The NHS 10-year plan set out how the Government planned to reform health care through three fundamental shifts: from hospital to community; from analogue to digital; and, from sickness to prevention.
It was anticipated to be bold in ambition and provide a roadmap for how the health service would tackle rising demand.
As the dust has now settled, it is fair to say that the plan set out bold and ambitious plans.
However, there were key areas of healthcare omitted from the plan.
Social care
The biggest omission from the strategy was social care reform, despite the message from the Health Secretary that fixing social care would be a crucial part of a pathway to fixing the NHS, and that without addressing this soon, progress of towards a sustainable health service could be hampered.
The link between better social care and a better health system is evident in multiple ways.
Social care involves caring for people who require daily help with living due to illnesses or disabilities. If that support isn’t readily available due to underfunding or staff shortages, it’s likely that the people who require social care will end up in hospital, because it becomes their only source of care.
In February 2025, the Royal College of Physicians reported that an average of 13,688 hospital beds were being used by patients who were medically fit to be discharged every day during the month of January. However, they could not be discharged because they were waiting for social care support.
This lack of available community-based social care means care patients end up keeping hospital beds occupied, despite not needing to be in hospital. This has a knock-on-effect on A&E waiting times and waiting lists for urgent care, because hospital beds are increasingly taken up by patients receiving care which they would usually receive in the community. This situation has created the corridor crisis.
The Royal College for Nursing also warned late last year that there was ‘barely a spare bed’ left in NHS hospitals, due to the lack of social care capacity. They cited that in November last year, an average of 11,969 beds each day were occupied by patients who were ready for discharge, taking up one in eight of all occupied adult general and acute beds (96,587).
Considering this evidence, it would have been expected that the 10-year plan would include reforms to social care to address these issues.
The reason social care reform was not included in the plan is because the Government is exploring reforms through a separate process. Baroness Casey (CB) is leading an independent commission into adult social care in two phases, with the first phase not expected to report back until 2026. The entire commission is not expected to be finished until 2028.
Considering the above evidence, it is fair to say that if no social care reforms are implemented until then, the progress of wider health care reform could stall.
This stalled progress is likely to see challenges remain with key indicators for NHS success, such as waiting lists and A&E backlogs, which will remain stubbornly difficult to clear in the absence of adequate social care. For example, the latest figures from NHS England show that the number of patients attending A&E has increased by 15 percent since 2015, and that corridor care has become a year-round crisis due to the lack of bed space. As of May 2025, 12,740 patients per day were still occupying bed spaces despite being fit for discharge.
Only by fixing social care can these numbers start to reduce, and knock-on-effects be mitigated.
Workforce
The plan was relatively light on detail relating to workforce reform. While it did mention that a strategy would be published later in 2025, it would have been a good opportunity to provide the NHS with some certainty on a key factor underpinning a sustainable health service.
This is because a larger and fundamentally different workforce will be needed to achieve many of the ambitions set out in the plan, such as moving care from hospital to community. This shift will require a different type of care, and NHS recruitment and upskilling will need to pivot in order to meet the demands of the change.
The move will involve improving access to GPs and dentists and establishing neighbourhood health centres in every community. If the Government is going to provide better GP experience for patients, improve access to services, and successfully build new health centres, there’s no doubt that an expanded and upskilled workforce will be crucialto implementing these plans.
Furthermore, a larger and appropriately skilled workforce will go a long way to reducing waiting lists for elective care and rising A&E figures in the immediate term, with over 7,321,879 people waiting for elective care as of the end of June 2025.
Additionally, the 10 year plan sets out ambitions to expand mental health support teams in schools and colleges, and support children and young people through Youth Futures Hubs.
The anticipated workforce plan will need to outline how the NHS intends to successfully recruit the skilled workforce needed if the ambition of providing better mental health support for young people is to be fulfilled, and if support is to be successfully expanded into areas of education.
Improving NHS employee satisfaction will also be a key part of any workforce strategy in the context of low workforce morale and burnout. Considering that the 10 year plan pledges to bring back the ‘joy’ of working in the NHS and support career progression through new skills, it’s important that the upcoming workforce plan provides details on exactly how the Government will do this.
Implementation and roadmap
On the topic of details, it would be fair to say that the NHS 10-year plan lacks detail on implementation and evaluation. For example, with the plans to implement neighbourhood health services, it would have been good if the plan outlined measurable targets for success.
Despite the fact that the Government have contacted health chiefs and local authority chief executives to begin the roll out of phase 1 of the neighbourhood service, it is unclear how long how long this will take and what the other phases of the roll out will look like. A clear roadmap which outlined time specific targets would have provided more clarity on when health care can be expected to be fully integrated into local communities.
As the King’s Fund put it, the lack of a delivery chapter in the plan may leave staff and the public wondering what the next practical steps are going to look like.
A delivery plan could be something the Department of Health looks to outline in the near future.
Conclusion
Ultimately, implementing the10-year plan is key for this Government to deliver on its promised healthcare reforms. NHS improvement was one of the biggest priorities for the electorate in 2024, as well as one of the Government’s five missions.
With the plan providing little detail on recognised key components of NHS reform – including social care, workforce strategy, or implementation plans – stakeholders and the electorate will look expectantly towards the results of the 10-year plan to see if it can still deliver meaningful change.