Q members reflect on the NHS 10-Year Health Plan for England: Rammya Mathew

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.

Neighbourhood health is perhaps the greatest opportunity for primary care. By creating integrated teams and pathways for people with complex needs, we can shift more care out of hospitals and closer to home. As a GP and place-based leader in my patch, I’ve often been frustrated by the lack of holistic management in hospital-based teams, where siloed working remains the norm. This is our chance in primary care to lead real system redesign.

Locally, we’ve been working hard to build optimism – to show colleagues that this isn’t change for change’s sake but a real opportunity to improve care. We’ve already launched new models such as child health hubs, giving staff and patients a tangible view of the benefits.

This year, we also commissioned proactive care planning for high-intensity primary care users, housebound patients and those on the palliative or end-of-life care register. Neighbourhood health allows us to deliver truly personalised care – ensuring patients’ goals and preferences are understood, documented and acted on – by coordinating the often complex web of professionals around them.

The challenge now? Turning these promising models into sustainable, impactful solutions that deliver clear value.

There’s also a growing excitement about the role of technology, AI and genomics in prevention – though some of the hype feels premature. Where tech is grounded in reality, though, it can make a real difference.

For example, we’ve integrated AI tools into our hypertension case-finding pathways as part of our recommissioned local enhanced services. Early results are encouraging. We’re on track to increase prevalence by 1–2%, which could mean 5,000–10,000 more patients being identified and supported. That’s a significant step forward.

As leaders and those working to improve health and care, our collective challenge is to:

• share, scale and spread real-world examples that align with the plan’s ambitions
• stay grounded — focus on what’s working, not just what’s new
• lead with optimism and clarity about the real benefits of change.

The next decade gives us a rare opportunity to reshape care around people and communities. Let’s make it count.