The NHS 10-Year Plan: What We Already Know

It looks like the government’s new 10-Year plan for the NHS may be close to release. For Primary Care Network (PCN) leaders, clarity on the plan is crucial for strategic planning. While we already know some of the changes that will make up this new direction, several key gaps still remain.

In this blog, we’ll take a look at what we know so far, the key questions remaining, and the specific implications for primary care and clinical pharmacy.

What is the 10-Year Plan?

The 10-Year Health Plan is the government’s strategic response to the profound challenges facing the NHS, exacerbated by the pandemic but rooted in longer-term pressures like an ageing population and rising rates of chronic conditions. Developed following the independent Darzi Review and extensive public and staff engagement, the plan aims to create a modern, sustainable health service.

When can we expect the 10-Year Plan to be released?

Following the “Change NHS” engagement process, the plan’s publication is anticipated in mid-2025. With June just a month away, it could be with us shortly (and, with a few surprises already this year, another sudden announcement wouldn’t shock most of us!)

What do we know about the 10-Year Plan for the NHS?

While the full details await publication, several key elements and near-term priorities are confirmed through official documents like the 2025 Mandate to NHS England and the 2025/26 Planning Guidance. The largest of these changes already highlighted is the “three shifts.”

The “three shifts”

The foundation of the plan rests on three core strategic “shifts”:

Hospital to Community: Moving care delivery away from acute hospitals towards primary care, community settings (including community pharmacies), diagnostic hubs, and patients’ homes. This is underpinned by the development of integrated “Neighbourhood Health Services”.
Analogue to Digital: Accelerating the use of digital technologies, including the NHS App, shared electronic records, data analytics for population health, and AI.
Sickness to Prevention: Rebalancing efforts towards proactively keeping people healthy, addressing health inequalities, and tackling the wider determinants of health.

Immediate Priorities for 2025/25

Focus on cutting elective waiting lists, improving urgent/emergency care performance, enhancing primary care access, improving productivity, and achieving financial balance.

Neighbourhood Health Foundations:

Initial steps for 2025/26 involve standardising and scaling six core components of existing integrated care practice to build the foundation for Neighbourhood Health Services for adults and children with complex needs.

These six components are: Population Health Management, Modern General Practice, Standardised Community Health Services, Neighbourhood Multidisciplinary Teams (MDTs), Integrated Intermediate Care, and Urgent Neighbourhood Services. The initial focus is on adults and children with complex needs.

Primary Care Access:

Improving timely access to general practice is a high-priority objective. The concept of “Modern General Practice” involves streamlining access, po10tially using more digital tools and integrating services like Pharmacy First. Investment in GP premises and digital infrastructure is also planned.

Pharmacy Inclusion:

Pharmacies are explicitly included in the planned expansion of primary and community services.

Digital Drive:

Emphasis on expanding NHS App functionality, pursuing shared records (with FDP First policy), and exploring AI is confirmed.

Workforce Plan Refresh:

Acknowledgement that the existing NHS Long Term Workforce Plan needs updating to align with the community-focused shifts.

What gaps still need clarifying when the plan is published?

Despite the known direction, significant uncertainties remain, critical for PCN leaders and pharmacists planning for the future:

Long-Term Funding: The overall NHS funding beyond 2025/26 is unclear.

Resource Shift: Concrete mechanisms to ensure a sustained shift of funding from hospitals to primary and community care are yet to be specified. How will historical inertia favouring acute funding be overcome?

Neighbourhood Model Detail: The definitive long-term structure, governance, funding flows, performance metrics, and the precise role/relationship with PCNs for Neighbourhood Health Services need definition.

Workforce Plan Specifics: Details on recruitment/re10tion targets (especially for primary/community roles), funded training places (e.g., for prescribing), skill mix, supervision, and strategies to manage inter-sector workforce flow needed.

Community Pharmacy Stability: A credible plan to address the widely reported financial and workforce crisis in community pharmacy is essential, but currently unspecified. How will the sector be sustained to deliver expanded roles, particularly without undermining the success of clinical pharmacy’s success in primary care?

Digital Roadmap: A detailed, funded plan for delivering interoperable IT, shared records, and managing AI ethically and equitably is needed.

What we hope the 10-Year Plan means for pharmacists?

The 10-Year Plan signals a significantly enhanced role for clinical pharmacy within primary and community care. For pharmacists working in PCNs and general practice (often via ARRS), the changes are likely to include:

Pharmacists are expected to be key members of Neighbourhood Multidisciplinary Teams, working alongside GPs, community nurses, social care, and others. This greater integration will allow pharmacists to unlock their true po10tial.

Building on the success of ARRS roles and Pharmacy First, there’s a clear drive towards pharmacists taking on more clinical responsibility. Whether it’s in primary care or community pharmacy, there’s services offered by pharmacists is likely to expand. This could include:

Independent Prescribing: The push for all new pharmacists to be prescribers and upskilling the existing workforce is pivotal. This will enable pharmacists to manage patients more autonomously, handle long-term conditions, support medicines optimisation and deprescribing, and free up GP capacity.

