NHS Reform Hinges on Funding and Staff, Say Leaders

Healthcare leaders have cautiously welcomed the government’s 10-year plan for the NHS in England, praising its ambitions while warning that workforce shortages and funding gaps could derail its success. 

Launched by Prime Minister Sir Keir Starmer on Thursday, the policy paper outlined major structural reforms intended to “fundamentally rewire” the NHS by shifting care closer to home and modernising services.

The plan centres on three strategic shifts:

• From a sickness service to a preventative model
• From a hospital-based system to neighbourhood care
• From analogue to digital delivery

Neighbourhood health centres will be established across England, offering diagnostics, nursing, post-operative care, and mental health services in community settings. These centres aim to reduce pressure on hospitals by extending hours and bringing services closer to patients.

By 2035, most outpatient services — such as cardiology, respiratory medicine, eye care, and mental health — are expected to be delivered outside hospitals.

England’s Health Secretary Wes Streeting described the plan as “one of the most fundamental changes in the way we receive our healthcare in history”. He said the NHS should function more like a “supermarket” for healthcare, offering integrated services under one roof.

Support from Healthcare Leaders

Dr Jeanette Dickson, chair of the Academy of Medical Royal Colleges, said the plan “promises a lot and, properly implemented, offers an opportunity to revolutionise healthcare”.

Matthew Taylor, chief executive of the NHS Confederation said the shift towards neighbourhood health services is a “vital step” that recognises the “complex and interconnected challenges many patients face”.

Caroline Abrahams of Age UK said the plan could be a “game-changer,” and Daniel Elkeles of NHS Providers said it would simplify the system and speed up innovation. 

The Patients Association’s CEO, Rachel Power, praised the plan’s multidisciplinary approach, while the social innovation agency Nesta said it revived the NHS’s original focus. “Nye Bevan’s original vision for the NHS placed prevention at its heart,” said Nesta’s chief executive, Ravi Gurumurthy. 

Workforce Shortages Raise Concerns

Despite strong support for the plan’s aims, many leaders questioned how it will be delivered given current NHS staffing challenges.

Dr Tom Dolphin, British Medical Association council chair, warned that without tackling workforce shortages, the plan risks “rearranging deck chairs on a sinking ship”. He warned that existing staff should not be “moved around like pieces on a chess board or made to work even harder”.

Professor Steve Turner, president of the Royal College of Paediatrics and Child Health, echoed this, calling for “sustained investment” in staff.

Royal College of Nursing general secretary Professor Nicola Ranger said moving care out of hospitals was necessary but “impossible” with the current state of the workforce.

Janet Morrison, CEO of Community Pharmacy England, stressed that with many local pharmacies under financial pressure, sustainable funding is needed if pharmacists are to play a role.

Funding and Implementation Uncertain

Leaders also raised concerns over a lack of clarity on how the reforms will be paid for or delivered.

Thea Stein, chief executive of the Nuffield Trust, said the proposals were “essential” but warned the lack of detail made their success uncertain.

Sarah Woolnough, chief executive of the King’s Fund, said patients would expect to see tangible improvements. “When will it mean people can see a GP more easily, or get mental health support for their child, or not wait hours in A&E?” 

Stein also cautioned that “care closer to home doesn’t mean care on the cheap”, pointing out that such models can be more expensive due to reduced economies of scale. Dr Steve Taylor from the Doctors’ Association UK said neighbourhood health centres already existed in the form of the existing network of over 6000 GP practices. “Investment in GPs and GP practices would be cheaper,” he said.

Dr Jennifer Dixon, CEO of the Health Foundation, agreed the plan was “the right direction”, but warned that past plans with similar goals had failed without “concrete policy changes and investment.”

While the plan received praise for its ambition, health leaders agree that its success will depend on political commitment, long-term funding, and a robust workforce strategy. 

“The hard work starts now,” said Elkeles. 

Rob Hicks is a retired National Health Service doctor. A well-known TV and radio broadcaster, he has written several books and has regularly contributed to national newspapers, magazines, and online publications. He is based in the United Kingdom.