The UK Government published the long-awaited NHS 10 Year Health Plan earlier this month. It has been great working with our clinical and operational teams, bringing our collective thoughts to life over recent weeks. Together, we have started to consider what it might mean for service delivery.
We welcome the ‘three shifts’ at the heart of the plan that flowed from the Darzi report published last year. These shifts include moving care from hospitals to local communities; preventing illness, not just treating it; and realising the potential of digital technology.
Through our delivery of health and wider community-based services, we’ve seen the value of localised, preventative and tech-enabled support to improve outcomes. Our teams see the impact of genuinely connected ecosystems of support built around the individual.
We also welcome the focus on digital-first and AI, reflecting the changing preferences of the public. It has potential to improve productivity throughout the system, one of the Health Secretary’s stated priorities.
The plan shows ambition and vision for where the NHS is seeking to go in the long-term. However, there are important issues to resolve in the short- to medium-term that are foundational stepping stones to achieving some of these shifts. Our clinical and operational colleagues see that areas such as mental health, elective care and urgent and emergency care may require more immediate change. Improved access at the ‘front door’ of these services will be key to supporting the plan.
4 themes that emerge from the plan
The need for a more effective ‘front door’ to services
Whether through NHS 111, the relaunched NHS App or neighbourhood approaches, improving ease of access to a broad range of NHS services will be vital to improve public satisfaction and outcomes, and reduce strain on the most overburdened provision. An excellent customer journey and experience will underpin how you change behaviours and turn the tide of dissatisfaction.
Bottlenecks to accessing support, particularly via overworked GPs and primary care services, can delay access to treatment or support when it is needed and in the right setting. Services commissioned through different institutions or tiers of government rarely share the same referral routes. From our own work on service design, solutions lie in the important development work of creating effective, system-wide points of access to assist with seamless navigation, signposting and tracking of personalised care and support.
Technology plays a key role, but an omnichannel approach is essential to maximise access. Services must remain universal, addressing diverse customer needs, from digital natives to those facing language or disability barriers. For public health, that could be through Integrated Lifestyle Services in a community setting. For non-urgent care, 111 provides access. And for mental health, the roll-out of walk-in centres offers vital support. Digital-first needn’t be in tension with more locally accessible services. What is important is clarity on how and where people access the information and support needed.
There will also be a need for more effective data-sharing and a focus on quality and transparency to underpin the approach.
Connected ecosystems of support
Commissioned services across the public sector, including in health, increasingly require integrated approaches. So it was no surprise to see a focus on joined-up working in the plan. We welcomed seeing these purposefully called out. For example, referencing the vital role of businesses, employers, investors, local authorities and mayors working together on the prevention agenda.
The Government has also showed openness to collaborate with partners, including the private sector, particularly in technology and primary care. We see the power of effective partnerships in our preventative health services, utilising a strong network of community, VCSE and specialist private sector partners. Together these networks provide choice, speciality and access to effective interventions. Their potential will grow as connections expand into the world of employment, skills, housing and financial support. This creates exciting opportunities for organisations like Maximus to support in service design and connection.
On integration, as the Kings Fund and others have commented, the concept of a neighbourhood health system has long been argued for and discussed. But whole-system design is needed, as is accountability, with a shared agenda and agreed outcomes. Developing these stronger connections across health and social care can act as a base to start to bridge the divide between the NHS and local authorities and other parts of ecosystem.
We see the need for a better-connected ecosystem of support through our delivery. For example, helping someone with a long-term health condition back into employment requires holistic services. Health, employment, skills and wider support services like finance, debt and housing need to be offered seamlessly. Similarly, effective phone-based mental health support depends on case managers rapidly referring to both clinical and non-clinical interventions.
Programmes like Work Well and the expansion of IPS delivery, genuinely aligning and integrating health and employment support in a health setting, are welcome. However, their delivery footprint remains patchy. As they roll out the plan, scale and consistency around the country will be key.
This agenda highlights the need for case-management through the process. It will help people navigate different support in a timely and effective way, especially for vulnerable citizens. Like improving ‘front door’ access, data sharing will also be critical here. It prevents customers repeatedly sharing the same health information and ensures the correct holistic care and support can be delivered. This could be expanded to incorporate wider information and support needs as it develops.
Listening to the voice of the customer
While support for the NHS remains strong, public satisfaction in the service is at a record low. A recent survey found that just 1 in 5 people said they were satisfied with the way the NHS runs in 2024. For social care, the figure was just 1 in 7.
In the NHS and across public services, there is a realisation that trust and confidence needs to be strengthened. Nowhere is this more important than in healthcare. There is clear opportunity to ensure that clinical governance is designed into the systems which will build trust and quality of outcomes as well as escalation pathways.
This starts with the power of relationships. Applying the principles of consultation and dialogue to ongoing service design keeps us moving in the right direction.
This raises two important but separate challenges.
- First, how do we most effectively utilise trusted individuals and institutions when we engage citizens? c Building strong community partnerships and outreach will be key.
- Second, how do we utilise technology and wider innovation to improve the citizen experience and drive productivity, building confidence in the system through more personalised and responsive services.
What follows from a baseline of quality in service delivery, underpinned by good governance, is the power to listen to the customer and take appropriate action to improve. Focus on designing truly person-centred care informed by what citizens need will be the foundation of optimised delivery providing holistic care. At Maximus we are keen to ensure we are listening carefully and widely.
Providing space and structure for innovation
Siloed working and a sometimes cautious approach to innovation in some areas have slowed reform throughout the NHS.
The push for innovation and technology adoption is welcome, including the bold aim of making the NHS the most AI-enabled health system. But our clinicians do stress that a regulatory environment must underpin it. It must be fit for purpose, less reactive to new technologies and enable change while protecting patients. Multi-year budgets are also essential alongside an ambition to become world-leading on innovation. This approach provides the capacity and bandwidth to make longer-term decisions with the power for transform services.
The dialogue about how capital investment and increased funding streams might underpin these investment decisions will be important to allow those innovations to flow. Commissioning capability and capacity also needs to match the aspiration.
Finally, we commend the aspiration to make ICBs coterminous with strategic authorities by the end of the plan where feasible. This alignment will support strategic coordination, joint planning and co-development efforts. It also compliments the Government’s work with combined authorities to develop more localised approaches across areas like health and work.
The plan provides an exciting vision for the future of healthcare services in our country. Whilst challenges are inevitable, it’s an opportunity to explore, contribute and support that evolution towards a genuinely connected care eco-system.
