Technology
not deepen existing inequalities in access to healthcare.7
It should not be that good care
shouldn’t rely on the quality of the smartphone that you have and can afford.
Costs and savings The 10-Year Plan aims to ‘bend the cost curve’ through a relentless focus on delivering value- based healthcare over the next 10 years. It notes that the NHS accounts for 38% of day-to-day government spending, rising to 40% by the end of the parliament, an unsustainable growth that has not improved health outcomes.8 The Plan identifies that there will be
streamlined national oversight, due to the merging of NHS England and the Department of Health and Social Care and the subsequent savings. There are now fewer arm’s length bodies, a reduction in targets and micro- management and a commitment to devolve more power to local NHS organisations. ICBs will become far more strategic and will be expected to plan and commission new services. The pattern of healthcare spend is likely to
move from the higher share of expenditure on hospital care, which will fall with more investment into neighbourhood care. There will be multi-year financial allocations for both revenue and capital and organisations will be asked to develop five-year spending plans and to reserve at least 3% of annual spend in service transformation. There will be new financial incentives that
reward good quality care and penalise poor quality care. There is little detail about how and who will make these assessments. A new financial framework will be published to sit alongside the 10-Year Plan. There is potential in the Plan to provide significant structural reform both organisationally and financially. However, there also seems to be a certain reliance on the
technology of the future to deliver a pathway to financial sustainability, which seems to this author to be unrealistic and unbelievably optimistic.
What does this mean for patients? There is a strong move to ensure that patients are actively involved in their care rather than the current passive relationship – this move will need considerable cultural shift especially if the means for change is via technological developments. But public satisfaction with the Health Service is at a very low ebb currently and needs drastic action to change this. The Plan reaffirms historical commitments to
ensure that patient experience and the quality of care are central and reignites Darzi’s Quality Framework. There is an ambition to reform the complaints process and improve response times to patient safety incidents which will benefit many patients and has been much needed for a long time. The voice of the patient is central to the way in which the NHS responds to difficulties and issues, often ignored, and is brought to the fore in the Plan, which is most welcome. Patients should not have to fight to be heard, as in many of the Maternity problems being investigated at present. The Plan describes patient experience,
feedback and outcomes as the most important measures that will be used to assess providers and commissioners. There are also proposals which would see patient experience data directly affect payments to providers by robust data collection and large-scale surveys. This should ensure that patient experience is front and centre of Trusts’ priorities. What will this mean to staff? Huge change
with the shift from acute to community care and subsequent role changes. The move across care to technology will be a very welcome change to
many who daily at present have to experience the torture of inadequate hardware and ancient software. There will need to be a blurring of the borders between primary and secondary care and the formation of loose multidisciplinary teams. We do not yet have the parallel workforce plan, which is due any time soon, but there need to be new roles for digital support to professionals both in acute and primary care. The vision is said to address holistic care needs, including building pharmacy, dentistry, social care, mental health and local authority staff into neighbourhood hubs, as well as the need to upskill staff in AI and data management to meet the technological challenges.
Conclusion The Plan signals enormous change which will affect every citizen of England, as well as anyone becoming a patient, and everyone working in the Service. Ten years in the life of the Plan and all the changes inherent in it is not long. Much of the change is very welcome and many of the changes are much needed national changes which will empower staff to deliver local developments. Many of the new ideas are ones that have been talked about in the past but never quite happened. The three shifts form the backbone of the plan, with many of the other reforms such as operating models, finances, workforce and care quality. It is ambitious and we await to see how much of it is able to be implemented, but it designs a huge change in how we access and deliver care.
CSJ
References 1. NHS England. Fit for the Future: A Ten-Year Health Plan for England July 2025 Accessed at
https://assets.publishing.service.gov.uk/ media/6888a0b1a11f859994409147/fit-for-the- future-10-year-health-plan-for-england.pdf
2. Ibid 3. Digital transformation in the NHS: a reference guide.2025 NHS Alliance Accessed at Digital transformation in the NHS: a reference guide
4. Ibid 5. The Kings Fund. 2025 Truly fit for the future? The Ten-Year Health Plan explained. Accessed at
https://thenhsalliance.org/resources/ digital-transformation-in-the-nhs-a-reference- guide
6. Ibid 7. NHS England. Fit for the Future: a Ten Year Health Plan for England July 2025 Accessed at
https://assets.publishing.service.gov.uk/ media/6888a0b1a11f859994409147/fit-for-the- future-10-year-health-plan-for-england.pdf
8. Ibid May 2026 I
www.clinicalservicesjournal.com 17
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