The NHS 10-year Plan. What will it mean for General Practice? LMC Chief Executive

The NHS 10-year Plan. What will it mean for General Practice?

Following a first read of the new NHS 10-Year Plan just what are the implications for general practice? This briefing pulls together my thoughts to date.

The document is most definitely a vision document and so does not focus on how to make the vision work. There is no formal implementation plan. No financial detail (other than referencing there is no new money). Most of the crucial detail is missing and will come in the months ahead.

First off there is no specific section on general practice. Perhaps the NHS leadership is nervous as to how GPs will react? There is no question that general practice is pivotal to how the NHS is delivered and should be a core element of any true plan. Secondly, it does seem to signal a major shift in how the NHS will operate in future. The focus will be on the neighbourhood health concept and not on GP practices, hospitals, mental health etc. Thirdly there is an emphasis on what appears a segmented patient group approach to the neighbourhood health delivery model. Does this indicate a move away from the GP registered list which has been around since the start (and before) of the NHS? This could be the biggest shift in thinking if this is the case.

To make it sustainable, the plan must address the long-standing workforce crisis with a credible strategy that not only recruits new GPs but, critically, improves working conditions to retain the experienced ones we have. Realistically, I expect the plan will be structured around the stated three strategic drivers: moving care from hospitals into the community, driving a digital transformation with a focus on the NHS App., and moving from treating sickness towards prevention.

The long-term vision will likely be constrained by short-term political and financial realities locally and nationally. The immediate priorities for 2025/26 are dominated by performance targets, including GP access, cutting elective waiting lists and improving A&E times. The often-quoted shift to the community will manifest initially as an expansion of digital services, with enhanced NHS App. functionality, and the scaling of existing initiatives like Pharmacy First to manage demand. We need to see multi-year contracts that give us time to embed transformative change properly. We need adequate time to get all the elements in place. We also need flexibility at the local level within a clear framework that ensures we are all moving in the right direction together. From a primary care network perspective, it would be great to have clarity on the future of PCNs and the Additional Roles Reimbursement Scheme. Although PCNs are hardly mentioned in the 10-year plan, Amanda Doyle (NHSE) said in a webcast on 3 July that NHSE is committed to them and they will continue beyond April 2026. She also said there is no risk to ARRS roles or to delivery of services on the PCN footprint

Where activity is shifted from secondary care to primary care and community care more space will be needed to house services, equally the funding will need to shift. In terms of estate, there is reference to neighbourhoods each having a community health centre hub. Some new buildings will be needed to house these hubs, however, there is a vast public sector estate that can be utilised as well as working on hub and spoke models. Any estates currently being built or designed will need to be able to co-locate services. It is not envisioned that all GPs sit in a neighbourhood hub but that each neighbourhood will have one hub that co-locates services.

William Greenwood

Chief Executive and Company Secretary