The 10-Year Health Plan: Seven key messages from the HEEC Citizen Panel 

It was late autumn when the Prime Minister and the Secretary of Health and Social Care launched Change NHS and invited us all to engage in the biggest ever conversation about the NHS and its future. Since then, a series of discussions and workshops have taken place with health care system leaders, professionals, NHS partner organisations, and members of the public. At the Health Equity Evidence Centre, we ran a workshop with our citizen panel to reflect on the upcoming 10-Year Health Plan and the key qualities that the NHS needs to adopt to be fit for the future. Below we summarise the key messages of that conversation with the ambition to keep the discussion alive ahead of the announcement of the plan in spring. 

The citizen panel members shared a common concern regarding existing gaps in medical competence. They shared personal stories of what they described as misdiagnosis and conflicting medical opinions, highlighting the importance of consistency in care and clinician expertise. Importantly, patients and caregivers shared experiences where kindness and dignity were also missing, making an already stressful healthcare journey even more challenging – and in certain cases traumatic. Our panel highlighted their desire for compassion in care and their vision of an NHS that treats them as individuals, not just as cases, and where patients feel confident in their diagnosis and treatment plan. 

A key fear that emerged quite early on in our discussion had to do with the fact “there won’t be enough doctors, nurses, and carers to support new models of care”. Our panel was well aware that the NHS is already struggling with workforce shortages, and worried that staff burnout will worsen if the system does not invest in its people. 

The panel members suggested: 

Reflecting on the planned shift from analogue to digital care, our citizen panel shared their hopes for the way technology can transform health care. They viewed that digital life coaches, AI-assisted diagnostics, and NHS apps can and should improve efficiency and reduce administrative burdens across the system. However, they also expressed fears about the possibility that such technologies will widen inequality gaps in health care, leaving the most vulnerable behind. During the discussion, it was stressed how many older adults and people with limited English proficiency struggle with online appointment booking and digital communication with their GPs. In our panel’s view, the NHS must ensure that alternatives like telephone and in-person assistance are not abandoned while the NHS transitions to a digital era, and that accessibility (in terms of spoken and non-spoken language, culture, and communication channels) is considered every step of the way. 

Thinking about technological progress, our panel highlighted that employing technology to improve coordination across services should be a priority. Our panel wants an NHS that operates as a cohesive system where patient records, referrals, and treatment plans are seamlessly shared between GPs, hospitals, and specialists. Our panel considered that investment in AI and digital tools is needed to speed up admin and diagnostics, while ensuring human oversight. People should not have to fight to get their medical information or wait months for treatment or diagnosis. One person shared that it took six months to get an MRI, only to be bounced between different specialists with conflicting diagnoses. These delays are not just frustrating – they affect patient outcomes and mental health. Our panel would like to see more ‘one-stop’ clinics where tests, consultations, and follow ups happen in one place, reducing unnecessary delays. 

The idea of moving care into the community was extensively discussed with ambivalence. More local health hubs could reduce pressure on hospitals and A&E departments, providing care closer to home. However, there were concerns that some essential services might be pushed out of hospitals without proper infrastructure to support them. The panel members highlighted that for community-based care to work, first and foremost, the NHS needs to ensure clear definitions of what can be safely moved out of hospitals and who will be responsible for the delivery of certain services. They also stressed the need for adequate funding and staffing for local clinics and home visits, and proper training for community health workers. As one of our discussants underlined “simply shifting care without investing in resources won’t solve the problem – it will just relocate it.” 

Health inequalities were discussed as a major concern, particularly for ethnic minorities, lower-income groups, and people with disabilities. Many of the participants expressed their frustration with the extent of the problem and the urgent need for systemic change. Among their priorities for action, they identified: ensuring culturally competent care by training staff to understand diverse needs, improving access for underserved communities, including better outreach programs, and addressing systemic biases that result in poorer treatment for disadvantaged patients. In this discussion, they also saw the potential of a shift from treatment to prevention. Encouraging healthier lifestyles through education and community initiatives, offering better mental health support, and improving programmes like NHS health checks, and stop smoking services were all mentioned as actions with great potential. However, our panel highlighted that this potential won’t be achieved without ensuring that prevention programmes are co-created with communities including those who are most disadvantaged. 

Many of the participants in the workshop expressed how they feel disconnected from NHS decision-making. In their view, the public needs to be involved more in decision-making as active participants in shaping the future of health care. They see the Change NHS conversation as a good start, but they want to see sustained efforts for public engagement from the NHS. Participants also expressed their frustration with the way the NHS is currently discussed in the media. They made clear that they want more transparency from NHS leadership about what’s working, what’s not, and how they can help.  

The members of the HEEC citizen panel believe in the NHS. They want it to remain a public institution that delivers high-quality, compassionate, and efficient care for all. Instead of viewing the NHS as something to consume, they want to see it as a shared responsibility – a system we all invest in, protect, and improve together.