NHS 10-Year Plan outlines key reforms for healthcare

The government recently published their NHS 10-Year Plan, which outlines key reforms for the future of healthcare in England, but omits learnings from avoidable deaths.

The Fit for the future: 10-Year Health Plan for England was published on 3^rd July 2025 to address the “critical condition” of the NHS and “guarantee its sustainability for generations to come.”

The NHS 10-Year Plan includes three “radical shifts” from hospital to community, from analogue to digital, and from sickness to prevention, and outlines a new operating model and a new transparency of quality of care for the healthcare service.

However, critics have argued that it lacks detailed learnings from avoidable deaths, particularly those of people with a learning disability and autistic people.

The government has spent 8 months developing the plan, speaking with thousands of healthcare staff and members of the public. They also considered 250,000 ideas submitted to the Change NHS Website. The resulting plan aims to create a new model of care which narrows health inequalities and provides patients with “real choice and control over their healthcare.”

NHS 10-Year Plan sets out 3 ‘radical shifts’ for healthcare

The NHS 10-Year Plan outlines the ambition to reinvent the healthcare service through 3 radical shifts. These are:

1. From hospital to community: the government has spoken of a “Neighbourhood Health Service” which is patient orientated. They want to shift from hospital-centric care to providing continuous, accessible and integrated care in local communities. This shift is built on the principle that care should happen as locally as it can, in a patient’s home or neighbourhood health centre where possible, and only within a hospital if necessary. This means greater investment in out-of-hospital care, training up thousands more GPs, improving the NHS App to include online advice and doubling the number of people offered a personal health budget (PHB), among other measures.
2. From analogue to digital: the government aims to make the NHS “the most digitally accessible health system in the world.” They want the NHS App to evolve to become a ‘doctor in your pocket’ and ensure rapid access for people in good health, free up physical access for individuals with complex health needs and make the NHS financially sustainable for the future. This shift will include providing everyone with a single patient record to enable more coordinated, personalised and predictive care, enhancing the NHS App to become a world-leading tool for patient access and care planning and allowing patients to leave feedback on their care, which is communicated back to providers.
3. From sickness to prevention: The government wants to narrow the gap in healthy life expectancy between the richest and poorest regions in England, while increasing it for everyone, and help raise “the healthiest generation of children ever.” Boosting the nation’s health will ease pressures on the NHS, ensuring its future sustainability, while also supporting economic growth for the country. They plan to work with businesses, employers, investors, local authorities and mayors to build a healthier nation. Measures include the Tobacco and Vapes Bill, which will prevent children who turn 16 this year (or younger) from ever being able to be legally sold tobacco and will stop the advertising and sponsorship of vapes and other nicotine products. They have also outlined measures to end the “obesity epidemic”, expand free school meals, extend access to weight loss medication, empower and incentivise the public to make healthier choices and expand mental health support teams in schools and colleges.

Supporting the vision for care in the NHS 10-Year Plan

These form the three pillars of the government’s new model of care. The NHS 10-Year Plan includes a raft of measures to support these key changes, including:

