The 10-year Health Plan for England – what it means for you, and Healthwatch

The Government has now launched ‘Fit for the Future’, the 10-Year Health Plan for England – an ambitious blueprint of reforms for the NHS.

The plan centres on three ‘shifts’ or changes the government wants to see:

• Moving care from hospitals to local communities
• Preventing illness, not just treating it
• Moving from analogue to digital

The Plan is 168 pages long and covers the Government’s ambitions and the steps it aims to take to get there. 

Here we are exploring some of the key points from the 10-year Plan, what it means for services and for Healthwatch. 

A bold and ambitious plan

Many of the ideas reflect things Healthwatch Kingston and Healthwatch England have championed for years, including:

• Better access to GPs and NHS dentists
• A bigger role for community pharmacies
• Improvements to the NHS app
• A simpler complaints system
• Personalised mental health emergency care

If done well, these changes could make a real difference to people’s everyday care, making it easier for patients to access information, manage their appointments and navigate services.  

From hospital to community services

The Plan sets out a vision for ‘neighbourhood health’ that increasingly brings care into local communities and links community and health services together. 

New Neighbourhood Health Centres will act as ‘one stop shops’ for patient care in every community. Open at least 12 hours a day, 6 days a week, Neighbourhood Health Centres aim to bring together NHS, local authority and voluntary sector services.

Hospital-based services like diagnostics, post-op care and rehabilitation will be available alongside services such as:

• debt advice
• employment support
• smoking cessation
• weight management services

Preventing illness, not just treating it

Where the Plan talks about preventing illness, it is focused on weight management, smoking cessation, encouraging exercise, improving air quality and tackling harmful alcohol consumption.

The Plan wants to achieve this through steps like collaborating with businesses, introducing incentive schemes for healthy eating and movement, expanding free school meals for families in receipt of Universal Credit and regulating food advertising. 

There are also important changes that focus on children’s health, including better access to dental care and mental health support. 

Moving from analogue to digital

The NHS app plays a key role in the Plan, and will include new functions to help people manage their health and care, access information and give feedback.

These changes aim to give patients greater control over their health and care, with the tools and information to manage their own health appropriately. 

While the Plan states inclusion will be designed into the NHS App by default, it does not outline what this will entail. We have concerns about what the reliance on smartphones will mean for patients who are digitally excluded. 

In our ‘Including Digitally Excluded Communities’ engagement, we found that many of the communities we engaged with preferred face-to-face opportunities to have their say, as digital processes are often inaccessible and isolating, for example, only three out of the 22 blind and visually impaired people we engaged with had Wi-Fi in their homes.

Other changes to take advantage of digital tools include a single patient record, and AI scribes for helping manage workload for staff. 

What will happen to patient voice?

Alongside big ambitions, the Plan includes major changes to how patient feedback is heard. 

As part of the Plan, Healthwatch England and local Healthwatch are being dismantled and their functions brought ‘in-house’ into the Department of Health and Social Care, Integrated Care Boards and Local Authorities. 

Since 2012, Healthwatch has been the independent champion for patients and the public. Our independence means we can speak honestly to build critical and collaborative partnerships across the NHS and local authority.

We’ve helped thousands of people:

• Make informed decisions about their health and care
• Share their experiences to shape services
• Navigate complex NHS systems

We constantly push for better access, quality and safety; our detailed reports are respected and acted upon, and we have built well-earned trust with the communities we serve.

The 2013 Francis Inquiry made clear that independent scrutiny and patient advocacy are essential. That report tells the story “first and foremost of appalling suffering of many patients” and outlines the impact of an institutional culture that “failed in its primary duty to protect patients and maintain confidence in the healthcare system.”

Acting as an independent champion is a role we are proud of, and we are concerned that losing it or replacing it with digital-only systems or in-house processes risks compromising hard-earned patient trust and leaving the voices of many, particularly those who are vulnerable and may be digitally excluded, behind.  

The King’s Fund says, 

“The decision to abolish Healthwatch will come with consequences that need to be carefully thought through.

Healthwatch [is] able to bring power to people’s individual voices by bringing them together and showing the scale and impact of what was happening – such as the huge impact poor admin processes can have on people’s care and wellbeing.

The government will therefore need to address concerns about how the collective patient voice will be heard and acted upon when some of these functions are moved from a body at arm’s length from the government into the Department of Health and Social Care.”

We’re still here for local people

A lot needs to happen before anything will change for Healthwatch. The Government needs to outline how this will happen and change the law.

This means that we are still here, open, and working for local people.

We continue to:

• Listen to your experiences of health and social care.
• Share what we hear with those in power to help improve services.
• Provide advice and information to help you find the support you need.