Q members reflect on the NHS 10-Year Health Plan for England: Anna Burhouse

The NHS 10-Year Health Plan for England has laid out ambitions for three shifts: from care delivered in hospitals to in communities, from a focus on treatment to prevention and from analogue to digital.

In the spirit of collaboration and learning, we asked members to share what they found exciting about the plan, what is missing and where they think improvement approaches can play a role. 

For the next week, we will be sharing reflections from members across England on the plan and the culture and conditions needed for its implementation. Our diverse community of people working to improve health and care is uniquely placed to make a real difference to the success of its implementation. These reflections can help us all take stock of where we are and think together about how to get where we need to go.

 The NHS 10-year plan focuses on three core ambitions: to move care into the community, change from analogue to digital and shift from treating sickness to prevention.

The biggest challenge is how to operationalise these ambitions at a speed and a pace that instils trust both in the public and within NHS staff. The cornerstones for success will be taking NHS staff on a cultural journey that helps to build the NHS for the future and finding systematic ways to listen to patient and staff feedback to discern if these changes really are an improvement. 

Patients and staff will be asked to change their practices, routines and behaviours to access care through digital portals such as the NHS App and to deliver care in community settings, to learn how to use new digital and genomic technologies and to increase self-care and promote wellness. We know from previous experience that these are not easy asks, especially when health inequalities mean that access for patients is not currently even and we are very aware that morale is lowering in the NHS workforce and burnout and change fatigue is high.

Using an improvement approach to co-produce change with patients and staff has been shown to help counter resistance to change and enhance engagement because it encourages the local ownership of change ideas. It does this by harnessing the experience and expertise of patients and staff to make sense of how to operationalise high level ambitions into local systems in ways that make best use of local resources and reduce health inequalities.

Improvement approaches also help to measure and monitor key success criteria, like patient and staff outcomes and experience, and use this data to inform the way new changes are rolled out. This data can be used to ensure underlying health inequalities are improved, not worsened, so that, for instance, when we roll out digital technologies, we also understand who might be potentially excluded and take positive steps to make reasonable adjustments.

We can also use improvement techniques to scale and spread good ideas from one part of the NHS to another and learn how to implement best practice from health systems in other parts of the world.