Delivering on the 10 year health plan for England

The 10 year health plan for England1 isn’t so much a plan as an ambition. Setting a view for a reshaped NHS through the lens of three shifts, its 168 pages are full of ideas. Many are interesting and sometimes exciting, but the quality of the evidence behind them is variable and some ideas have been tried before and are being presented again under a different guise.2 To date there is little articulation in the plan of how these changes will actually happen: a clear theory of change is notably lacking,3 and a delivery chapter was reported to have been omitted.4 Also striking is some rather technocratic, top-down, and paternalistic thinking that does not sufficiently recognise the importance of those who use and work in the NHS having agency—a sense of control and ability to make choices that will be so critical to actually making things happen.5Neighbourhood health and shift…