen overnight and without a detailed plan on resourcing it properly. Done too quickly and without thorough thought it risks heaping pressure on both hospitals and primary care by taking resource away from one while piling work on to the other.’
And he added: ‘If this plan is to be as ambitious and transformative as the Government would have us believe, it needs the backing of staff and any changes must be implemented in genuine partnership with workers on the frontline.’
‘The hard work starts now’
Matthew Taylor, chief executive of the NHS Confederation, said the NHS 10-year plan was a ‘vital step’ towards a more preventative, community-based NHS.
‘Bringing care closer to people’s homes through blended neighbourhood health teams recognises the complex and interconnected challenges many patients face, and it is the right direction for both improving outcomes and alleviating pressure on hospitals,’ he said.
‘Delivering on this ambition will require sustained investment in digital and estates, support for the NHS’s workforce, and a commitment to decentralise national control by empowering local leaders to do what is best for their populations. On behalf of our members, we are eager to work with the Government to help turn this bold vision into lasting change.’
Daniel Elkeles, chief executive, NHS Providers, said: ‘The hard work starts now. The focus must be now on how health services make this plan’s bold ambitions a reality and turn the tide on falling public satisfaction with the NHS.
‘NHS Trust leaders support the Government’s three ‘shifts’ and ambitions. A joined-up, tech savvy NHS, working with partners and with cross-government support, can make the long-term changes that the heath of the nation and economy need.’
He added: ‘The plan acknowledges too the major pressure which many parts of the NHS – including mental health services and urgent and emergency care – are under today. While the Government’s plan includes support for new ways of investing in buildings, equipment, facilities and digital technology to boost productivity and to give patients the best care possible, it will take time and resources to put these new structures in place.’
Other details of the NHS 10-year plan were previously unveiled, including plans to increase patient access to information and streamline patient access to clinical trials through the App. Last month, it was announced that all ‘appropriate’ messages will be sent via the NHS App within the next three years.
The plan also states that personalised care plans will be developed for the majority of complex patients within two years.
