NHS 10-year plan: What does it mean for nursing?

Core to the plan is the government’s roll-out of new neighbourhood health centres which will be staffed by nurses, health visitors, palliative care staff, doctors and other palliative care professionals.

Prime Minister Sir Keir Starmer said the centres would shift historically hospital-based services, such as diagnostics, into the community, and will also offer services like smoking cessation and weight management.

The centres will support part of Labour’s shift from hospital to community-based care, working with the government’s other key goals of moving from sickness to prevention, and analogue to digital, two other core parts of the 10-year health plan.

When launching the plan, the health and social care secretary, Wes Streeting, said the changes would ‘turn the NHS on its head’ and deliver ‘fundamental changes’.

Last month, he also suggested that nurses should be ‘leading’ neighbourhood health services and that the NHS must ‘not be bound by traditional expectations of how services should be arranged’.

All centres are scheduled to be open for 12 hours a day, six days a week and based within local communities.

Royal College of Nursing (RCN) general secretary and chief executive Professor Nicola Ranger said the government ‘needs nursing staff in the driving seat’ for the plan to work.

Professor Ranger acknowledged that moving care away from hospitals is ‘urgent and necessary’, but said this will ‘prove impossible’ while the community nursing workforce is ‘depleted and undervalued’.

Separately, she warned that nurses needed more reassurance on how care will be delivered away from hospital settings.

‘Nursing staff are crying out for change, and we stand ready to get behind this plan. Modernising services, bringing care closer to home and helping people to lead healthier lives couldn’t be more necessary,’ she stressed.

Nurses will also be given ‘a range of opportunities to lead’ under the government’s plans for a Neighbourhood Health Service.

For example, the 10-year plan said: ‘We will introduce neighbourhood nursing and midwifery leads who will act across multiple neighbourhoods to coordinate local strategy, convene partners and represent the community’s voice.’

In addition, it suggested nurses would ‘play a central role’ in a new ‘genomic population health service, including by providing genomic counselling and support’.

While Nursing in Practice is seeking further information on the genomics service, the plan suggests that by 2035, the government anticipates ‘half of all healthcare interactions will be informed by genomic insights and other predictive analytics’.

The government has also committed to developing ‘advanced practice models’ for nurses to better reflect the ‘essential leadership’ roles for nurses, midwives and allied health professionals (AHPs).

The plan details how the ‘range of clinical tasks’ completed by nurses has risen in recent decades, including around prescribing, management of complex wounds and the administration of intravenous therapies.

It explains how the government will ‘work closely with the Nursing and Midwifery Council (NMC), the professions, and employers to ensure that effective systems of accreditation and regulation for advanced practice roles are introduced as quickly as possible’.

The models will aim to give greater autonomy for advanced practice nurses working across a range of heath settings, with a focus on community and public health services.

As part of this, the government will support the NMC to consult on its planned advanced practice standards due in 2027-2028.

The Queen’s Institute of Community Nursing chief executive, Steph Lawrence, explained that advanced roles already exist across community services in nurses who complete specialist practice qualifications (SPQ), including in district and general practice nursing.

She also warned that recent changes to Level 7 apprenticeships, with the government’s decision to remove funding for Level 7 apprenticeships for people aged 22 and over, could jeopardise the future of these roles.

‘The QICN would reiterate that for nurses to undertake this training, be it SPQ or advanced clinical practice, it is very much reliant on the soon to be abolished level 7 apprenticeship funding,’ she said.

In March, the NMC  was given the greenlight on its definition and principles of advanced practice, following several months of delay.

In addition, the government’s plan has committed to ‘increase the number of nurse consultants, particularly in neighbourhood settings’.

Nursing in Practice is seeking further information on what this means in practice.

But for now, the plan says: ‘Nurse consultants and consultant midwives will play a vital role in the Neighbourhood Health Service, providing advanced clinical care and system leadership, driving improvements in care quality, and advancing professional practice.’

The government will ‘reorientate the focus’ of NHS recruitment away from international recruitment as part of the plan, with the goal of reducing international recruitment to less than 10% by 2035.

Last month, latest data from the Nursing and Midwifery Council (NMC) data found that whilst the register had reached a record high, despite overseas nurse recruitment falling for the first time in six years.

Emma Wescott, executive director of strategy and insight at the NMC, said England needs a strong domestic workforce to meet the healthcare needs of the country.

‘With rising patient demand, an ageing population, and increasing pressures on the NHS and social care, it is more urgent than ever to invest in a sustainable, homegrown nursing workforce,’ she said.

