Analysing the NHS 10-Year Plan: The shift to community-based care

The third core pillar of the government's 'Fit for the Future' 10-Year Health Plan is a structural shift away from a hospital-centric model of care. The plan proposes to dismantle what it terms a "fragmented" and inconvenient system by establishing a Neighbourhood Health Service. The strategy aims to provide more integrated and accessible care within local communities, with the dual goals of improving patient outcomes and alleviating pressure on acute hospital services.

This final analysis in our series examines the framework of the Neighbourhood Health Service and its practical implications for the life sciences sector and the healthcare workforce.

The framework of the Neighbourhood Health Service

‍‍This new model is built on a "preventative principle" that care should happen as locally as possible: "digitally by default, in a patient's home if possible, in a neighbourhood health centre when needed, in a hospital if necessary".

Neighbourhood Health Centres (NHCs): At the heart of the model are Neighbourhood Health Centres (NHCs). The plan envisions these as "one-stop shops" for patient care, operating at least 12 hours a day, six days a week. They will serve as the base for multidisciplinary teams and co-locate services traditionally found in hospitals, such as diagnostics and post-operative care. Crucially, the rollout will begin in the areas with the lowest healthy life expectancy to directly address health inequalities.

Expanded roles for community pharmacy: The role of community pharmacy is set to expand significantly. As community pharmacists gain additional prescribing rights, they will become increasingly integral to the management of long-term conditions. The plan also specifies a bigger role for pharmacy in prevention, including expanded vaccine delivery and screening for cardiovascular disease, with their services securely linked to the Single Patient Record.

The end of outpatients: A stated goal of the plan is to end the traditional outpatient model by 2035. This will be achieved by moving most services out of hospitals, leveraging digital tools, virtual consultations, and expanding the use of patient-initiated follow-up (PIFU). This is a significant structural change, designed to make care more convenient and resources more efficient.

Personal Health Budgets (PHBs): To support personalised care, the plan includes a major expansion of Personal Health Budgets (PHBs). The target is to offer a PHB to at least double the current number of people by 2028-29, rising to 1 million people by 2030, and making it a universal offer for all who would benefit by 2035. This gives patients direct financial control over how their care needs are met.

A spending shift to out-of-hospital care: Underpinning this entire shift is a firm commitment to reallocate spending. The plan states that over the next decade, the share of expenditure on hospital care will fall, with a proportional increase in investment in out-of-hospital care. This is supported by evidence cited in the plan suggesting that every £100 spent on community care can achieve an average of £131 in acute sector savings.

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Implications for the Life Sciences industry

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For pharmaceutical companies:

• Decentralised engagement: With care delivery and prescribing shifting to NHCs and community pharmacies, engagement strategies must evolve. The introduction of new GP contracts for leading larger "neighbourhood providers" creates a new type of stakeholder for commercial teams to understand and partner with.
• Focus on community-managed therapies: There will be a clear preference for medicines that are simple to administer, monitor, and manage in a community setting, particularly for long-term conditions.
• New payment models: The testing of "year of care payments" from 2026-27 will incentivise providers to adopt the most cost-effective treatments over a complete care cycle, favouring products that demonstrably prevent hospital admissions.

‍For the medtech industry:

• Point-of-care diagnostics: The creation of NHCs will generate significant demand for compact, rapid, and user-friendly diagnostic equipment suitable for a community setting.
• Remote monitoring and virtual care: The goal of ending the traditional outpatient model creates a substantial market for technologies that enable "hospital at home" and virtual ward models, including wearables and telehealth platforms.
• Assistive robotics: While a longer-term prospect, the plan's focus on community rehabilitation and pharmacy automation may create future opportunities for robotics outside of the surgical suite.

‍‍‍Implications for the healthcare workforce:
This model will reshape the roles and career paths of healthcare professionals, a critical consideration for NHS workforce planning.

• New leadership roles: The Neighbourhood Health Service creates new leadership opportunities for GPs, nurse consultants, and other professionals to manage community-based provider organisations. The plan explicitly states an intention to increase the number of nurse consultants in neighbourhood settings.
• Evolving team structures: The emphasis on multidisciplinary teams will continue to blur traditional professional boundaries, fostering a more integrated and flexible approach to care.
• New role for hospital specialists: With fewer routine outpatients, hospital specialists will likely focus more on complex cases and providing remote expertise to support their colleagues in community teams.

Conclusion: A new landscape for UK healthcare

The three core shifts outlined in the NHS 10-Year Health Plan—from analogue to digital, from sickness to prevention, and from hospital to community—collectively represent a new strategic direction for healthcare in England. If implemented, they will create a system that is more integrated, data-driven, and located closer to the patient.
For professionals and organisations across the NHS and life sciences, this is more than just a policy update; it is a new landscape to navigate. Success will require an understanding of new payment models, new points of care, and a workforce with new skills. By preparing for these changes now, we can all play a role in building a healthcare system that is truly fit for the future.

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