NHS PLAN
Reshaping healthcare for the next decade
Claire Colgan, director and cost centre lead, UK Real Estate Advisory Cost Centre at Turner & Townsend, looks at how the NHS 10 Year plan is driving system transformation across estates, service models, and clinical priorities.
The NHS has entered one of the most significant periods of transformation since its inception. Demand is growing faster than capacity, health inequalities continue to widen, workforce pressures are deepening, infrastructure is ageing, and patient expectations of digitally enabled access are accelerating at pace. In this environment, the question is no longer whether transformation is required but how it should happen, at what scale, and over what timescale.
Despite constant policy churn and operational volatility,
one strategic framework continues to offer clarity, coherence and long-term direction: the NHS 10 Year Plan, published in July 2025. More than a high level policy statement, it has become the central interpretive lens through which Integrated Care Systems (ICS), Trusts, government bodies, and advisors understand system pressures and design the future of care. The direction set out in the Plan is shaping not only how services are delivered, but how estates are planned, how capital is prioritised, how clinical pathways evolve, and how digital maturity must accelerate. At the heart of the Plan are three fundamental shifts
Top inset: Sign announcing the coming arrival of a new CDC.
Below: Integrated COVID Hub North East at Baltic Park in Gateshead.
that are no longer theoretical but now visibly shaping transformation programmes across the country: 1. From an acute centric model to a neighbourhood- centred system.
2. From reactive treatment to proactive, preventative, and anticipatory care.
3. From analogue, fragmented infrastructure to digitally enabled, interconnected systems.
These shifts are now emerging across transformational commissions that include neighbourhood-based healthcare models, system wide infrastructure strategies, community diagnostic centres (CDCs), clinically led estate transformation programmes, and integration initiatives across organisational boundaries.
The NHS 10 Year Plan: the strategic anchor for system transformation The uniqueness of the NHS 10 Year Plan lies in its long term, system, and regional perspective. While short term interventions focus on immediate operational challenges, the Plan provides an integrated vision of what the future system must become: more localised, more preventative, more digitally enabled, more integrated, and fundamentally more sustainable. The Plan mirrors the pressures and opportunities the
system is already experiencing. Workforce constraints, the increase of multiple chronic conditions, the changing nature of clinical work, accelerating digital expectations, and the need to reduce variation and improve outcomes are all intensifying, making the Plan’s relevance even stronger than at publication. The Plan shifts thinking from reactive firefighting to purposeful redesign. It reframes estates, digital, and workforce not as operational costs but as enablers of change and it provides a shared framework for transformation across geographies, organisations, and clinical teams.
In our work with ICSs, Trusts, and regional estates
leaders, a consistent set of challenges is emerging. Clients describe rising capacity gaps between acute demand and community provision, estate portfolios that are misaligned to new neighbourhood based models of care, and capital programmes that struggle to keep pace with service redesign. Many leaders also reference the difficulty of planning long term infrastructure where clinical pathways, workforce models, and digital maturity are still evolving. From these ambitions, the three shifts emerge as the clearest articulation of how the future NHS must operate.
Shift 1 Acute to community – building a neighbourhood- centred health system The move from hospital-centred to neighbourhood care is now visible across transformation programmes. This shift recognises that the majority of health needs, including long-term condition management, mental health support,
26 Health Estate Journal September 2026
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