Last month we were delighted to host a panel session exploring how Labour’s priorities for the NHS are translating to on-the-ground action. To tackle this question, we were joined by an expert panel including David Thorne, Transformation Director of Well Up North Primary Care Network (PCN), Mike Bell, Chair of South West London Integrated Care Board (ICB), and Ellen Rule, Deputy CEO of Gloucestershire ICB.

Guided by WA’s Head of Health, Dean Sowman, the discussion dived into the key challenges and opportunities in shaping the NHS 10-Year Plan, offering a thought-provoking vision for the road ahead.

Since the Labour Government took office, healthcare has been placed firmly in the spotlight. Health Secretary Wes Streeting’s description of the NHS as ‘broken’ and in need of repair has ignited a bold wave of review and reform. From the influential Lord Darzi review and the subsequent three transformative shifts in healthcare – from hospitals to community care, analogue to digital, and treatment to prevention – to the recent launch of ‘name and praise’ league tables and the upcoming NHS 10-Year Plan, the stage is set for significant change.

As decision-making shifts from NHS England to the Department of Health and Social Care, the UK is entering a new era in healthcare. In the short term, the focus is on decentralisation with ICBs gaining more autonomy and greater control over budgets, sparking tensions between national oversight and local autonomy.

Below we outline five key insights from the panel discussion, shining a light on what these changes could mean for the future of healthcare.

1. A Budget Focused on Stability, not Growth

The latest budget promises no return to austerity, but still falls short of the investment needed to rebuild public services that have been significantly reduced and strained. While the NHS welcomes a projected funding growth of 3.6–3.7% over the next two years, the system continues to grapple with the lingering consequences of underfunding.

On a positive note, this funding boost provides an opportunity to invest in NHS digital infrastructure, a vital step towards stabilising operations and creating a foundation for transformative change.

Productivity remains a key challenge, with NHS staff expected to improve efficiency despite limited increases in resources. The legacy of austerity continues to hold back progress, while the funds allocated for the elective recovery programme have fallen short of delivering anticipated improvements.

Panellists described the budget as a ‘stand still’ measure – enough to maintain current services but offering little scope for meaningful progress. They concluded that while the resolution of GP pay disputes is a step forward, critical issues such as GP contracts and National Insurance rises  remain unresolved.

2. Building the Digital Foundation for NHS Innovation

Before AI can revolutionise healthcare, the NHS must first build a solid digital foundation by tackling basic issues, such as interoperability and shared patient records. Currently, fundamental issues concerning digital skills and infrastructure are apparent, for example healthcare professionals requiring keyboard skills training or multiple landlines needing to be installed.

The shift from analogue to digital is essential, but it’s about more than just adopting new technology. The NHS still lacks an integrated system of care and addressing the fragmentation and “tribalism” between NHS departments is critical to achieving any real progress.

To unlock the potential of AI, ICBs must first strengthen their collaborative efforts, with Chairpersons meeting regularly to align on strategy. AI could help triage patients more efficiently, ease pressure on ambulance services, and optimise primary care across regions.

Meanwhile, investing in ambient technology could boost GP productivity by up to 20%. By automating notetaking and coding during consultations, GPs could see a reduction in administrative burden andincreased capacity, while also preventing burnout. In turn, this could lead the way to a more sustainable workforce, with less bureaucracy, and ultimately improved patient care.

3. Rethinking Prevention and Productivity

Healthcare transformation should extend beyond focusing solely on economic metrics, incorporating prevention models that prioritise social value and patient outcomes.

Traditionally focused on hospitals and waiting times, the NHS must shift its focus to prevention and address the root causes of hospitalisations. However, the current emphasis on productivity often overlooks acuity – the complexity of modern patients – and fails to address the underlying causes of ill health.

A major challenge is the workforce imbalance. The NHS Long Term Workforce Plan calls for a 40% increase in hospital staff, but only a 5% increase in GPs, this disparity is unsustainable under Labour’s three healthcare reforms. To support the shift from hospital to community care, a fundamental reallocation of both funding and workforce planning is urgently needed.

PCNs are already preparing for this shift by planning further investment into preventative and primary care services and reducing investment in acute hospital care over the coming years. This means redirecting resources from hospitals to community care and integrating services across both sectors within single NHS trusts. By doing so, hospital admissions will be reduced and NHS pressures alleviated, while the focus will shift from output-driven metrics to quality patient care.

4. Integrating Responsibility: ICBs and the Future of Resource Management

ICBs already have significant autonomy, but the challenge lies in making collective responsibility for resources a reality and ensuring accountability. While some ICBs are integrating services effectively, there is a need for stability during this transformation period, with limited capacity to test new ways of working.

ICBs are already shifting their resources to integrate services at the neighbourhood level, which is key to managing the hospital-to-community shift within existing budgets. Meanwhile, PCN’s have the potential to better manage vulnerable patients through enhanced GP roles and personalised care plans, reducing pressures on ambulance services and hospital waiting lists.

The partnership model in general practice is crucial, and more local integration is vital to managing complex patient needs. There is also an opportunity to empower NHS trust providers to act as direct commissioners, easing the burden on ICBs and facilitating smoother transitions from hospital to community care.

5. The Opportunity of Specialised Commissioning Delegation

To truly transform healthcare, specialist care must be viewed within the context of the entire patient pathway leading into specialised services, which will ensure a more integrated healthcare system. This requires stronger collaboration between neighbouring ICBs to ensure seamless care.

As ICBs review specialised commissioning budgets, there is an opportunity to better integrate local authority and public health services. Since a single ICB’s footprint is too small for effective delegation, a pathway approach is essential.

The focus must be shifted from costly end-of-pathway interventions to prioritising the full patient journey, and shifting care from acute settings into community and primary care.