The government’s new 10-year NHS plan, published on July 3rd but not coming into force until 2026, is a significant document, and one that may change the NHS and healthcare in England substantially. It may even save it from the brink of disaster, if some commentators are right. 

The plan’s three main pillars are:

•    hospital to community
•    analogue to digital
•    sickness to prevention

3 Radical Shifts: FPM Explains the Headline Measures

Hospital to community:

• NHS becomes the Neighbourhood Health Service. To facilitate this, the pattern of health spending will change: less expenditure on hospitals, more on care outside of hospital, over the next 3 to 4 years. 
• The NHS App will be used much more to let patients book appointments, talk to professionals and self-refer to local services. 
• Every community will have a neighbourhood health centre – a one-stop-shop for patient care and MDTs, open 6 days a week, 12 hours a day
• increased role of community pharmacy in management of long-term conditions and linked to a Single Patient Record
• £120 million for dedicated emergency mental health centres

Analogue to Digital:

• The digital revolution will be harnessed, and NHS moves ‘From bricks to clicks’ – patients get control over single, secure account of their data 
• By 2028, the app will be a full front door to the entire NHS – patients will be able to choose their preferred provider, and book tests directly (where clinically appropriate) with in-app consultations
• Single sign-on for staff, with increased use of tech like AI scribes to liberate staff from current burden of bureaucracy and administration

Sickness to Prevention: 

• A ‘moonshot’ will be launched to end the obesity epidemic; restricted junk food ads, bans on energy drinks, reform of soft drinks industry, and a world first: mandatory health food sales reporting for all large food companies.
• Citizens encouraged to play their part, including through new health reward scheme to incentivise healthier choices
• ICBs helped to establish Health & Growth Accelerators models to help people find and stay in work
• A new genomics population health service, accessible to all, by the end of the decade 

What Other Changes Should I Expect?

• Two new GP contracts – an alternative to the partnership model:
  • Single neighbourhood providers: delivering enhanced service for patients with similar needs (a neighbourhood is defined as c.50,000 people). The current PCN system is set up to act as a sort of springboard for this way of working.
  • Multi-neighbourhood providers: these aim to deliver care to larger cohorts of around 250,000 people across different neighbourhoods, and across all GP practices and providers.
• Patients get patient choice charter, letting them decide how and where they get their care; there will also be a trial of patient power payments aimed at linking certain funding to patient satisfaction); and making more data on performance and quality public, aiding transparency and public accountability. 
• Investing in our future workforce – with focus on local talent and clearer career paths:
  • Stronger, fairer leadership: new college of Executive and Clinical Leadership to make sure leaders have the necessary skills, are paid more fairly, and are retained better
  • Personalised, better-supported careers: every NHS staff member will have a personal career plan with flexible pathways so they can move between specialisms if necessary; new mentoring programmes to matchmake experienced and new staff and aid retention
  • Focus on local - not overseas - talent: the NHS aims to keep reliance on overseas staff to below 10% by 2035 – they will do this by bringing in new apprenticeship and medical school places in the communities that need them most, and channelling funding to coastal and rural communities where staff shortages are most acute
  • AI tools to free up time: summarising clinical notes automatically is one way these tools could help; and simpler, better-connected systems reduce sign-ins and speed things up
  • New advanced roles: the aim is to shift work out of hospitals and into the community by funding more nursing consultants, community health leads and specialist clinicians.

Analysis: Reading Between the Lines

Less is more

In terms of workforce, interestingly the 10-year plan predicts fewer staff than were being planned for in 2023’s long term workforce plan. The earlier estimate was that headcount should be increased by 60% by 2037, but this month’s plan regards that as unworkable. As the plan puts it:

“On that trajectory, by the turn of the century, every single working age adult would be working in health and social care. This future is a fiction, and we reject it.”

The shift is due to a change in focus; asking not ‘how many staff are needed to make the current model workable’, but rather ‘how many will the new ways of working require?’ Though there will be fewer staff, they will (hopefully) be better trained and more motivated.

Getting rid of the bodies?

More than 200 NHS bodies and organisations are going to be abolished, including Healthwatch England and Integrated Partnerships. NHSE has also gone. But some observers have pointed out that though unpopular, some of these so-called ‘quangos’ have taken on important roles which now risk becoming underserviced. Innovation is certainly the new watchword, with predictions that we could see GPs running hospitals, nurses leading neighbourhood providers or acute trusts running community services.

Good ‘on paper’ but where are the PMs?

Many seasoned commentators have noted that in amongst the plans for bringing more services into the community, there is little mention of GP Practice Managers. The Institute of General Practice Management is meeting the health and social care committee later in July to urge them to recognise primary care management as a core leadership role, properly funded, within neighbourhood teams.

No room for Heidi?

There has been confusion about which ambient voice tech should be used, and how, to avoid liabilities. Mid and South Essex ICB advised their staff to appoint a CSO (Clinical Safety Officer) before introducing AI voice technology and that many packages such as Heidi are not suitable (though Heidi has said no scribe tool meets all requirements). Some observers have been exasperated that the health secretary is rolling out AI but ICBs seem to be trying to stamp it out where possible.

CQC Rapid Response Based on AI

There have been some raised eyebrows at the news that the CQC will instigate “rapid response inspections” based on prompts they will receive form a new AI-driven warning system. Whether this measure succeeds in restoring the lost credibility identified in last year’s Dash report remains to be seen.

Get ahead of the curve by upskilling your staff to lead the future NHS: we offer ILM qualifications and have a 25% discount on all UK-wide ILM 3 and 5 running this September. Contact our advisor Helen Murray on 07764.370.881 or helen@firstpracticemanagement.co.uk