The NHS 10 Year Health Plan is the UK Government’s long-term strategy for changing the NHS in England between 2025 and 2035. Published on 3 July 2025 under the title Fit for the Future, it is built around three big shifts: moving care from hospitals into communities, moving from paper and analogue systems to digital services, and moving from treating sickness to preventing it. This guide explains what the plan says, what it means for patients, how it is funded, and what has happened since it was published.

The plan applies to England only. Health is a devolved matter, so Scotland, Wales and Northern Ireland run their own health services and have their own plans. Within England, the plan is the current strategy for the NHS, replacing the 2019 Long Term Plan. It was presented to Parliament by the Secretary of State for Health and Social Care and published as Command Paper CP 1350.

Why was the plan written?

The plan was the Government’s answer to Lord Darzi’s independent investigation of the NHS in England, published in September 2024, which concluded that the health service was in serious trouble. The investigation described an NHS at a historic crossroads, with long waits, strained hospitals and a service struggling to meet rising demand from an ageing population and more people living with long-term conditions.

Before writing the plan, the Government ran a national engagement exercise called Change NHS, which gathered more than 250,000 contributions from staff, patients and the public. The plan itself describes the NHS as being in critical condition and says the choice is change or decline. Its central argument is that the NHS cannot simply carry on working in the same way with more money, and that the model of care itself has to change.

The plan contains more than 200 specific commitments and initiatives. Rather than listing them all, it organises them around three fundamental shifts that are meant to reshape where care happens, how it is delivered, and when the NHS steps in.

What are the three shifts?

The first shift is from hospital to community. The plan argues that too much care happens in hospitals when it could happen closer to home. Its answer is a new Neighbourhood Health Service, built around neighbourhood health centres that bring together GPs, nurses, pharmacists, mental health workers, social care staff and other professionals in one place. The aim is for care to happen as locally as it can, in a patient’s home where possible, in a neighbourhood health centre when needed, and in a hospital only when hospital care is genuinely necessary.

The second shift is from analogue to digital. The plan wants the NHS App to become the front door to the NHS by 2028, so that patients can book appointments, see test results, manage prescriptions and access their records in one place. It also promises a single patient record, so that a patient’s information follows them between a GP surgery, a hospital and community services instead of sitting in separate systems. Artificial intelligence is named as one of the technologies that should help clinicians, from reading scans to cutting paperwork, and the plan sets the ambition for England to have one of the most AI-enabled health systems in the world.

The third shift is from sickness to prevention. This is the shift that reaches furthest beyond hospitals. The plan promises action to stop people becoming unwell in the first place, including a generational smoking ban through the Tobacco and Vapes Bill, restrictions on junk food advertising aimed at children, a ban on the sale of high-caffeine energy drinks to under-16s, reform of the soft drinks industry levy, and mandatory reporting of healthy food sales by large food companies. It also promises more use of genomics, vaccination and screening to catch disease earlier, when it is easier and cheaper to treat.

What will change for patients?

For patients, the most visible changes are meant to be in how everyday care feels. The plan promises same-day GP appointments for people who need them, with more routine care handled by neighbourhood teams rather than in hospital outpatient departments. It describes a future in which a patient with a long-term condition such as diabetes or heart disease is looked after by a team that knows them, rather than being passed between separate services that do not share information.

The plan also sets out a new order for how care should be delivered: as locally as it can be, digitally by default, in the patient’s home if possible, in a neighbourhood health centre when needed, and in a hospital if necessary. Hospitals are not being closed under the plan. Instead, they are meant to be kept for the care that only a hospital can provide, such as emergency treatment, complex surgery and specialist care, while routine care moves out into the community.

Digital change is meant to cut waiting and repetition. A single patient record should mean patients no longer have to repeat their history at every appointment, and the NHS App should let them manage more of their own care. The plan also promises that patients will be able to access NHS services online and offline, around the clock, rather than only during surgery hours.

How is the plan being paid for?

The plan is funded by a £29 billion real-terms increase in day-to-day NHS spending over three years, announced in the Spring 2025 Spending Review. The Government says this money will fund the reforms, service improvements and new technology the plan requires. The Spending Review of June 2025 also committed £10 billion for NHS technology and digital transformation by 2028–29.

The plan argues that prevention and community care should save money over time by reducing demand on hospitals, but it does not promise immediate savings. Its financial case rests on the idea that treating people earlier and closer to home is cheaper than treating them late in hospital, and that digital tools can free up staff time. Critics have pointed out that the plan was published without a detailed delivery plan or a new workforce plan, and that the practical detail of how the three shifts will be delivered is still emerging through NHS planning guidance.

What has happened since publication?

Delivery has begun in stages. In September 2025 the Government announced 43 areas that will pilot neighbourhood health services, testing how the new model works in practice before it is rolled out more widely. Local health boards have been producing their own updates on the plan and its implications, and the House of Commons Library has published a research briefing tracking the plan’s commitments.

The plan also sits alongside a wider reorganisation of the NHS in England, with a redesigned centre of the system at the Department of Health and Social Care and other national bodies. The Government has said further detail will come through subsequent strategies and guidance, including NHS planning guidance and a new NHS Workforce Plan, because the workforce is the group that will have to deliver the three shifts.

Some measures in the plan depend on new laws. The generational smoking ban, for example, requires the Tobacco and Vapes Bill to complete its passage through Parliament. Other measures, such as the energy drinks ban and advertising restrictions, require regulations and consultation before they take effect.

Who does the plan cover?

The plan covers the NHS in England only. It does not cover Scotland, Wales or Northern Ireland, where health policy is devolved and separate plans apply. Within England it covers the whole NHS, from GP surgeries and community services to hospitals, mental health services and dentistry, although the detail is heaviest on general practice, community care and hospitals.

Patients in England do not need to do anything because of the plan. There is no new registration, no new card and no change to how people are entitled to NHS care. The changes are to how services are organised and delivered, and most patients will notice them gradually, as neighbourhood health centres open, the NHS App gains new features, and more appointments become available outside hospitals.

What are the main criticisms?

Support for the plan’s direction has been broad, including from medical royal colleges, professional associations and charities quoted in the Government’s launch. The main criticisms have been about delivery rather than direction. The House of Commons Library noted that publication was not accompanied by a specific implementation plan, and that further details were expected to emerge later. Others have asked how neighbourhood health centres will be staffed at a time when the NHS already faces shortages of GPs, nurses and other professionals, and whether the promised digital systems can be built on time.

There are also questions about timing. The plan runs to 2035, which spans more than one Parliament, so its delivery depends on future governments and future spending decisions. The Government’s answer is that the three shifts are a long-term direction of travel, not a single spending round, and that the £29 billion settlement gives the NHS a stable base to start from.

Frequently asked questions

When was the NHS 10 Year Health Plan published? It was published on Thursday 3 July 2025 as Fit for the Future: 10 Year Health Plan for England.

What are the three shifts in the NHS 10 Year Health Plan? Hospital to community, analogue to digital, and sickness to prevention.

Does the plan apply to the whole UK? No. It applies to England only, because health is devolved to Scotland, Wales and Northern Ireland.

What is the Neighbourhood Health Service? It is the plan’s model for bringing GPs, nurses, pharmacists, mental health workers and social care staff together in neighbourhood health centres, so more care happens close to home.

When will the NHS App become the front door to the NHS? The plan sets 2028 as the target for the NHS App to become the single digital front door for patients in England.

How much extra funding does the plan involve? A £29 billion real-terms increase in day-to-day NHS spending over three years, announced in the Spring 2025 Spending Review.