Five big questions surrounding delivery of the 10-Year Health Plan

While the ambition in the Government’s publication of its much-anticipated 10-Year Plan for the NHS is clear, it reads more as a broad vision for the future direction of health service reform than a concrete roadmap. With many of the proposals echoing past reforms that struggled to gain traction, the key question now is whether this renewed vision will be matched by what is needed to truly make it a reality. 

Here are five challenges that will help determine whether this plan is successful on the ground, or will become another in a long list of past NHS reform plans gathering dust. 

1. The proposals lack detail on how they should be implemented within the system 

The plan sets out bold ideas for what the NHS is hoping to deliver, including neighbourhood health centres, digital access, personalised care, but is light on the specifics of how these will be delivered. Unlike previous strategies, this plan doesn’t come with significant new funding or staffing commitments – it’s unclear how comprehensive the Government’s refresh to the NHS Workforce Plan expected later this year will be.  

In reality, delivering this vision will require tough choices, and the Government must be honest about these with the public, NHS leaders, and frontline staff. A dedicated implementation plan is expected to be published later this year (with reports of this chapter being removed just before publication last week), but with Labour counting on delivering NHS improvements as a key political win – the process of reform needs to begin urgently.  

2. The Neighbourhood Health Centre model needs more than co-location 

Central to the plan’s vision is a shift towards local hubs designed to bring services closer to home. But looking to past reform work, we know that simply putting different professionals in the same building isn’t enough. The model is similar to the “polyclinics” proposed by Lord Darzi in 2007, which struggled with a lack of funding, local buy-in and clarity of purpose.  

With the new plan currently lacking detail on infrastructure funding, timelines, or how to ensure neighbourhood care teams work as one (especially with multiple organisations involved), time will tell whether the model in Wes’s plan will have a more successful fate. 

3. Not another reorg. NHS workforce morale and fatigue risk slowing progress 

The plan expects the NHS workforce to deliver fundamental transformation – yet provides little by way of solution to repairing existing challenges. Morale remains low, with burnout, pay disputes and staff feeling undervalued – resident doctors have this week voted in favour of further strike action.  

While the plan gestures toward leadership support and flexibility, it doesn’t directly address issues related to workload pressures, contract reform or pay. Expecting NHS staff to buy into major structural change without first addressing their current reality risks apathy, or even resistance, to the proposals of the 10-Year Health Plan. 

4. Big ambitions for digital transformation, but the basics are still broken 

The NHS App is billed as the new “front door” to the health system – enabling people to access appointments, records, and advice in one place. While other sectors such as banking already offer a similar model, the NHS is a different beast – still contending with fragmented, outdated IT systems, inconsistent data sharing and potential cyber security challenges. Although investment has been committed to digital transformation, we know that implementing new technology into the juggernaut that is the NHS is far from simple. Questions remain over how easily local hospital infrastructure can be updated and systems joined up at scale. 

5. Prevention needs more than slogans 

Finally, the plan’s focus on prevention arguing ignores the reality of over a decade of disinvestment in public health, with local authority budgets slashed by over 26% since 2015.  

Behaviour change is complex and resource-intensive, requiring deep community relationships and sustained engagement. Right now, the NHS lacks the staff, tools and funding to deliver this shift at scale. Without restoring public health capacity and clarifying responsibilities across local, regional and national levels, prevention risks remaining a policy buzzword. 

The 10-Year Plan is full of aspiration for the future of the NHS. But for those working across healthcare, the unanswered question remains: what gives this plan a real chance of working? Without proper investment, strong leadership, and clarity on delivery, even the best ideas risk becoming unfulfilled promises. The opportunities are real – but so are the risks.  

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