There has been a lot of talk about plans, strategies and frameworks in the NHS over the last few years, and sometimes it feels like there are more documents than ambulance sirens on a winter afternoon. But every now and then, one of these plans lands a bit differently. The NHS 10 year health plan feels like one of those moments, partly because it is trying to align care with how people actually live their lives rather than how systems have always worked. Statistics show that the NHS waiting list for elective treatment in England was 7.39 million in April 2025, its lowest level in two years, but still far from targets.
That statistic, perhaps surprisingly, helps you see why strategy feels urgent rather than optional. The plan is not just a long document gathering dust; it is a response to stubborn pressures that even small improvements have not yet fully eased. In London, for example, only about 61.1% of patients were waiting less than 18 weeks for treatment in 2025, still well below the 92% target.
A slow move from hospitals to communities
One of the clearest themes in the plan is this shift from hospital-centric care to care delivered closer to home, and that bleeds into how people talk about NHS community services too. It feels like a recognition that if we keep pushing the same model we are going to keep bumping into the same walls.
Emergency care figures underscore that pressure. In late 2025, about 74.2% of people attending A&E departments were admitted, transferred or discharged within four hours, still well below the 95% constitutional standard.
This is where strengthening NHS community services feels not just like everyday administrative talk but like something with real stakes. If people had better support with chronic or emerging conditions before they became emergencies, those A&E queues might be less Herculean. That is the intuition behind the strategy, even though community services themselves are sometimes under resourced and inconsistent in coverage.
The workforce question sits underneath everything
No plan works without people. That sounds obvious, but it is worth saying out loud. The upcoming NHS 10 Year Workforce Plan is meant to be published in Spring 2026 and it is meant to take the ambitions of the health plan and map them onto real workforce realities, not just hopeful projections.
Right now, the numbers are striking. In June 2025, there were about 1,374,557 full time equivalent staff working in NHS Hospital and Community Health Services, up around 2.3% from the year before.
But that does not tell the whole story. There are still persistent gaps in certain roles such as GPs and community nursing, projected to grow significantly over the next decade if unaddressed. For example, shortfalls in fully qualified GPs could hit around 15,000 by 2036/37 without action.
So when people talk about the NHS 10 Year Workforce Plan, they are not just discussing training numbers; they are also talking about retention, burnout and whether the system can both recruit and keep the right people in the right places.
Prevention as a serious idea, not a slogan
Another thread running through the NHS 10 Year Health Plan is prevention, and this is where the NHS prevention strategy starts to show its teeth.
It can be helpful to look at the numbers to understand why this feels so important. Long term conditions, for example, are a major driver of demand in the NHS. Data from NHS England suggests that people with long term conditions can cost the health and social care system significant amounts annually, especially those with multiple conditions.
If prevention can reduce the progression of those conditions, then both patient quality of life and system cost may improve. That is the logic, and it resonates with clinicians who have often felt they are spending most of their time reacting rather than preventing.
Digital, not as a silver bullet but as quiet infrastructure
There is also a strong digital thread woven through the NHS medium term planning framework, and the health plan itself talks about digital in terms of infrastructure and connectivity rather than shiny gadgets.
One benchmark that gets quoted a lot is the NHS digital maturity targets. Data from 2025 suggests that a significant number of trusts are still not at the “core level” of digital maturity as defined by national frameworks. That means there is work to do before systems talk to each other fluently and clinicians can see a full picture of a patient’s journey anywhere in the country.
This is why digital transformation is part of the planning conversation, but not presented as a magic fix. It is slowly woven into service redesign and workforce support, which feels right if sometimes a bit slow on the ground.
So why does this moment feel different?
Maybe it is the alignment. The NHS 10 Year Health Plan, the forthcoming NHS 10 Year Workforce Plan, the NHS medium term planning framework and the emphasis on prevention seem to be pointing in roughly the same direction.
And there are glimmers of progress. For example, the NHS waiting list fell to 7.39 million in April 2025, the first sustained reduction in a long time, even though the number remains historically high. That tells you that staff efforts and incremental change are not irrelevant, even if the challenges remain formidable.
Perhaps it is that mixture of ambition backed by real numbers, and real numbers shaped by years of entrenched pressures, that makes this moment feel like a genuine pivot rather than just another round of policy talk. It might not be dramatic, but it feels significant, and maybe that is what matters most right now.
FAQ:
At a simple level, the NHS 10 Year Health Plan is trying to move the NHS away from being mostly reactive and hospital focused, towards something more preventative, more community based and more digitally connected. It is about shifting care into communities, strengthening prevention, and making better use of data and technology so the system feels joined up rather than fragmented. It is not one single change, it is a long series of adjustments that together are meant to reshape how care is delivered over time.
The NHS 10 Year Workforce Plan sits underneath the health plan and focuses on the people side of the transformation. It looks at how many staff the NHS needs, what skills they will need in future, and how to recruit and retain them. Without the workforce plan, the health plan is just a set of ideas, because nothing changes unless there are enough trained, supported people to deliver it.
There is a growing recognition that many health problems can be better managed earlier and closer to home, rather than waiting until they become emergencies. Strengthening NHS community services means investing in things like community nursing, mental health support, long term condition management and social prescribing. The idea is that this reduces pressure on hospitals while improving patient experience at the same time.
The NHS medium term planning framework is a practical planning document that translates the long term ambitions of the health and workforce plans into shorter term priorities and targets. It covers things like productivity, waiting times, digital maturity and financial sustainability over the next few years. In other words, it is the bridge between the big vision and what actually gets worked on right now.
The NHS prevention strategy is about stopping people becoming seriously ill in the first place, or at least slowing the progression of disease. That includes early diagnosis, screening, lifestyle support, vaccination and better management of long term conditions. It sounds simple, but it requires the NHS to invest earlier, think longer term and accept that some of the benefits will only show up years down the line.