The NHS Ten Year Plan 

We apologise for the delay in publishing this Surrey and Sussex LMCs update about The NHS Ten Year Plan (10YP), as it was published on 03 July 2025.  This is the new Labour Government’s flagship NHS policy document following on from the earlier highly critical commentary about NHS services from the Secretary of State, Wes Streeting. 

There are very polarised views of both individuals and LMCs, with a number of LMCs encouraging a complete boycott in terms of invited participation in the invitation by NHS England to submit Place-based bids, by a deadline of 08 August 2025.  This is on the basis that, if implemented as described – an admittedly highly unlikely premise – the 10YP could erode investment in “Core Contract” General Practice to the point where it is no longer viable.  The Plan suggests two new contracts for a ‘Neighbourhood Health Service’, there being: 

• Single Neighbourhood Provider (SNP) Contracts designed to cover populations of around 50K.  If this seems reminiscent of the PCN DES colleagues would not be mistaken. 

• Multi-Neighbourhood Providers (MNPs) which will deliver care [or coordinate its delivery] across populations of around 250k.  Colleagues will need slightly longer memories to recall the concept of Multi-speciality Community Providers [MCPs] developed as part of what was then only a five-year perspective of the future, the NHS Five Year Forward View (5YFV).

Colleagues are right to be concerned about the future of General Practice, but these concerns predate the 10YP.  GPC England are clear that unless the current GMS “Core Contract” can be renegotiated, General Practice cannot survive in its current Independent Contractor Partnership Model, as it is neither professionally or personally rewarding as a long-term career.  This view, presented emphatically to the Secretary of State during 2024/25 against a backdrop of Collective Action, resulted in what GPC England regard as an unambiguous commitment to the renegotiation of the current GMS Contract during the lifetime of this Parliament, in the form of letter received before the LMC Special Conference in March 2025. 

Clearly it would be naive in the extreme to expect politicians to adhere to all the promises they make, even written ones, that are not legally enforceable.  However, not doing so can create a lever for consequences and the profession can see, despite the barriers, complexity and diversity of the NHS, Collective Action (CA) has had an impact both nationally and locally. 

There is, as yet, no real evidence that the DHSC political commitment to national GMS renegotiation has been withdrawn, and the Government’s recent announcement that the Carr-Hill Formula will be reviewed is a necessary prerequisite to any such negotiation.  A successful renegotiation of the Formula can only be achieved in the context of increasing the ‘pot’, or reducing the ‘ask’, i.e., what the Formula is designed to pay for.  In addition, the fact that the Carr-Hill Formula creates a weighted capitation dependent, primarily, on patient list demographic factors, means when funding is increased, it is differentially distributed within practices in a way that is not directly proportionate to the ‘ask’, or the workload required of the practice. 

The Minister of State, Stephen Kinnock MP, attended a meeting of GPC England on Thursday 17 July 2025, and discussed the 10YP and answered questions from GPC England colleagues which primarily focussed on the role of General Practice within that Plan and the risks it may bring.  Again, time will tell, but the GPC England Officer Team believe a national GMS renegotiation can occur in tandem with the developments proposed within the 10YP. 

The recurrent allusion to the concept of a ‘Neighbourhood Health Service’ within the 10YP is somewhat irritating, as England already has an efficient and effective [within the constraints of inadequate funding] neighbourhood health service, called General Practice.  The concept of a Neighbourhood Health Centres seems highly reminiscent of the Darzi Centres [poly clinics] proposed in 2007 but seen as a duplication of spend and resources and gradually phased out over the next five years.  These also offered no real advantage to patients in more rural areas. 

The phrase ‘from bricks to clicks’ probably generates an eyeroll, but if this means NHS England, or its responsible successor, focusses on Acute and Community Trust IT to improve and integrate, and for example, implement EPS, this will represent significant progress.  Creating a unified ‘Single Patient Record’ accessible and manageable across the NHS sounds so far removed from current reality it is hard to do more than admire the aspiration of this proposal, but it seems highly unlikely GPs will wish to be the Data Controller in such circumstances, certainly without State Indemnification, but probably not even then.  It is also hard to imagine public concerns about the confidentiality of their personal data and its potential use for commercial purposes will be easily overcome. 

The 10YP also envisages a greater role of the NHS App and AI-algorithms; since this would appear to be the exact opposite of most patients preference – to see “their”  organic GP, this again may represent limited value as a patient facing service even though in terms of diagnostic, therapeutic, and information management, AI is likely to have many future benefits. 

In terms of the future organisation and governance of the NHS, and the role of NHS Trusts, any developments need to be placed within the current scorched earth policies being forced on both NHS England and ICBs.