Ms Westcott added that internationally educated staff are ‘welcome and valued’ but warned that the ‘long-term resilience’ of the UK’s nursing workforce depends on educating and retaining more domestic nursing professionals.

‘This means positive routes to registration, support for new entrants, and a decent work-life balance to mitigate the risk of burnout,’ she added.

The plan promises to create 2,000 additional nursing apprenticeships over the next three years, with a further commitment to ‘reform and modernise’ the process of paying travel expenses for nursing students on clinical placements.

The move comes as applications to nursing careers have dropped significantly in the last decade, from around three applications per post in 2014 to just two in 2024, the government said.

A spokesperson for the Council of Deans of Health told Nursing in Practice that the body had long advocated for ‘proper support’ for students on placement, including the ‘simplification’ of expense procedures.

John Unsworth, Queen’s Institute of Community Nursing (QICN) chair and deputy faculty pro vice-chancellor (education) at Northumbria University, welcomed plans to expand nursing apprenticeships but was wary about the difference apprentices would make given their small number.

‘Universities stand ready with more than 50 approved educational programmes. However, with only 2,000 roles across seven NHS regions numbers will remain relatively modest,’ he said.

Earlier this year it was revealed that applications to study nursing in the UK had fallen for a fourth consecutive year and were down by more than 15,000 compared to 2021.

Health visitors will play an increased role in childhood vaccination under the plan, with the government introducing ‘new models’ for health visitors to administer vaccines to babies and children in ‘underserved groups’. 

The plan will also ensure health visitors ‘fully support’ children’s development, including by supporting ‘higher uptake of and better quality early childhood developmental checks’.

Beyond childhood, the government also aims to increase uptake of human papillomavirus (HPV) vaccinations among young people who have left school as part of its goal of eliminating cervical cancer by 2040 and will introduce a catch-up programme in pharmacies next year.

Chief executive officer of the Institute of Health Visiting (iHV), Alison Morton, said health visitors were keen to support the plan but said more professional autonomy and personalised care is needed to improve support for families.

‘It is clear that delivering this ambitious plan will require sustained investment over the next 10 years,’ she said.

‘We now need the government to set out its plan for delivery, the workforce needed to turn it into reality, and to end the years of uncertainty that has undermined the confidence of so many brilliant people who work in the NHS,’ she said.

A digital overhaul of community-based health services will also be introduced as part of the move towards a ‘Neighbourhood Health Service’ in the 10-year plan.

This includes a new digital platform which will be rolled out across NHS provider organisations, with new developments to the NHS App, like remote patient monitoring and a Single Patient Record.

The platform is expected to use scheduling and tracking tools and use generative AI to draft initial care plans using patients’ health data alongside best-practice guidelines.

These draft plans are expected to be reviewed by a healthcare professional, in collaboration with patients.

The platform will also use ambient AI to capture ‘relevant information’ during patient consultations.

It is hoped these changes will support health professionals to detect early signs of health deterioration before emergency admissions become necessary.

Importantly, the plan also moots the creation of a new ‘national approach’ to support the safety of community NHS workers through the use of digital technologies.

‘Hundreds of thousands of NHS staff work in the community, visiting patients at home or elsewhere, without the benefit of digital technology,’ the plan said.

‘They should have access to important safety features such as GPS tracking, emergency help buttons, and live broadcast in emergency situations. We will take a national approach to sourcing technology that delivers these requirements and make it available to all provider organisations.’

The chief executive of the Queen’s Institute of Community Nursing (QICN), Steph Lawrence, said: ‘The safety of nurses working in the community often in challenging circumstances and environments is paramount and this move towards additional technology to support this is very much welcomed.’

It was also announced in the plan that CNO for England, Duncan Burton, will be launching a new ‘professional strategy’ for nursing and midwifery later this year.

Mr Burton, who has been in post since July 2024, is working on the strategy which is set to focus on supporting nurse progression, student attrition rates and clinical placement opportunities.

The government said reducing attrition rates among nursing students will be a ‘key objective’ of the strategy.

It will also focus on ensuring ‘every nursing student spends sufficient time across a range of clinical settings’.

In a video shared by NHS England (NHSE), CNO Mr Burton, said the 10-year plan was an opportunity to improve health services for both staff and patients.

‘It’s an opportunity to improve the experience of people using our services and also the experiences of our staff working in our services who want to come to work, and come to work every day, to do the best that they can, and this is about actually making it better so they can do the things that they do best,’ he said.

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