Healthcare delivery
around technologies. For example, she pointed out that 99% of GP practices now have cloud- based telephony and there has been investment in triage systems. There is a need to build on this foundation. She stated that the 10-year plan will highlight some bold, ambitious additional steps that will turn these “pieces of the jigsaw” into a much more “comprehensive neighbourhood health offer”.
The digital shift
Digital has been the most visible of the changes being delivered in recent years, as Amanda Pritchard pointed out. “Our spending on digital has increased by around 30% in recent years,” she reported, adding that significant efforts have gone into frontline digitisation, to ensure providers have electronic patient records – moving away from paper to digital systems. Investment has also focused on the digital
infrastructure – to ensure data, which sits in different systems, becomes joined up. She highlighted the federated data platform has been an important step forward. This initiative aims to securely connect data, break down information silos, and provide insights to assist in decision-making, reduce costs, and improve patient outcomes. By streamlining access for healthcare professionals, the aim is to reduce the need for multiple logins, resulting in faster, more coordinated care. She also highlighted investment in efforts to enable GP systems to better communicate with pharmacy systems and vice versa. In addition to this, there has been investment in larger transformation initiatives such as the NHS App. “Around 90% of GP practices now have patient
records available on the NHS App,” she revealed. “This has been a huge shift from where we were a couple of years ago.” The 10-year plan will build on this, but will also look at transformational potential around artificial intelligence in healthcare, for example.
Shift to prevention “The NHS has a huge role to play in prevention but, in lots of ways, we have to be a partner to others, who are much better placed to lead
on prevention. The development of ICBs and Integrated Care Systems (ICSs) was a really big commitment, a few years ago, to saying the NHS needed to have the right structures in place to build stronger relationships locally. This is so they can lean on the expertise and insights within local government. “They can then design solutions that actually work locally, rather than trying to do things at a National level,” Amanda Pritchard explained. The Chair asked whether this meant a devolution of power and control from the centre to a local level. Amanda Pritchard responded that “no one is better placed to respond to the needs of local populations than local leaders”; however, it has to be done “in partnership”, between the NHS and local government, and also between the NHS, patients, and voluntary sector partners. She said NHS England wanted to give local leaders “maximum flexibility” to make decisions, but there also has to be accountability.
NHS 10-year plan The Chair moved the conversation on to the 10-year plan and asked what will make this plan different to the many other plans that have gone before? What did NHS England believe we need to see in this 10-year plan to see change really happen? Amanda Pritchard responded that, firstly, there needs to be a clear vision, co-designed and built bottom-up: “There has been huge engagement,” she noted. “There isn’t a secret plan waiting to be revealed. It really is being developed based on a true engagement exercise. It will set out a clear vision for patients, for the pubic, and for staff.” Secondly, there is a need for a roadmap that sets out the steps required to turn the vision into a reality. This will focus on the next few years, but after that, Amanda Pritchard hopes to see a period of stability and certainty – so
that National and local leaders can “get on with the job”. There are four key enablers, in her view:
1. The state of the NHS’s Estate (especially the community estate).
2. Technology – particularly around data sharing.
3. Workforce – the workforce plan will be refreshed in the Summer.
4. Financial flows – as the focus shifts to community, we need to make sure “the money follows the patients”.
Ring-fenced funding As local health leaders will have more flexibility on how to spend budgets for their local populations, the question arises: will ring fenced funding be decided centrally? When asked about the role of ring fencing for healthcare priorities in the future, Julian Kelly told the committee that, as a matter of principle, he did not believe that “all ring-fenced funding was bad”. However, it is a question of choosing “when and where it is appropriate”. He cited the example of targeted lung health checks. “We have been providing ring fenced funding
in order to drive a programme of work that we know improves early cancer diagnosis and saves lives. We have focused it on areas where we know there have been high health inequalities and we have seen a change in the early cancer diagnosis rate. We have also seen a narrowing of health inequalities as a result,” he commented. Nevertheless, he admitted that there will be
a reduction in the total number of ring fences, going forward. The panel was then asked if they felt there
was a case to ring fence funding for women’s health, as the Women and Equalities Committee identified misogyny in the healthcare system. Amanda Pritchard agreed there is an issue
March 2025 I
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