Enhanced Service Commissioning: Potential for roles in diagnostics, health screening, and more complex long-term condition management within the primary care setting.

Digital Enablement: Improved access to patient records (e.g., via GP Connect enhancements and systems will be crucial for safe and effective practice.

It’s important to acknowledge the wider context when looking at the role pharmacy is expected to play in the new neighbourhood system.

The expansion of primary care pharmacy roles via ARRS, while very positive, has contributed to workforce pressures within community pharmacy. A sustainable future, where both primary care and community pharmacists can maintain effectiveness, requires a holistic approach.

We hope the final plan includes a joined-up workforce strategy addressing recruitment, re10tion, training, and funding across *all* pharmacy sectors, ensuring stability and preventing the simple shifting of pressures. Diplomacy and collaboration between sectors are vital as roles evolve.

What are our thoughts on the 10-Year Plan at this stage?

Ultimately, the credibility and success of the 10-Year Plan hinge on translating strategic vision into actionable, funded reality. For PCN leaders and pharmacists, the key hopes for the final publication centre on clarity regarding:

Demonstrable commitment and mechanisms to rebalance investment towards primary and community care.
A clear blueprint for how Neighbourhood Health Services will function, be governed, and integrate existing structures like PCNs.
A detailed, funded, and integrated plan addressing staffing across primary care, community services, and pharmacy.
A strategy to ensure the sustainability of the entire pharmacy network, enabling it to fulfil its expanded role.
Roadmaps for digital integration and supportive performance metrics reflecting community-based care goals.

Navigating uncertainty with flexible support

The upcoming changes promise exciting opportunities but also bring uncertainty. In such a dynamic landscape, flexible, high-quality clinical support is invaluable.

Medacy offers fully-managed services, deploying experienced prescribing pharmacists and pharmacy technicians rapidly to meet evolving primary care needs. Our teams integrate seamlessly, providing capacity and expertise precisely when and where it’s needed, helping PCNs navigate the changing demands of the NHS landscape effectively.

Get in touch to find out more.

Appendix: Summary of the 10-Year Plan (what we know & what we don’t)

Feature	Confirmed Elements (Gov/NHSE Statements/Guidance)	Speculation/Recommendations (Stakeholder Analysis/Asks)	Key Uncertainties
Overall Strategy	10-Year Plan based on “3 shifts”. Publication Spring/Mid-2025.	Scale of ambition vs. resources. Balance of recovery vs. reform.	Overall long-term funding envelope. Impact of NHSE abolition.
Primary Care: Structure	Development of “Neighbourhood Health Service”. 2025/26 focus on standardising 6 core components (Pop Health Mgt, Modern GP, MDTs etc.).	Specific long-term models for neighbourhood services. Role of at-scale providers. Need for regulatory reform (e.g., LLPs).	Definitive long-term structure, governance, and relationship with PCNs. How integration across sectors will be mandated/incentivised.
Primary Care: Funding	Mandate includes investment for GP surgery upgrades. 2025/26 GP contract weighted towards core funding.	Calls to increase primary/community care’s proportion of NHS budget (e.g., 11% for GPs). Suggestions for specific funding targets/metrics. Review of Carr-Hill formula needed. Multi-year local budgets needed.	Concrete mechanisms/commitment to shift funding proportion from acute to primary/community. Long-term funding levels. Details of revised funding formulas.
Primary Care: Access	Priority to improve timely access to GP appointments. “Modern General Practice” model aims to streamline access (inc. digital/Pharmacy First).	Need for longer consultations. Focus on continuity. Fixing operational failures.	How access improvements will be balanced with workforce capacity and continuity goals. Specific performance targets beyond 2026.
Pharmacy: Role/Services	Plan includes expansion of pharmacy services. Pharmacy First established. Ambition for new pharmacists to be prescribers by 2026.	Calls for broader Community Pharmacist Prescribing Service. Commissioning of further enhanced services (diagnostics, LTCs, public health). Greater role for technicians.	Specific services to be commissioned nationally/locally. Funding/remuneration for new services. Pace of independent prescribing rollout for existing workforce.
Pharmacy: Funding/Viability	(No specific confirmed actions addressing core funding issues in snippets)	Urgent need to address community pharmacy funding crisis via contract reform. Calls for sufficient remuneration for activity/costs.	Government’s plan/commitment to stabilise the community pharmacy sector. Details of future CPCF negotiations/funding models.
Workforce (Primary/Community)	Workforce plan to be refreshed to align with 10-Year Plan’s shifts.	Calls for specific recruitment/retention targets (GPs, nurses, pharmacists). Need for integrated planning across sectors. Investment in training/supervision (esp. prescribing). Focus on staff wellbeing. Move ARRS funding to core contract.	Specific targets, funding, training capacity, and retention strategies in the refreshed workforce plan. How inter-sector competition for staff will be managed.
Digital Integration	Expand NHS App. Pursue shared records/interoperability. Explore AI. Mandate includes investment in primary care digital.	Calls for single shared patient record. Need for infrastructure investment, skills training, addressing digital divide.	Detailed roadmap, funding, and timelines for major digital infrastructure projects and achieving interoperability. Strategy for digital inclusion.