What NHS overhaul means for you as Keir Starmer unveils 10-year 'reform or die' plan

Putting the NHS “on people’s doorsteps” is at the heart of plans to reboot our ailing health service.

Millions will be helped closer to home in a bid to ease the burden on hospitals, under a decade-long blueprint to revive the NHS. New teams of health professionals are to treat and care for patients nearer where they live, Keir Starmer is due to unveil on Thursday. As Downing Street seeks to recover from a bruising rebellion this week over welfare reforms, the PM is launching the government’s 10-year health plan. The strategy is split into three strands to move the NHS from analogue to digital, treatment to prevention, and from hospital to more community care.

Starmer is billing the blueprint as “care on people’s doorsteps” – declaring it is time to "reform or die". But the Lib Dems attacked it, branding the plan “a castle built on sand” – and highlighted the need to “tackle the crisis in social care”. The so-called “Neighbourhood Health Service” is set to feature teams established in communities “to dramatically improve access to the NHS”, the government says. The teams are to “free up overstrained hospitals from perpetual firefighting so they can focus on delivering”, it adds. The neighbourhood teams will be based in new health centres, eventually open 12 hours a day, six days a week, the government says.

READ MORE: ‘I’m GP and here’s why more funding is desperately needed for NHS 10-year plan’

It comes after a damning review of the NHS last year by ex-Labour health minister Lord Darzi found the health service was still struggling “with the aftershocks of the pandemic”. The NHS was, he concluded, “in critical condition”. The majority of outpatient care is intended to happen outside of hospitals by 2035 – with less need for hospital appointments for things such as eye care, cardiology, respiratory medicine and mental health. Neighbourhood health services are set to be rolled out nationwide to bring tests, post-op care, nursing and mental health teams closer to homes.

The move is designed to give access to a full range of services, allowing hospitals to focus on the sickest. Neighbourhood health centres will be staffed by teams including nurses, doctors, social care workers, pharmacists, health visitors, palliative care staff and paramedics. Debt advice, employment support and stop smoking or obesity services will also be included in new services.

Meanwhile, “local areas will be encouraged to trial innovative schemes like community outreach door-to-door – to detect early signs of illness and reduce pressure on GPs and A&E”, the government says. The plans also outline training for thousands more GPs, with the government pledging to "bring back the family doctor" – ending the "8am scramble" to get an appointment.

Starmer, who led Labour to victory at last summer’s election after 14 years of Tory rule, said: “The NHS should be there for everyone, whenever they need it. But we inherited a health system in crisis, addicted to a sticking plaster approach, and unable to face up to the challenges we face now, let alone in the future. That ends now. Because it’s reform or die. Our 10 Year Health Plan will fundamentally rewire and future-proof our NHS so that it puts care on people’s doorsteps, harnesses game-changing tech and prevents illness in the first place.

"That means giving everyone access to GPs, nurses, and wider support all under one roof in their neighbourhood - rebalancing our health system so that it fits around patients’ lives, not the other way round. This is not an overnight fix, but our Plan for Change is already turning the tide on years of decline with over four million extra appointments, 1,900 more GPs and waiting lists at their lowest level for two years. But there’s more to come. This government is giving patients easier, quicker and more convenient care, wherever they live.”

Health secretary Wes Streeting said the plan “will turn the NHS on its head, delivering one of the most fundamental changes in the way we receive our healthcare in history”. He added: “By shifting from hospital to community, we will finally bring down devastating hospital waiting lists and stop patients going from pillar to post to get treated. This Government’s Plan for Change is creating an NHS truly fit for the future, keeping patients healthy and out of hospital, with care closer to home and in the home.”

New tools are to be rolled out to support GPs over the next two years, with AI scribes said to be ending “the need for clinical notetaking, letter drafting, and manual data entry to free up clinicians’ time to focus on treating patients”. And “digital telephony” will be used so all calls to GP practices are quickly answered, the government says. Meanwhile, dental care professionals are set to work as part of the neighbourhood teams. Dental therapists, who tend to carry out some of the straightforward work of dentists, could undertake check-ups, treatment and referrals, according to the plan. And there will be a new requirement for newly-qualified dentists to practise in the NHS for a minimum period, intended to be three years, the government says.

Lib Dem leader Ed Davey said: “This plan will be a castle built on sand until ministers finally tackle the crisis in social care. Years of Conservative neglect pushed the NHS to breaking point, with overcrowded A&Es, people waiting weeks to see a GP and parents unable to find a dentist for their children.” He added: “Without bold action to fix the social care crisis, our NHS will remain overwhelmed and patients will continue to suffer."

Matthew Taylor, chief executive of the NHS Confederation, said a key part of making sure the plan is successful "will be resetting the relationship between the NHS and the public so that local communities are placed at the heart of these reforms and people are supported to be active agents in their own health and wellbeing".

Sarah Woolnough, chief executive of the King's Fund thinktank, said: "... our call for a fundamental shift of care from hospital to community and a more people-first approach has been echoed by successive governments, so, whilst welcome, the vision itself is not new, the radical change would be delivering the vision." The plans follow the government earlier this year announcing NHS England was being abolished to “cut bureaucracy”.