2025 has been a year of contrasts for the NHS. On one hand, we witnessed record access, survival rates at new highs, and community alternatives that gave patients dignity close to home.

November 2025 has brought a flurry of announcements, actions, and arguments that reveal not just the state of the NHS—but the state of our national priorities.

The NHS’s 10-Year Plan, Fit for the Future, launched in July 2025, and updated September 2025, promises transformation: more prevention, less hospitalisation, better digital infrastructure, and stronger community care. But beneath the ambition lies a structural flaw—one that no oversight, framework or winter planning letter can fix.

Recent developments around childhood vaccinations—both in the UK and the US—have stirred concern. Some are reassuring, others troubling. As someone who spent years in public service, I find myself reflecting not just on the data, but on the shifting attitudes beneath it. What’s at stake here isn’t just immunisation—it’s trust, responsibility, and the quiet dignity of collective care.

The NHS waiting list in England has now reached 7.4 million appointments—an astonishing figure that’s hard to absorb until you realise it represents over 6 million individuals, each with a story, a condition, and a hope for care. 

The newly released NHS England Patient Charter—You and Your General Practice—is now live on the NHS England website. It outlines what patients can expect from their GP practice, and what practices ask of patients in return. As part of the 2025/26 GP contract, it must be displayed on all practice websites by 1 October 2025.

After more than 20 years as a Practice Manager across three very different NHS practices, I finally retired earlier this year. Having spent years contributing articles and shaping policies for FPM, I once imagined retirement would leave me restless—struggling to fill the time I once devoted to work. But, as many before me have discovered, life quickly finds ways to fill the gaps.

I have now been retired for a couple of months and have adapted to the change surprisingly well—far better than I initially expected.

FPM's Secret Diarist (and recently retired practice manager) gives their thoughts on a possible end to the 8am scramble, and recent votes in Parliament on NI changes (written prior to announced abolition of NHSE). 

FPM's Secret Diarist and anonymous Practice Manager has taken the tough decision to retire after decades of working in primary care. Here they share their thoughts on retirement and the future.