• A new operating model to create a more diverse and devolved health service, with power distributed among local providers, staff and citizens. Plans had already been announced to combine NHS England and the Department of Health and Social Care (DHSC). The government will also make ICBs the strategic commissioners of local healthcare services and close commissioning support units. The new system will allow “earned autonomy” and address underperformance in areas with the worst health outcomes. There are also plans to reinvent the NHS Foundation Trust model, set higher standards for leaders and work in closer partnership with local government and other local public services, among other changes.
• A new transparency of quality of care to prevent systematic and avoidable harm. The government plans to publish easy-to-understand league tables to rank providers against key quality indicators, allow patients to choose services based on quality data from the NHS App and use patient-reported outcome measures and experience measures to help people choose providers. They also set out plans to establish a national independent investigation into maternity and neonatal services and a national maternity and neonatal taskforce to inform a new action plan, co-produced with bereaved families. Other measures include reforming the complaints process, improving response times to patient safety incidents and reforming the CQC to a more data-driven regulatory model.
• A new workforce model, aligned to the future direction of the NHS. The government asserts that staff will be better treated, better trained and more motivated, with more scope to develop their careers. NHS staff will have their own personalised career coaching and development plan, will access AI as a “trusted assistant” and will benefit from significant contractual changes which include modern incentives and rewards for high-quality and productive care. The government plans to work with the Social Partnership Forum to develop minimum employment standards and will work with trade unions and employers to reform employment contracts. Other measures include the development of advanced practice models for nurses and other professionals, increasing the number of nurse consultants and creating 1,000 new specialty training posts.
• A reshaped innovation strategy that harnesses 5 transformative technologies – data, AI, genomics, wearables and robotics – to personalise care, improve outcomes, increase productivity and boost economic growth. The government has set out plans to establish a new Health Data Research Service (HDRS) in partnership with the Wellcome Trust and backed by up to £600 million of joint investment. They want to make the NHS the most AI-enabled health system in the world, launch large-scale studies on genomic sequencing of newborn babies and adults and make wearables standard in preventative, chronic and post-acute NHS treatment by 2035. They also want to expand surgical robot adopting in line with NICE guidelines, starting next year, and establish new global institutes for science and innovation, among other measures.
• A different approach to NHS finances, moving away from simply providing more investment to focusing on reform. The government argues that “more money alone has not always led to better care,” and wants to introduce a value-based approach which is “focused on getting better outcomes for the money we spend.” Money will be directed out of hospitals and into the community and there will be a focus on rewarding best practice across the NHS. The three key shifts at the heart of the NHS 10-Year Plan are all designed to help secure financial sustainability for the future of the NHS, with care in the community, digitisation and a focus on prevention all promising to be more cost effective. The government aims for the majority of NHS providers to achieve a financial surplus by 2030, and they will require all organisations to create robust, realistic 5-year plans to secure financial sustainability. Other measures include a move away from block contracts that are paid irrespective of productivity and quality of care and a shift from national tariffs based on average costs to tariffs based on best clinical practice. NHS funding will also be distributed more equally locally so that it is better aligned with health need.

Response to the NHS 10-Year Plan

The NHS 10-Year Plan has been met with broad support from across the health and social care sector, with organisations welcoming its focus on prevention, digitisation and community-based care.

But key commentators have raised concerns about gaps in the plan.

The Chief Executive of the Social Care Institute for Excellence (SCIE), Kathryn Marsden OBE, has criticised a lack of “sustained, strategic attention” to social care within the plan.

She explained:

“The 10-Year Health Plan sets out a welcome ambition to move care closer to home, to focus on prevention, and to invest in digital tools, but these aims will fall short unless they are matched by a coherent, long-term vision for social care. While SCIE has welcomed the Casey Commission and its forthcoming work, the Commission is not due to report until 2028. By then, healthcare reform will be three years ahead of a roadmap for social care reform.

“Social care supports people to leave hospital safely, helps them stay well at home, and to live meaningful, independent lives. That’s why the success of the Neighbourhood Health Service rests on the strength and stability of our social care infrastructure. Neighbourhood working, at its best, is about trust, shared decision-making and holistic, person-centred care. If we want a future NHS that is proactive rather than reactive, social care should be recognised as a driver of wellbeing and prevention in our communities.

“The government has set an ambitious mission of building an NHS fit for the future. SCIE calls on government and NHS leaders to bring the care and health sectors together as equal partners to deliver the Plan’s aims for prevention, wellbeing, community support and tackling inequalities.”

Meanwhile, Joseph Brunwin, UK Policy and Public Affairs Manager at the Royal College of Occupational Therapists (RCOT), heralded the NHS 10-Year Plan as setting out an “encouraging vision for the future of health and care.” But he also warned that it was “imperative” that the new 10-Year Workforce Plan “delivers an enlarged and strengthened occupational therapy workforce to achieve these ambitions.”

Sarah Woolnough, Chief Executive of The King’s Fund, expressed concerns about expectations for providers to “reduce deficits in the NHS without compromising on the range or quality of services the NHS delivers.”

But she welcomed the plan’s vision for a Neighbourhood Health Service, saying:

“A commitment to invest more money as a proportion of health spend in the community over the next 3–4 years is to be commended. It’s this sort of concrete action that’s needed to make the shift from hospital to community a reality. We also need to see health professionals working differently, NHS estate renewed and used more imaginatively, and better links between health and social care data.”

Paula McGowan reacts to the NHS 10-Year Plan

Finally, Paula McGowan OBE, campaigner and mother of the late Oliver McGowan, gave her reaction to the NHS 10-Year Plan on LinkedIn, sharing her dismay at the plan’s lack of detail around learning from avoidable deaths.

She said in a post:

“Over the last 10 years, 14,000 people with a learning disability have died avoidable deaths due to very poor service from NHS health and care.

