The 10-Year Plan, Spending Review, and no more NHS England: Navigating a year of change in healthcare

With the NHS's long-trailed 10-Year Plan and a multi-year Spending Review on the horizon, 2025 was already set to be a pivotal year for primary and secondary care organisations. Now, the recent announcement of NHS England's abolition diverts more power to Ministers.

Senior Consultant at Luther Pendragon Jonny Girling sat down with Luther’s Executive Chair and healthcare campaigns and advocacy expert Simon Whale to discuss how those organisations can refine their campaign strategies to drive meaningful Government engagement.

What will be the main theme shaping healthcare this year?

The key theme in healthcare this year is the need for transformative change within the NHS, which is widely perceived as underperforming, characterised by treatment backlogs, missed wait targets, low productivity and staffing pressures. Public dissatisfaction with the NHS is at its highest level. The challenge is to evolve the system into one that is reliable, accessible, and provides high-quality care. The forthcoming 10-Year Plan aims to address these challenges through practical, evidence-based, and achievable measures. Even if the Plan articulates the transformation that is required, it is a mammoth task to make it happen.

Where are the opportunities for organisations to influence the 10-Year Plan?

The big themes of the 10-Year Plan have been signposted for some months. The Plan itself is largely written and is now being scrutinised  and signed off through various government channels. However, it is not too late to highlight the elements organisations feel should be included in the Plan. But the biggest opportunity arises once the Plan is published, as it marks the beginning of a new phase - implementation. Organisations should ensure they have solutions that address the problems or challenges outlined in the Plan and align with the key themes set out by Wes Streeting and colleagues. When the plan is released, organisations must be ready to demonstrate how they can help to turn ideas into practice.

Can you think of any existing examples of organisational impact?

At Luther, we are working with several primary care organisations to demonstrate their potential impact. Independent, evidence-based research shows that if primary care teams are empowered to provide additional services, they can improve patient access, experience, and outcomes while saving the NHS money. Moving care into the community and away from hospitals is more cost-effective, convenient, and delivers better access. These primary care providers are articulating their value both now, before the Plan is finalised, and will be ready to support implementation of the Plan once it is published.

How important is ensuring campaigns are patient-focused and data-driven?

It is crucial that ideas are patient-focused and data-driven. Patients are at the heart of what the NHS does, despite the fact that attention sometimes seems to focus on systems and structures. Any proposals and improvements must benefit patients by enhancing their experience and outcomes. Data is essential to demonstrate the potential success of these improvements. Organisations that present a data-driven approach to their business or service expansion cases are more likely to be taken seriously. The NHS may not always be the best at capturing or utilising data, but organisations that can provide robust data and evidence will have a stronger case.

What will be the impact of the abolition of NHS England on influencing campaigns?

The abolition of NHS England represents a massive change, and it will be a long process. In the short term, there is uncertainty and a lack of clarity about the changes and where responsibilities will end up. NHS England is still absorbing this news and, of course, it has an entirely new leadership team tasked with transitioning responsibilities. The Department of Health and Social Care (DHSC) is now in the driving seat of healthcare. It is the primary focus for those wanting to influence not only policy but also delivery. Integrated care boards will also undergo substantial changes, facing uncertainty and the need to absorb cuts and reductions. The removal of NHS England aims to create direct relationships between the DHSC, ministers, and the NHS on the ground. Organisations should be in no doubt that they should focus on the DHSC to influence policy.

How would you advise organisations to approach Party Conference this year?

By the time party conference season arrives, the 10-Year Plan will likely be out and beginning to be implemented. Wes Streeting and colleagues will want to hear how organisations can help achieve the changes outlined in the plan. Organisations should focus on demonstrating how they, and those they represent, can improve patient experience, the quality of care, and NHS efficiency and productivity. How can the changes you articulate deliver economic benefits? When attending party conferences, organisations should align their messages with the 10-Year Plan, as the government will be guided by it. This has to be the focus.