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Many consider the current condition of the NHS to be in a state of crisis. Statistics behind this include the waiting list which stands at 7,359,457 as of May 2025 compared to 2,600,000 in May 2010 and shortages in medical staff meaning that as of 2022, the UK has one of the lowest ratios of doctors per capita compared to other European countries. The BMA (British Medical Association) says the NHS is currently experiencing some of the most severe pressures in its 77 year history.
There are several reasons behind the challenges the NHS is now facing, one of which is the aftermath of COVID-19. During the pandemic, millions of appointments and elective surgeries were cancelled to accommodate for the care of COVID-19 patients. This created a significant backlog of patients on the waiting list on top of new patients in the following years, which the NHS did not have the resources to clear. Additionally, years of pay erosion, inadequate planning, mismanaging of resources and the aging population have contributed to the NHS’s current critical condition.
The Fit for the Future 10-year plan identifies four major areas of the system that are being affected by this crisis:
The government’s Fit for the Future plan outlines a radical proposal for reforming the NHS in the next 10 years, targeting the above major concerns.
On the 3rd of July 2025, Kier Starmer’s government published their Fit for the Future 10-year plan to reform the state of the NHS. The plan is based around the NHS’s founding principles; universality, equity, and free at the point of delivery. The proposal is split into 3 major shifts:
Current NHS care and resources are centred around in-hospital treatment and there is a lack of continuity between hospital-based and community-based care. The plan therefore proposes a new Neighbourhood Health Service. This new service represents a transition from hospital to community care and aims to treat patients “at the patients home if possible, in a neighbourhood health centre if necessary and in hospital if needed”. Some ways in which the plan proposes to implement this transition include:
As the world transitions into a new digital age, the NHS is lagging behind, with many hospitals still relying on physical patient notes and records. As well as contributing to the lack of continuity between hospital and community care, physical systems are prone to inefficiencies.
By digitalising NHS systems, the Fit for the Future plan aims to increase the speed of access to healthcare for patients and enable them to have more control over their care and records through new sections of the NHS app such as My Specialist, My Medicines and My Vaccines.
Finally, incorporating modern technology and AI into the service aims to relieve staff of some of the bureaucracy and administrative day to day tasks to allow them to spend more time on the patient.
With our aging population, people are living longer but with more healthcare burdens, resulting in higher demands on services and increased cost of care for the NHS. Decades of research have demonstrated the financial and health benefits of prevention versus treatment approaches. A couple examples include the ban on indoor smoking to reduce rates of lung cancer and the implementation of vaccination programmes for conditions such as meningitis type B.
The Fit for the Future plan aims to introduce further prevention initiatives including the Tobacco & Vapes Bill, the restriction of junk food advertising to children and an increase in vaccination programmes e.g. for HPV (Human Papillomavirus).
As well as demonstrating knowledge of hot topics such as the new 10-year plan in interviews, you should be able to show critical thinking skills to score the highest marks. Therefore, consider what potential advantages, disadvantages and issues may arise from the proposed plan. To get you started, here are a couple of ideas you may wish to consider.
The Fit for the Future plan demonstrates a heavy focus on patient experience, specifically increasing the ease and availability of healthcare access and shifting care into the community. This is an important thing to address as public satisfaction with the NHS is, as of 2024, the lowest it has been since the survey began in 1983.
The increased shift from treatment to prevention by targeting and reducing key health risk factors such obesity, smoking and alcohol use could have profound benefits on the population’s life expectancy and years lived in poor health. Additionally, it could have beneficial financial implications as preventing disease is generally cheaper than treating it.
The plan proposes a specific focus on improving mental health services in the NHS, with an investment of up to £120 million. The NHS’s mental health services are particularly struggling, with the BMA describing it as a ‘broken’ system. With the burden of mental health conditions at an all time high, this is an essential aspect of the NHS to be addressed.
While the plan outlines some key positive changes to be made to the NHS, it does little to address the concerns of doctors working in the service. Doctors have experienced pay erosion since 2008 that requires a pay uplift of 26% to restore. Additionally, major training bottlenecks have emerged leading to record highs in competition ratios for specialty training posts and leaving many doctors facing unemployment.
Additionally, consequences of these issues cause understaffing and stressful working environments. Due to the lack of initiative of the government to address these concerns, the BMA has confirmed a new wave of industrial action to start late July 2025.
As some trusts have transitioned to EPR (electronic patient records), many issues and frustrations regarding electronic systems have already arisen. For example, there is a lack of continuity between trusts and community care leading to incomplete records.
Secondly, many systems are not designed by medically trained professionals, meaning they are not as user friendly for medical staff, leading to issues such as errors in prescriptions. There is a lack of detail in the Fit for the Future plan for how these digital systems will operate and how they will address the current shortfalls.
Although the plan addresses some of the areas of the NHS in most need such as mental health services, there is still a significant void in other areas such as social care services that are yet to be addressed.
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