“I expected learning from lives and deaths to feature prominently in the NHS 10-Year Plan.

“But absolutely nothing.”

Paula’s son Oliver tragically died aged 18 when healthcare staff failed to understand his learning disability and autism and he received inappropriate treatment.

Since his death in 2016, his family have campaigned tirelessly for better training for healthcare staff. This eventually led to the introduction of the Health and Care Act 2022 and the statutory requirement for all health and care staff to undergo high quality training in learning disabilities and autism appropriate to their role.

Paula McGowan worked with NHS England, Skills for Care and people with learning disabilities and/or autism to develop the Oliver McGowan Mandatory Training Framework on Learning Disability and Autism. This aims to provide health and care staff with this valuable training and improve outcomes for people with learning disabilities and autistic people.

The Oliver McGowan Draft Code of Practice was recently published, which sets out the standards for this training.

Fears risks to vulnerable groups could be ‘deprioritised’

Although the NHS 10-Year Plan does reference “systematic and avoidable harm”, and includes measures to narrow health inequalities and improve patient safety, quality of care and transparency, it does not specifically address the issue of avoidable deaths among individuals with learning disabilities or autistic people.

Critics argue that the plan lacks targeted actions, metrics or commitments focused on reducing mortality risks in these vulnerable groups, and there are concerns that efforts to cut bureaucracy – which will see the total number of NHS targets almost halved – will also lead to important targets around dementia, women’s health and learning disability care being deprioritised.

Leading national charity Mencap have been campaigning for an NHS that includes people with a learning disability.

Mencap Campaigns Officer Vijay says:

“If the government really wants to improve the NHS in England over the next 10 years, then it has to be better for everyone, including people with learning disability.”

High quality training to support health and care

First Response Training (FRT) is a leading, national training provider.

They deliver over 7,000 courses each year in the fields of health and safety, first aid, fire safety, food safety, mental health, health and social care and other special focus topics.

Their diverse portfolio includes training awards designed for care workers, such as Learning Disability Awareness, Understanding Autism, Oliver McGowan Mandatory Training, Positive Behaviour Support, Safeguarding Adults, Equality, Diversity and Inclusion, Person Centred Care and Support and many others.

Their course portfolio spans Care Certificate standards, mandatory training awards, clinical skills, special focus courses and training for supervisors and managers.

A Trainer at FRT, says:

“We know that the NHS faces multiple challenges. Hopefully any reforms can benefit the health service and the people it cares for. The priority must always be high quality, safe, effective and compassionate care for all.

“Tailored training and development solutions can help ensure staff are focused on patient safety and empowered to deliver high quality care.”

Oliver McGowan Mandatory Training

FRT was one of the first training providers in the country to be approved to offer essential training in line with the Oliver McGowan Mandatory Training on Learning Disability and Autism.

The national training provider aims to empower and educate staff to transform their practice by embracing the lived experiences of autistic individuals and those with learning disabilities. Through the collaborative strength of their trios—facilitating trainers and experts with lived experience — FRT aims to inspire lasting change in how individuals are understood, supported, and valued.

FRT are hosting a series of open, public Tier 2 courses in London, Manchester and Birmingham in the coming months. You can book a space on any of these courses online now.

FRT have also developed a free-to-download quick guide to the new Oliver McGowan draft code of practice.

This guide explains what the new code of practice means for health and social care providers, how to stay current, and how to meet new legal duties.

You can also download FRT’s free Oliver McGowan Mandatory Training brochure.

Providing an alternative training solution

To offer health and care providers flexibility and choice, FRT have also developed their own Tier 2 Mandatory Autism and Learning Disabilities Training package.

Fully mapped to the core capabilities framework, Oliver McGowan Mandatory Training Code of Practice and externally accredited, this package offers providers an efficient, affordable alternative solution.

Please note that, while fully interactive, this webinar-based training solution does not meet the code of practice’s requirement for the training to be ‘face-to-face’.

The training is designed to meet statutory standards and equip health and social care staff to deliver more empathetic, person-centred support.

A trainer at FRT explains:

“This isn’t just about compliance. It’s a chance to improve outcomes, reduce bias, and truly understand the lived realities of autistic individuals and people with learning disabilities.”

You can learn more about how FRT developed this training package here.

For further information on other types of neurodiversity training, visit their webpage or download the brochure.

You can contact FRT via freephone 0800 310 2300, send an e-mail to info@firstresponsetraining.com or submit an online enquiry.