The NHS is poised for one of the most significant strategic shifts in its history with the forthcoming NHS 10 Year Health Plan. Developed in parallel with NHS England’s restructuring and the Department of Health and Social Care’s (DHSC) policy alignment, this Plan is expected to be published imminently. It promises a blueprint for a decade of transformation, framed around three core strategic shifts:

1. Prevention at the Forefront.
2. Acceleration of Digital Transformation.
3. Rebalancing Care from Hospitals to Community Settings.

For Integrated Care Systems (ICSs), Trust Boards, and provider leaders, understanding and anticipating the direction of this Plan is essential. This blog offers a forward-looking analysis of the strategic shifts, systemic implications, and where health leaders must position themselves for sustainable success over the next decade.

1.Prevention First: Tackling the Root Causes of Ill Health 

The Strategic Shift

The Plan recognises that an NHS built predominantly around treatment is economically unsustainable and clinically sub-optimal. Instead, the prevention-first agenda is designed to tackle the root causes of ill health, reduce healthcare demand, and narrow health inequalities.

Beyond Healthcare: Addressing Social Determinants

Poverty, inadequate housing, poor education, and employment instability are all significant contributors to poor health outcomes. A truly preventative NHS must be backed by cross-government policy alignment that addresses these social determinants. Strategies like community-based public health interventions, better urban planning for physical activity, and early education initiatives must be integrated into the prevention agenda.

Long-term health creation requires investment beyond traditional healthcare boundaries. Sustainable prevention must be insulated from short-term political cycles, with multi-decade commitments that ensure health equity improvements are seen and sustained.

System Leader Imperatives

• Align ICS and provider strategies with prevention targets.
• Collaborate with local authorities, education, and housing sectors to tackle upstream health determinants.
• Embed prevention metrics within performance and incentive frameworks.

Leadership Insight: Prevention is not peripheral; it must sit at the heart of commissioning and policy planning, backed by sustained, cross-sector investment.

 

2.Digital Transformation: Enabling a Data-Driven, AI-Enhanced NHS

The Strategic Shift

The Plan envisions a digitally mature NHS where data, technology, and artificial intelligence (AI) power clinical decisions, improve efficiency, and personalise care.

Priorities in Digital Health

• Integrated Digital Care Records: Achieving true interoperability across health and care systems.
• Data-Driven Population Health: Leveraging predictive analytics to anticipate and address system pressures.
• AI in Diagnostics and Clinical Support: Expanding AI tools in imaging, diagnostics, and decision-support systems.
• Virtual Care Models: Embedding telehealth, remote monitoring, and patient-initiated follow-up (PIFU) pathways.
• Cybersecurity: Strengthening protections against escalating digital threats.

System Leader Imperatives

• Develop and fund ICS Digital Strategies that align with national digital health frameworks.
• Upskill the workforce in digital literacy and data analytics.
• Participate in national platforms and data-sharing initiatives, ensuring local benefits from federated data platforms. 

Leadership Insight: Digital transformation is not an optional enhancement, it will define system capability, efficiency, and clinical excellence over the next decade.

 

3.From Hospital to Community: Rebalancing the Health System

The Strategic Shift

The Plan operationalises the long-articulated ambition of moving care closer to home, reducing the NHS’s dependency on acute hospital infrastructure.

Core Components

• Community Diagnostic Centres (CDCs): Expanding access to diagnostics outside hospital settings.
• Out-of-Hospital Care Pathways: Developing robust community, primary, and intermediate care models.
• Reablement and Rehabilitation: Investing in post-acute services to support recovery at home.
• Integrated Primary Care Networks (PCNs): Enhancing the role of general practice as a coordination hub.

System Leader Imperatives

• Reallocate investment and workforce capacity from hospitals to community and primary care.
• Formalise partnerships across health, social care, and the voluntary sector.
• Develop shared governance and funding models across care settings.

Leadership Insight: Hospital-centric systems will struggle in the new landscape. Leaders must create or strengthen community service portfolios to remain viable and effective.

 

The Time Lag of Transformation: Planning for the Curve of Change

Shifting the trajectory of a national health system takes time, often decades, not years. Preventative health gains, digital maturity, and community care transitions do not yield immediate results. Yet, the NHS faces these ambitions amidst workforce contraction, rising demand, and budgetary constraints.

How can we reconcile long-term strategy with short-term fiscal reality? This is the governance challenge for leaders. Without protected funding, continuity of leadership, and workforce retention, the risk is that the NHS 10 Year Plan becomes yet another unfulfilled vision, added to the growing list of unexecuted reforms.

Boards and policymakers must commit to:

• Protected timelines and funding envelopes that shield transformation efforts from annual budget pressures.
• Transparent monitoring with publicly accountable delivery milestones.
• Acknowledging that workforce growth, not just productivity, is essential to sustain change.

Leadership Insight: We can no longer afford to cycle through 10-year plans without delivery. The price is public trust, workforce resilience, and national health outcomes.

 

Final Word from Altin Biba, MBA, AMBA Chief Executive of ProMedical

The NHS 10 Year Health Plan must be more than a blueprint, it must be a commitment to change that survives elections, budget cycles, and leadership churn. We have had decades of long-term plans, but without long-term discipline and cross-sector alignment, strategy remains paper-deep.

If prevention is to genuinely shift the health curve, if digital transformation is to modernise care, and if community-first models are to rebalance the system, then leaders must guard this plan against the familiar fate of under-delivery. Health transformation demands more than ambition, it demands accountability, investment, discipline, patience, and partnership.

At ProMedical, we stand ready to support NHS leaders in turning policy into practice, translating national vision into operational, clinical, and workforce realities. The measure of this Plan will not be in its announcement, but in its execution, and we must all hold ourselves to that standard.

Health prosperity is a national responsibility. It should not be tethered to political cycles or partisan ambition. The wellbeing of a nation is not a manifesto pledge, it is the foundational duty of leadership at every level, across every government. Anything less, and we fail those we serve.

References

1. NHS England Board Meeting Minutes, July 2025
2. Draft NHS 10 Year Health Plan Briefings, 2025
3. NHS Long Term Workforce Plan, 2024/25
4. Department of Health & Social Care publications
5. NHS Transformation Directorate – Digital Health Strategy
6. The King’s Fund – Future of Health and Care Report
7. Nuffield Trust – Community Care Futures