NHS 10 Year Plan: Nelson Advisors healthcare technology clients share their initial thoughts

Lloyd Price
4 days ago
6 min read

Nelson Advisors initial thoughts on the NHS 10 Year Plan

Nelson Advisors canvassed the opinion of our healthcare technology clients today to gauge the reaction of the long awaited NHS 10-Year Plan. The overwhelming feedback from HealthTech Founders, CEO's and Investors is this 'represents as a momentous declaration of intent from the Government' that aligns well with their capabilities and offerings.

They are eager to partner with the NHS to deliver on these ambitions but remain pragmatic about the considerable operational, cultural and foundational challenges that will need to be overcome to turn rhetoric into reality. The "innovator passport" is a particularly welcome practical step to unblock procurement.

The 10 Year Plan focuses on three "big shifts":

Analogue to Digital Services: Harnessing technology, including AI, the NHS App, and a single patient record.
Sickness to Prevention: Emphasizing preventative care, early intervention, and addressing wider determinants of health.
Hospital-Centric to Community-Based Care: Shifting services out of traditional hospitals into neighbourhood health centres and people's homes.

Strengths

Clear Strategic Direction: The plan outlines a bold vision with specific "big shifts," providing a framework for future development and investment.
Emphasis on Prevention: Acknowledging that prevention is more sustainable and effective in the long run can lead to better population health and reduced burden on acute services.
Digital Transformation Focus: The commitment to a digital-first NHS, with expanded use of the NHS App, AI, and a single patient record, has the potential to improve efficiency, access, and patient empowerment.
Community-Based Care Model: Moving care closer to home and into neighbourhood centres can improve accessibility, reduce hospital pressure, and foster more integrated local services.
Workforce Training Commitment: The pledge to train thousands more GPs and develop the wider workforce is crucial for delivering the new model of care.
Addressing Bureaucracy: The announced abolition of NHS England and scrapping of other oversight bodies aims to streamline the system and reduce administrative overhead.
Patient Empowerment: Initiatives like personal health budgets, patient-initiated follow-ups, and the enhanced NHS App aim to give patients greater control over their care.

Weaknesses

Implementation Challenges: NHS reforms historically face significant hurdles in implementation. The scale of this "rewiring" is immense, requiring cultural shifts, significant capital investment, and widespread buy-in.
Workforce Capacity and Morale: While training more GPs is planned, the existing workforce faces burnout, shortages across many disciplines, and retention issues. Delivering the new model requires a well-supported and expanded workforce immediately.
Digital Divide and Equity: Relying heavily on digital solutions may exacerbate health inequalities for those without reliable internet access, digital literacy, or appropriate devices.
Funding and Capital Investment: While a £226 billion budget up to 2028-29 is allocated, and £10 billion for technology, the scale of transformation, particularly in infrastructure for neighbourhood centres and digital systems, may require even greater capital investment.
Data Security and Privacy Concerns: The push for a single patient record and greater data sharing, while beneficial for care, raises significant concerns about cybersecurity and patient data privacy, which could undermine public trust if not handled robustly.
Integration Complexity: Shifting care to communities requires seamless integration between primary care, community services, social care, mental health, and acute care. This level of coordination has historically been difficult to achieve.
Public Engagement and Buy-in: Resetting the relationship between the NHS and the public, asking citizens to take more responsibility for their health, and embracing new digital methods will require careful communication and public acceptance.

Opportunities

Technological Advancements: Rapid developments in AI, digital health platforms, genomics, and remote monitoring offer unprecedented opportunities to improve diagnosis, treatment, and preventative care.
Learning from International Best Practice: The plan can draw lessons from other countries that have successfully implemented community-based care models or advanced digital health systems.
Strengthening Local Communities: The focus on neighbourhood health centres and community engagement can foster stronger local partnerships with local government and voluntary sectors, leading to more holistic support.
Economic Benefits: A healthier population can contribute to a more productive workforce and reduced economic burden from illness. Investment in health tech also presents opportunities for UK innovation and growth.
Addressing Health Inequalities: The plan's commitment to shifting resources to communities with the greatest health needs and addressing wider determinants of health offers an opportunity to reduce long-standing disparities.
Improved Patient Experience: If successfully implemented, the plan promises easier access to care, more personalized services, and reduced waiting times, leading to higher patient satisfaction.

Threats

Economic Climate and Funding Constraints: Future economic downturns or changes in government priorities could lead to reduced funding or slower implementation than planned.
Public Resistance to Change: Patients and staff may be resistant to significant changes in how they access or deliver care, especially if the initial transition is disruptive or perceived as reducing quality.
Cybersecurity Risks: Increased digitalization inherently carries greater risks of cyber-attacks and data breaches, which could severely disrupt services and erode public trust.
Supplier Market Fragmentation and Vendor Lock-in: The push for digital transformation could lead to reliance on a few large IT providers, potentially limiting competition and innovation, or creating vendor lock-in.
Global Workforce Shortages: Competition for healthcare professionals globally could make it difficult to recruit and retain the necessary staff, despite increased training efforts.
Political Instability and Policy Shifts: A change in government or health secretary could lead to a re-evaluation or alteration of the plan, creating uncertainty and hindering long-term progress.
Rising Demand for Healthcare: An aging population and increasing prevalence of long-term conditions will continue to put immense pressure on the NHS, making it challenging to implement transformative changes while managing day-to-day demand.
Failure to Address Social Determinants of Health: While the plan mentions addressing wider determinants, if this isn't backed by significant, cross-government action on housing, poverty, education, and environment, the prevention agenda may falter.

Mixed reaction from Healthcare Technology suppliers

The Nelson Advisors Hhalthcare technology client base shared their mixed reactions to the NHS 10 Year Plan, with some expressing concerns about its feasibility and implementation.

While the plan aims to shift care from hospitals to communities, from analogue to digital, and from treatment to prevention, some key challenges and areas of skepticism for technology suppliers include:

Funding and Investment: Concerns exist about whether there will be sufficient and sustained capital funding for digital technology. Some reports indicate that only 10% of capital is currently allocated to IT and software, and many providers are considering halting digital projects due to financial pressures. The ABPI (Association of the British Pharmaceutical Industry) also highlights a concern about the plan's lack of commitment to increase investment in medicines and vaccines, viewing innovation as a cost rather than an investment.
Interoperability and Data Sharing: There are significant challenges with inconsistent digital infrastructure, fragmented data-sharing arrangements, and limited interoperability between systems. Suppliers emphasize the need for standardized data sharing, quality, and interoperability across providers to maximize the benefits of digital technologies.
Workforce and Skills: The success of the digital shift relies on increasing the number of digital and data specialists and ensuring the entire health and care workforce has the necessary skills.
Procurement: Navigating the technology market and implementing evidence-based solutions remains challenging, suggesting a need for improved procurement processes.
Clarity and Detail: While the plan sets out a strategic vision, some stakeholders are looking for more detailed, funded, and integrated plans, particularly regarding staffing, capital funding, and the "how" of implementation.There's a desire for clarity on how various initiatives will pull together to achieve overall ambitions.
Long-Term Commitment: There is a question of whether the plan will be consistently supported and funded over the entire decade, given past tendencies for plans to flounder or shift priorities.

Despite these concerns, there is also an acknowledgment of the "seismic potential" of technological advances and a willingness from industry to collaborate. The plan's focus on digital transformation, AI, and data analytics is seen as an opportunity, but the key to success lies in addressing the practical challenges of funding, infrastructure, and implementation.

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