On 3rd July, the Government published its long-awaited 10 Year Health Plan for England.

The Rebuild General Practice campaign responded strongly: “The 10 Year Health Plan for England will not deliver additional funding for general practice and will restructure the heath service to sideline GPs. From what we have seen so far, the plan looks to be disastrous for general practice. The Health Secretary rightly wants to shift the way we provide care – from treatment to prevention and from hospital to community. The way to do this is invest in general practice, recruit and retain more GPs, and deliver the funding boost promised. As it stands, this plan is the death knell for general practice as we know it. We urgently call on the Government and Wes Streeting to listen again to the calls of grassroots GPs if they want to save the family doctor.”

The plan sets out a vision to shift care out of hospitals and into neighbourhoods, embrace digital-first delivery, and prioritise prevention over treatment. The plan is heavier on rhetoric than on policy detail, which makes it difficult to determine how exactly it will impact on GPs and their patients.

We need your help to make sure the voice of general practice is heard loud and clear.

We’ve created a new toolkit to help you take action in three ways:

• A template letter you can send to your MP

• Social media templates which you can use to advocate online

• A Rebuild GP survey for you to let us know your thoughts in detail

You can read Rebuild General Practice's full analysis of the 10 Year Plan for Health below.

Rebuild General Practice

Full 10 Year Plan for Health Analysis

The Government’s Fit for the Future: 10-Year Health Plan for England outlines a vision to shift NHS care out of hospitals and into communities, prioritise prevention, and embrace digital transformation. For general practice, the plan presents a mix of opportunities and unanswered questions. While it positions GPs at the centre of neighbourhood-based healthcare, it lacks the necessary detail and funding clarity to reassure frontline clinicians already under immense pressure. Below is an analysis of the plan’s potential implications for general practice.

Strategic shifts and new neighbourhood contracts

As expected, the plan centres the government’s three strategic shifts: moving care from hospitals into communities, embracing digital-first delivery, and prioritising prevention over reactive treatment. It places particular emphasis on places to create a neighbourhood health service, involving investment in community diagnostics and multidisciplinary teams co-located in local hubs. The creation of these hubs is framed as a major opportunity for GPs, and the plan sets out that the government will introduce two new contracts to ‘allow GPs to work over larger geographies and lead new neighbourhood providers’:

• One for ‘single neighbourhood providers’ that deliver enhanced services for groups with similar needs over a single neighbourhood (c.50,000 people).

• One for multi-neighbourhood providers’ of services that ‘require working across several different neighbourhoods’ (e.g. end of life care). The plan suggests these might be provided to populations of 250,000 or more.

These contracts are intended to support federated practices and encourage clinical leadership, but detail is sparse – with the plan not explaining how funds will follow function, how practices will pool budgets, or how critical workforce shortages will be addressed.

Unaddressed pressures in general practice

More generally, the ability of GPs to play these roles effectively will depend on a range of issues on which the plan is essentially silent: from investment in practice premises to workforce expansion to entrenched system fragmentation. GPs will likely be struck by the plan’s lack of acknowledgement of current pressures on general practice, including burnout, patient demand, and practice closures. Each of these points – and the absence of any specific GP recruitment or retention targets in the plan – reinforces the importance of the Long Term Workforce Plan, which we’re expecting to be published in autumn.

Introduction of Integrated Health Organisations (IHOs)

Another NHS structural change outlined in the plan which will likely have significant implications for GPs and their patients is the introduction of Integrated Health Organisations (IHOs). The plan envisions that high-performing foundation trusts will be invited to become IHOs, meaning that they assume responsibility for managing the entire healthcare budget for a designated local population. This approach aims to integrate primary, community, mental health, and hospital services under a single governance structure, promoting a more coordinated and preventative model of care, but how fully consistent these plans are with the partner model is at best unclear. The BMA has warned that these changes could pose an ‘existential threat’ to independent GP practices, particularly if integration leads to vertical or horizontal consolidation with acute or community trusts. It should also be noted that the union has expressed concerns about the lack of wider engagement in the development of the new ICB model, which underpins the IHO framework.

Community investment promises vs. historical delivery gaps

Encouragingly, the plan does emphasise that the share of overall NHS expenditure directed towards hospital services will fall and that the share directed toward community and out-of-hospital care will grow. Indeed, and despite media briefings to the contrary, it states that this shift will materialise within three-to-four years as neighbourhood health services expand. Equally, funding rebalancing of this sort has been promised repeatedly in the past and hasn’t materialised, and past efforts have shown that a lack of capital expenditure and workforce bottlenecks can stall progress. More to the point, there is no commitment to an overall increase in funding for general practice specifically, despite a high-profile campaign for a minimum investment standard by the RCGP.

As had been pre-announced, the plan also includes a commitment to review the Carr-Hill formula, the current method for allocating core funding to general practice. The government has acknowledged that the existing formula does not adequately account for factors such as deprivation and rurality, which can lead to inequities in funding distribution. Wes Streeting had emphasised to the media that this review will aim to ensure that working-class and coastal areas receive their fair share of resources, and this is reflected in the document. The review will draw on evidence and advice from experts, including the Advisory Committee on Resource Allocation (ACRA), and will be conducted in consultation with the BMA's GP committee. The RCGP welcomed this announcement when it was made last week, describing the review as "long overdue", but more sceptical commentators have noted that the formula has been reviewed before without meaningful changes being made. It’s also true that, without an overall increase in funding for general practice, simply redistributing existing funds could relieve pressures in some areas but create new pressures in others.

Digital innovation and the risk of exclusion

Another significant theme in the plan is the way in which new technologies will be used to simplify appointment systems and enhance the responsiveness of organisations across the NHS, with a notable amount of detail provided on the future design of the NHS app. GPs will be aware that, while these innovations promise improved efficiency, they also raise concerns about digital exclusion. A significant portion of the population, particularly older adults and those in deprived areas, may lack the necessary digital skills or access to engage with these platforms effectively.

Staff development plans

GPs may also be interested to read that the plan promises every single member of NHS staff will receive personalised career coaching and development plans, with the goal of enabling them to ‘practice at the top of their professional capability’. Of course, with staff shortages already stretching clinical teams thin, whether doctors will be able to take advantage of new training opportunities is an open question.

Final analysis

Overall, the plan sets out what’s arguably a compelling vision of transformation: shifting funding into communities and reforming contracts; accordingly, prioritising prevention and digital innovation; and investing in workforce development. Most responses from sector stakeholders published so far have welcomed this vision, but it’s notable that the document published today offers very little detail as to how these goals will be achieved. The government has suggested in recent days that the plan’s release should be interpreted as the beginning rather than the end of a process, and a glass-half-full view would be that it represents the government reasserting the importance of its three strategic shifts following a winter dominated by a focus on secondary care waiting lists. A glass-half-empty view would be that the government has not demonstrated that it has plans in place to deliver those shifts, which have each been promised in several health service strategies in the past without coming to pass.