The DHSC has published an engagement insight report on the 10-Year Plan, outlining the views of members of the public and health and care staff on what success looks like; the three shifts from hospital to community, analogue to digital, and sickness to prevention; and a vision for the future of the NHS.
The findings are made from a collection of reports via Change NHS, launched in October 2024 to inform the development of the 10-Year Plan. More than 270,000 contributions were received through avenues such as face-to-face events, the Change NHS website, partner engagement, and community conversations.
When asked what success looks like and what needs to change to achieve it, public priorities were around improving access, improving communication, reducing waiting times for hospital procedures and A&E, and reducing health inequalities. Staff priorities looked at improving day-to-day life for the workforce throughincreasing capacity, and resolving challenges that have impeded past reform such as technology.
Specific themes emerging on what needs to change highlighted the need for adequate resources and infrastructure to underpin change efforts, a more integrated service and a culture of collaboration, effective leadership with a clear vision, freedom from “unnecessary bureaucracy”, and an environment that fosters innovation.
Looking at the shift to digital specifically, the DHSC shares that the public and staff considered the potential for tech to support more coordinated care, particularly through a single patient record, to be exciting. 50 percent of nationally representative survey participants felt the biggest opportunities lay in improving testing and diagnostic capabilities; 38 percent cited the single electronic patient record; 34 percent pointed to making administrative processes more efficient; and 31 percent looked at improving the overall quality and accuracy of care.
Participants expected the shift to digital to improve access, with 62 percent saying they would be happy speaking to a healthcare professional through a digital appointment, and the same percentage supporting the idea of the NHS App becoming the main way of accessing services and information. A selection of staff and members of the public attending events and community engagement expected that increased use of AI in diagnostics would “lead to faster diagnosis and therefore quicker access to the right care”, the DHSC states.
On enhancing workforce productivity, the main findings were that having a “sufficient number” of up-to-date devices with reliable WiFi connections would reduce time spent logging into multiple systems and dealing with tech issues, and that tech could help reduce the admin burden and minimise duplication by automating routine tasks. Staff and children and young people also reported that AI could be used in delivering more personalised care to patients, helping clinicians with personal preferences about communication, as well as information about previous treatments.
“Among all audiences, the most significant concern expressed about this shift was about the NHS’s ability to deliver it,” the DHSC notes. “Staff and partner organisations were most sceptical, often pointing to perceived historical underinvestment in this area and to what they described as the NHS’s failure to deliver large-scale change in the past.” Other concerns included the possibility of the shift to digital worsening inequalities, the loss of the human touch in patient relationships with the health service, and privacy, security, and bias around AI and other technologies.
Most nationally representative survey participants felt the cost of implementing new tech and delivering value for patients was the biggest concern (39 percent). Also mentioned were less human contact with health professionals (38 percent), unreliability of IT and infrastructure (37 percent), some being less able to access digital services (37 percent), data protection and privacy (28 percent), tech not being fit for purpose or meeting patient needs (27 percent), staff not being able to use tech effectively (22 percent), and resistance to change from patients and staff (16 percent).
The most significant concerns were about how well the shift to digital could be achieved in practice, with the DHSC reporting that staff “lacked confidence” in the NHS’s ability to deliver in the next ten years, and concerns from partner organisations about a backlog of digital infrastructure needing updating after “previous underinvestment in technology”. For the public, “the 10-year timeframe meant that some participants in the deliberative events were concerned that technologies would be out of date by the time they were successfully rolled out”. Funding was another area of concern, with worries the NHS would underinvest in other areas of the system to fund the shift.
Two areas identified by staff as needing investment included funding for staff to have time to work on transformation initiatives on top of their current workloads, and the resources to address skills gaps in the existing workforce. Staff and health system leaders further expressed concern that current procurement processes are a barrier to the shift to digital being “delivered well”, being described as “too complex for suppliers” and as having an emphasis on cost rather than value.
Participants voiced that an area of priority should be where tech can help better coordinate care. “The public felt that a single patient record would be the cornerstone of delivering more co-ordinated care,” according to the DHSC. “Participants on the Change NHS website, across all demographics, most commonly selected ‘staff having access to all your records from across different services so you don’t have to repeat yourself’ as the benefit to prioritise when rolling out a single patient record.”
The feeling amongst staff members was that a focus on the basics was needed as a first step, which they saw as including more up-to-date devices, reliable connectivity even when working remotely, fewer systems and logins, a single patient record, and secure messaging between departments and settings. Putting staff at the centre of the change process was recommended, with the need to engage early, test new systems with users to ensure ease of use and benefits, and ensure a continuous feedback loop to resolve challenges.
Wider: 10-Year Plan
The UK government published its Fit for the Future: The 10 Year Health Plan for England in summer, aiming to “build a truly modern NHS”, with focus on moving from hospital to community, analogue to digital and sickness to prevention. The plan outlines a new operating model, a new era of transparency, a new workforce model with staff aligned to the direction, a reshaped innovation strategy, and a different approach to NHS finances. AI, technology and digital tools play a key role in realising the ambitions in the plan, with the UK government signalling the intention for patients to gain “real control through a single, secure and authoritative account of their data and single patient record” aiming to deliver more co-ordinated, personalised and predictive care.
The government also outlined the role of the NHS App in its health system of the future, highlighting AI-enabled features, links with wearable tech, and access to the Single Patient Record. The NHS App will become a “doctor in their pockets” for patients as a tool for access, empowerment, and care planning, creating a “full front door to the entire NHS”. It will offer remote or face-to-face appointment booking and signposting to the most appropriate service with the AI-enabled My NHS GP, and allow patients to select preferred providers through My Choices.
The DHSC issued a call for evidence to inform the development of a 10 year workforce plan, looking to understand the roles and skills that will be critical to successfully implementing the 10 year plan. Respondents were invited to share views and experiences either as an individual or on behalf of an organisation, with a request for evidence of the three shifts outlined in the 10 year plan being implemented locally and their impact on the workforce.
