A Plan in Need of a Plan—Early Reflections on the New 10-Year Plan for the NHS

After some early leaks and much expectation, the Government finally published its 10-year health plan for England on 3 July 2025. It has a clear vision for the future of the NHS but it feels like objective and ambition (aspirations of “what” the NHS should be) without any real detail on the “how” and (importantly) the “how much.”

1. The plan needs a plan (and a budget)

It is difficult to argue against the key themes raised in the 10-year plan. However, a strategy is not a strategy unless it has a clear execution plan with defined roles and responsibilities and this is no different. If the NHS represents 38% of government spend today and 40% by the end of parliament (with the 30 June 2025 Spending Review suggesting a real terms increase in funding of only 3% per year), then is that really consistent with the scale of change required? And where can private capital help take the strain?

“The big ideas are right—but without a delivery roadmap and committed funding, we’re not looking at a plan, we’re looking at a wish list. It is difficult to back vision statements—we need executable models with real accountability.”

— Gordon Henderson, Stax Healthcare Advisor

2. The ambition for better access to care and more focus on prevention rather than cure is laudable but our starting point is scarily low

The scale of the turnaround cannot be overstated. The UK’s health system is on its knees. Although improving slightly recently, the NHS England waiting list remains well above 7 million. Our February 2025 report offered a stark reminder of the ongoing severity of the situation.



But all journeys start somewhere, and we welcome the ambition in areas such as ramping up screening, working on wellbeing (including obesity, alcohol, tobacco, etc.), embracing wearables and genome testing initiatives.

3. Changing patterns of care delivery and the increasing role of digital health should provide real opportunities in the coming years

Among the landmark announcements was the roll out of Neighbourhood Health Centres (NHCs). This is a concrete step towards the ambition to move more care from hospital to community and to optimise hospital flows by reducing the need for follow up appointments (given that follow-ups account for over 50% of hospital appointments according to the HFMA). These local hubs could combine care and diagnostics and include a mix of doctors, nurses, specialists, and pharmacists.

The government has promised to set up 300 of these NHCs by 2035 and these feel like an interesting area for further public/private cooperation. A word of caution comes from The King’s Fund who highlighted in their 3 July 2025 response, “History has shown us that you can’t simply co-locate different health professionals in a building and expect a neighbourhood health service to flourish.” Again, this feels like a nice ambition but lacks detail to date.

Trends to more care being delivered in the community (including pharmacies) and in the home should provide opportunities in care provision, technology, and services such as staffing and logistics.

When transforming care models, it is a shame that plans do not really consider where health meets social care. There is an independent commission on adult social care reform but this is not due to report back until 2026 and, as Helen Morgan MP said, “Everyone knows you can’t fix the NHS without fixing social care.”

The shift from analogue to digital was a key theme from the Darzi report and it took centre stage in the new plan. This is a game-changer and an area which should provide opportunities in the coming years. Central to the plan is the role of the NHS App (described as “the doctor in your pocket” by some). The plan also considers focus areas such as increasing the use of AI, better health and genomic data, and leveraging wearables.

“The focus on AI is laudable and needed but the reality of the NHS IT estate is it is inefficient and disparate. The current barriers to national NHS adoption of new digital technologies are significant and the concept of a “digital passport” is very welcome. The government should ensure they favour UK innovation from relatively small players and not just favour US multinationals because they have the largest lobbying budgets.”

— Keith Gibbs, Stax Healthcare Advisor

4. Plans for the NHS workforce feel well intentioned but don’t give much comfort over the government’s ability to drive such fundamental change through a tired, under-staffed, and low morale team

UNISON broadly welcomed the plan but highlighted the strain placed on the workforce. In their 3 July 2025 response, they said, “Significant funding…is crucial” and “staff morale is low. NHS organisations are being restructured or abolished. Service cuts and job losses are now the reality for health workers. Trusts are having to axe resources and lose the very people that could make the plans happen.”

This doesn’t feel like a balance that can work. In addition, the big shifts and moves to community care are planned to be delivered with fewer people than budgeted in the 2023 workforce plan and with reduced use of an international workforce. Whilst moves such as the use of digital solutions, more training and development and leveraging apprenticeships are sensible, this doesn’t feel enough. The independent sector should have an increasing role to play in areas such as care delivery, digital innovation, and workforce solutions.

“It’s a tough sell to ask fewer, overworked NHS staff to deliver more transformation with less support. The independent sector must be seen as a partner, not a threat, in helping to close that gap. The future has to lie in a hybrid model where a patient can seamlessly move between Public / Private healthcare systems and not be penalised for doing so.”

— Gordon Henderson,  Stax Healthcare Advisor

5. The need for better operational performance and more financial discipline is clear but how can targets really be met? The gap between ambition and reality on the ground feels enormous

Alongside execution and staffing challenges, there is some understandable scepticism around productivity targets. One could argue that calling for a more efficient system serves as a way to sidestep the tougher question of where the necessary funding will come from. This feels a bit too much like a schoolmaster shouting at a tired and broken child that they must do better. Nuffield Trust called it “heal thyself.”



Plans for productivity improvement targets, league tables, changing tariff models, and a more mid-term (5-year cycles) planning mentality are interesting but NHS bodies have had to deal with short term crises so often that the gap feels daunting. In addition, all providers need to be in surplus by 2030, yet 136 Trusts are currently in deficit with data published in February 2025 showing the worst deterioration in NHS provider financial health in over a decade. 

6. Finally, the plan feels unlikely to be met without the support of independent providers and private capital but the role of both is unclear from the plan as it stands

“There’s no pathway to success here that doesn’t include private investment—capital, tech, and delivery expertise. If the NHS wants support, it needs to stop sending mixed messages about the role of independent partners”

— Gordon Henderson, Stax Healthcare Advisor

Closing Comment

“The 10-year plan will need to take a pragmatic and open-arms approach to how the independent sector can help solve the long-standing challenges in the NHS. This should open up a raft of opportunities for private capital, technology players and providers to make inroads into waiting lists, improve outcomes and drive new, more efficient models of care. Winners will be those who can support “end-to-end” pathway management and get their commercial model right. It should be an exciting few years for the sector.”

— Dr. Bayju Thakar, Stax Healthcare Advisor

“Even if this plan is successful, healthcare demands will continue to increase and consume more of the budget, so funding the investment in the required area of transformation is an unresolved challenge. We need to avoid this being yet another NHS transformation “so big it can be seen from space” which once again fails to deliver. They can’t do it alone.”

— Keith Gibbs, Stax Healthcare Advisor