Fit for the Future or Not Fit for Purpose? The NHS 10 Year Health Plan

06 October 2025

The NHS is in crisis; that much is inarguable. Long waiting times; patients struggling to access doctors and dentists; over-stretched resources; declining public satisfaction; workforce shortages; undervalued staff… the list is familiar and lengthy. Without reform, the list becomes longer, and the discontent runs deeper. Enter Fit For the Future, the NHS’s 10-year health plan for England.^{^[1]} Could this be the plan to save the NHS, to finally fix the incredible entity that (in a quote often attributed to NHS founder Aneurin Bevan), “[…] will last as long as there are folk left with the faith to fight for it.”

And fighting we are: fighting for the future of the NHS; for the safety of the NHS workforce; for the provision of resources they need to keep the failing, flailing system afloat. As it stands, you can throw as much money as you want at the NHS, and it would absorb it without touching the sides. Recognising this means recognising it is a systemic problem, and recognising that increasing funding does not resolve inefficiencies.

Will the 10-year plan resolve inefficiencies and cut waiting lists, or is it simply paying lip service? In a nutshell, the plan includes a renewal of the NHS whilst maintaining its founding principles (universal healthcare that is free at the point of delivery). Hospital care will be taken into the community through the implementation of neighbourhood health services. GP numbers are to be expanded (to avoid the ‘8am scramble’), and there will be a greater integration of care around people’s needs, as well as community-based treatments to reduce reliance on hospitals. The NHS App will be expanded to be the front door of digital access, including all booking, health records, care plans, prescriptions and test results. Sickness prevention will be a core principle in tackling obesity, smoking, and alcohol-related harm, and there will be a £120 million investment into the development of dedicated mental health emergency departments.

CBS Founding Member, Mr. Nigel Mercer, says:

“It’s an aspirational plan, that’s for sure, but some elements do make sense. The primary focus should be on stopping healthcare being used as a political football — the way it is being kicked around to garner votes rarely translates to real improvement simply because the concepts within manifestos do not run deep enough to rectify core issues. Politicians don’t tell Generals how to fight wars, they trust and rely on them to make the best possible decisions. We can equally do so, yet are subject to a disconnected management structure that leaves us unable to carry out our work in the most efficient way. It is not simply a lack of money: that is an easy fix. What we need is a plan that goes beyond funding and targets, putting the health of patients and staff back at its core.”

The 10-year plan outlines many reforms that the government feels will be beneficial in rebuilding the NHS into a model that once again works for everyone, but how, for example, hospital league tables — due to be implemented soon — will be beneficial in any way is a question we must ask. A hospital that is, for example, excellent for obstetrics and less than excellent for infectious diseases would be lower in the table. Labelling an entire hospital based on an average performance is short-sighted. How a professional does their job is key, with individual doctor output as a measurable marker much more useful than an arbitrary league table system.

Nigel Mercer continues:

“Other points in the plan include a shift back into community care. This is something we certainly do need, complete with an expansion of social and primary care. This is reminiscent of the system that worked, including community, GP-run hospitals and convalescent homes we had many years ago. But whether it works in the proposed model remains is untried and tested. And how can we manage any changes without a robust IT system in place? The proposed switchover from analogue to digital works in theory, but in reality it is a mammoth undertaking far beyond scanning records on to the system - it needs extensive investment into IT infrastructure, including a complete overhaul of current incompatible systems, and the employment of a team of people to transfer data over. This is not something I see happening within the next decade. The reforms for surgical care that would be truly beneficial haven’t even been mentioned, yet would be simple to implement: a return to a firm-based structure, for example, giving trainees a ‘home’ in the unit they are working in; more theatre time for surgeons to do what they are trained (and being paid) to do; and the basics of workplace dignity — somewhere to sit, to park, somewhere to eat a sandwich, somewhere to have a coffee and to have a rest if on nights. If these simple things are what everyone wants, then why can’t they happen? How we value surgeons and trust them to do their jobs efficiently directly affects patient care and outcomes. If protecting surgeon wellbeing is built into reform, the result will be not just a healthier workforce but a healthier NHS.”

[1]. https://assets.publishing.service.gov.uk/media/6888a0996478525675738f3a/fit-for-the-future-10-year-health-plan-for-england-executive-summary.pdf

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