The 10 Year Plan: a long-term vision for healthcare 

Later in the Spring, the Department for Health and Social Care will publish a new 10 Year Plan for the NHS in England. We know that it will set out details on how the government will achieve three key ‘shifts’ to modernise the NHS, refocusing attention to neighbourhood care and building a more integrated system to provide lifelong care to the population.  

The three shifts are: 

• Analogue to digital 

• Hospital to community 

• Sickness to prevention 

At its heart, the plan will seek to improve outcomes by leveraging the NHS’s greatest asset: its ability to act as a single, unified healthcare system which empowers teams to deliver neighbourhood care based on local needs. It will likely signal a sharper focus on technology, not just as an enabler, but as an essential pillar of reform.  

It looks like a centralised technology blueprint will emerge to reduce variation in digital maturity and adoption, ensuring that innovations reach patients and clinicians more quickly and consistently.  These variations in technology adoption and usage have grown over several years for a mixture of reasons, including local procurement of technology without full integration, a lack of central capital for national tech procurement and rollout, a lack of capacity within national and local digital teams to implement emerging technology and a lack of scalability for existing technology. 

The 10 Year Plan has been formulated based on the work of eleven focus groups established to look at various areas, including data and technology, research, life sciences and innovation, and accountability and oversight. The plan also considers suggestions by the public and clinicians submitted as part of a consultation found online at change.nhs.uk. Leaked draft reports from some of these focus groups have given an indication of some of the measures which will be recommended within the 10 Year Plan, but many of the details remain unclear at this stage. 

At Feedback Medical, we fully support these three shifts and the wider drive to improve tech maturity across the NHS. However, we would like to see further specific commitments which we believe will bring the best of the NHS to the rest and work with the independent sector to improve services for all. This includes: 

Standardise core technology across settings 

• A unified approach to core infrastructure through a more comprehensive NHS Spine, including a mandated clinical collaboration platform which will help connect fragmented services and support more effective multidisciplinary working across primary, secondary and community care. This will reverse the rise in variation and lack of interoperability, which has grown across and within regions in recent years. To do this will require a system-wide, top-down approach to reform, with support – both logistical and via capital spending – from the centre, with a focus on strategic planning. 

Fund the recovery, not just the system 

• Long-term funding linked to elective recovery targets to promote reductions in referral to treatment times and the elective wait list. Funding models must reflect the practical realities of how waitlists are rationalised and patient journeys improved, such as through the use of straight-to-test pathways, diagnostic enhanced advice and guidance and digitally-enabled interdisciplinary working. 

Build the neighbourhood health service 

• A modern neighbourhood health record, designed in collaboration with the independent sector, to support a truly localised model of care. This record must be underpinned by interoperable technology focused on collaboration, allowing services to be delivered closer to home, fully integrated with all neighbourhood health teams, with visibility across patient pathways. 

We have also heard that the government wants to make the NHS a better customer to the independent sector. We already know that solutions exist to tackle the biggest problems facing the health service, but a lack of engagement from key NHS decision makers, an unwillingness to collaborate with suppliers and slow progression on procurement mean that many innovative solutions die before the NHS ever allows them to see the front line. The 10 Year Plan must set out how the NHS will work more collaboratively to bring solutions to patients and improve services. 

While the 10 Year plan will establish a long-term vision for healthcare, work must commence quickly to implement this vision. With the recent changes to the structure and leadership of NHS England, now is the perfect time to spearhead these reforms.