The NHS 10-year health plan: conditions for success

The 10-Year Health Plan (10YHP) is an opportunity to renew the healthcare system, putting patients and communities at the centre of decision making and supporting value for money and sustainability. It will provide a roadmap for delivering the three shifts that the government has set out across prevention, digitisation and community care.

The case for transformation is undeniable – the question is how to undertake this when NHS services are so overstretched and working within an extremely challenging financial context.

NHS trusts will be at the forefront of implementing the 10YHP, with trust leaders already playing a key role in its development. Earlier this year, NHS Providers held two roundtables, bringing together trust leaders from the policy working groups which informed how the government was shaping the plan. Together, we discussed progress and the plan's impact on the sector, focusing on how to drive the best outcomes for patients and communities.

Through our conversations, a number of themes became clear on the conditions needed for success: 

1.      Consolidation of a strong evidence base

An emphasis on evidence-based decision making should be clear in the 10YHP and at the core of how the NHS develops in the coming years. Trust leaders emphasise that policy recommendations need to be tested and evidenced to ensure practicality and achievability. A collaborative model to track progress using benchmarked data would be beneficial. Given the 10YHP's decade-long span, it will be important to map and phase goals to track progress and adapt to the changing external environment. 

2.      Robust finances and access to capital

The 10YHP provides an opportunity for long-term planning which supports strategic investment decisions. Trust leaders require multi-year funding allocations to ensure resources are distributed equitably based on need, to tackle health disparities and enhance population health, which in turn boosts productivity.

A real terms increase to capital expenditure is vital for enhancing NHS productivity by upgrading facilities and adopting advanced technology. Trusts should have the capacity to invest additional resources to address the maintenance backlog and partner with the private sector to initiate major infrastructure projects, ensuring the NHS estate is prepared for the future.

To tackle rising demand and equip trusts with the resources needed to meet future challenges, a robust financial settlement is necessary. This includes funding for innovative solutions and improvements in patient care delivery. The government must acknowledge the need for a period of "double running" in some areas to invest in measures that will reduce future demand.

3.      Integration of digital technology

The NHS needs to rethink services based on what patients need and what technology can do for us. There is immense potential for widespread use of digital records and other technologies to streamline processes and enhance patient care. Trusts are making progress in electronic patient records, cybersecurity, and IT infrastructure.

However, our recent survey shows trust leaders face significant challenges in digital transformation. Funding constraints, operational pressures, and inadequate infrastructure hinder faster progress.

New technologies will empower patients to manage their care, helping the NHS keep people healthier for longer and reduce demand for medical services. Investment in digital infrastructure and workforce proficiency in digital tools is essential.

4.      Expansion of multidisciplinary teams across the health sector

NHS staff are the driving force behind the healthcare system, providing daily care, compassion, expertise and innovation. Trust leaders know that caring for their workforce enables them to care for others. They know too that staff are at the frontline of meeting rising demand and increased pressures, which has driven up rates of burnout and staff leaving the service.

Within the plan, there needs to be a focus on staff wellbeing, morale, retention and making the NHS a great place to work – including a strong focus on inclusion and tackling discrimination. Trust leaders also advocate for expanding multidisciplinary and partnership working across the health, social and voluntary care sectors to shift the focus from hospital to community and ensure holistic care.

5.      Evolution not revolution

After years of continuous change but mixed results, there is a sense of fatigue among NHS trust leaders and the workforce. To engage providers, the 10YHP needs to bring focus to what matters, and fresh insight on how to achieve the three shifts while building on the good work already being done within the NHS and with its partners.

In the broadest terms, partnership will require working beyond the NHS and reaching out into communities to best understand and respond to their needs.

The 10YHP is set to provide a roadmap for the future of our NHS. Trust leaders are ready to work with government to create a picture of health – a service which is accountable, delivers value for money, works closely with partners to offer person-centred care, is agile and responsive to patient needs.

This article was first published in Healthcare Management