10 Year Health Plan

Today, the Government announced the details of its 10 Year Health Plan for England. Promising the ‘most ambitious transformation of the NHS since it was created’, Health and Social Care Secretary Rt Hon Wes Streeting MP has today provided additional clarity on the future direction of England’s Health Service.

Despite having faced an uncertain first year in office, health reform and delivery remains an area where the Labour Government has a distinct advantage, both in its messaging and policy. This time a year ago, NHS satisfaction rates were at an all-time low while A&E queues had more than doubled during the previous fourteen years of Tory rule. Using September’s Darzi Review – which revealed the sheer extent of the NHS’ current failings – as justification for the pace of change planned, today’s announcement continues much of the Government’s existing messaging in the sector: if the NHS doesn’t reform quickly, it will die.

The Government has established an impressive record on health. According to administration statistics, 4.2 million additional appointments have been made, waiting lists are at their lowest level in two years, and 1,900 GPs have been recruited since October. All of this has been bolstered by the 2.8% funding boost the NHS revealed at the Spending Review. They are under no illusions, however, that more needs to be done. In line with the messaging since the General Election, today’s announcements reaffirm that change in the NHS will come in three policy transitions: From hospital to community, from analogue to digital and from sickness to prevention.

The first area of change, from hospital to community, is perhaps where the Government’s most consequential announcements can be found, in the form of new Neighbourhood Health Centres. Intended to bring care into local communities, convene professionals into patient-centred teams and end fragmentation, the centres will attempt to free up capacity at general practices and hospitals. As part of this wider commitment to community-centred care, the share of expenditure on hospital care will fall, with proportionally greater investment going into out of-hospital care.

The Government also sees technology as a key enabler in delivering change. The Plan promises to make the ‘NHS the most artificial-intelligence -enabled care system in the world’. Most of the reforms to tech, will come on the access side, with flagship changes to the NHS App. Notably, patients will be able to book additional appointments, communicate with professionals, receive advice and draft or view their care plan in the App. By 2028, they’ll even be able to choose their preferred provider, hold consultations and access data on long-term conditions, or vaccinations.

On the prevention side, perhaps the most nebulous element of today’s announcement, as well as the already announced reforms to tobacco purchasing, junk food advertising and weight-loss medication, the Plan also points out the Government’s expansion of free school meals and update to school food standards. They will also introduce a new genomics population health service, by the end of the decade to identify early-stage cases for intervention.

Alongside these three strands, the NHS will also operate under a New Delivery Model. The headquarters of the NHS and the Department itself will be combined – to reduce headcount by 50%. Integrated Care Boards meanwhile will become the strategic commissioners of local healthcare services and new targets for 2% yearly productivity gains have been set. In a move which may raise eyebrows on the left of the party, embedded into the latter half of the document, the Plan re-affirms that private contracts will be sought to deliver new digital platforms and confirms that Public Private Partnerships will be trailed for new Neighbourhood Health Centres - ahead of a final decision at the Autumn Budget.

There is a degree of political consensus on the Plan with Shadow Health and Social Care Secretary Rt Hon Edward Argar MP saying it was the “right” thing to do. He did however raise concerns that the reforms outlined are "sketchy on some of the details of delivery", including on staffing and on social care. In a similar fashion to the recent Industrial Strategy, today’s Health Plan doesn’t provide many new funding settlements. It does, however, provide a sense of clear direction where this Government sees its priorities laying, in an area where it can – and has to – deliver on its promise for ‘Change’.