We have seen the government’s 10-Year Health Plan: it is a mess
The draft of the government’s 10-Year Health Plan circulated this weekend, which HSJ has seen, is a highly ambitious document. Unfortunately, this is not meant as a compliment
The 150-page document contains many good ideas. However, they are set in a framework that would challenge the logic of the most credulous of policy radicals.
Put crudely – and that is the right word for the plan’s swathe of hi-tech references – the government’s argument is this: the recovery and transformation of the NHS can be achieved by shifting care into the community, applying AI to almost everything and stepping up prevention work.
A new operating model proposed by the government’s 10-Year Health Plan will radically reform the role and governance of foundation trusts and integrated care boards.
HSJ has seen a recent draft of the plan, which states that the strongest foundation trusts will be allowed to become “integrated health organisations”. These will be given the responsibility of managing the budget for the health and care of a designated population.
Meanwhile, the plan says elected mayors will take over from local authority leaders on integrated care boards, and the new role of the boards will often involve shaping the provider market.
‘The draft plan says the Department of Health and Social Care will seek to approve the first “new FTs” in 2026.
The authorisation will be undertaken by a unit within the DHSC, whose work will be overseen by an independent group of experts. There will be no return for Monitor, the standalone FT regulator.
The plan reveals FTs will no longer be required to have governors. The public and staff representatives will be replaced by more “dynamic” ways of reflecting their views.
The highest performing new FTs will be able to manage the entire healthcare budget for a local population. These FTs will become “integrated health organisations” or “IHOs”.
This approach, the plan claims, will avoid the problem in which improving preventative care in one type of provider, such as GP practices, advantages another, for example, a hospital. It is a concept similar to “accountable care organisations” in the USA.
Read full story (paywalled)
Source: HSJ, 23 June 2025