10 Year Health Plan for England - member briefing on the published plan

See the UK Government 10 Year Health Plan for England

The RCPCH President, Professor Steve Turner, gave initial reflections on 3 July. This briefing takes a deeper dive analysis into what the new government announcements mean for children and young people and outlines the College’s priorities for the plan’s implementation. 

Our summary

At the College we welcome the Plan’s inclusion of children and young people (CYP) across the document. We are particularly pleased to see: 

1. A focus on children and young people within prevention, with a number of commitments made to support early intervention and reduce key health inequalities in order to meet the healthiest generation of children ever commitment
2. The announcement of new neighbourhood health services and centres – bringing together teams of professionals around new models of care, including administration of vaccines by health visitors to increase uptake, and better quality early childhood development checks as part of comprehensive Best Start in Life Hubs
3. Children considered within the digital shift, with a commitment to the single unique identifier, as well as the ‘My Children’ addition to the NHS app, a 21st century alternative to the red book.

Next steps

Fundamentally, success of the 10 Year Health Plan in working effectively for children and improving child health outcomes will require:

1. An implementation plan specifically tailored to children and young people, to understand how the plan will be rolled out in practice and includes clear milestones, funding commitments, and accountability mechanisms
2. Equitable investment through a Children’s Health Investment Standard to address the investment gap between child and adult health services. RCPCH would like to see a proportion of the plan’s funding earmarked specifically for child health initiatives
3. A long term workforce plan that ensures the ambitions in the plan can be delivered effectively for the unique needs of children and young people.

Hospital to community

What's in the plan?

Neighbourhood health services have been announced to bring together teams of professionals to focus on patients with multiple long-term conditions and people with complex needs. Neighbourhood Health Centres will also be rolled out, which will be open 12 hours a day, 6 days a week and include multidisciplinary teams of staff. They will be delivered in the most-deprived areas first, with the first 42 sites rolled out from September. For children, this will include new models where health visitors can administer vaccines to babies and children in underserved groups, to increase uptake, as well as supporting higher uptake of and better-quality early childhood developmental checks.

RCPCH welcome this, as we have long been calling for commissioning models to provide flexibility to enable the increase of availability of community care and appointments outside of school hours and to reduce long waits. The plan states that those who need it will get a digital or telephone consultation for the same day they request it, reducing the need for parents to take children out of school for medical appointments. 

The plan also sees the matching of the Start for Life programme to Family Hubs expansion to ensure seamless provision of services for families with young children in Best Start Family Hubs, with a commitment to create up to 1,000 hubs across every local authority by the end of 2028. This will ensure that Neighbourhood Health Services work in partnership with family hubs, schools, nurseries and colleges to offer timely support to children, young people and their families including those with SEND. We have long been calling for ensuring funding for rolling out family hubs/best start for life programmes across all local authorities.

Finally, the plan commits to fixing the foundations in dentistry, with children as the urgent priority for improved access. Given tooth extraction is the leading cause of hospital admission among children aged 5 to 9 years old, yet it is almost entirely preventable, this is very welcome. 

Our priorities for implementation

We welcome the shift from hospital to community; at RCPCH we have been urging the UK Government to have a greater focus on and investment in children’s community health services. Current community child health services face significant challenges and have some of the longest waits in the health system. We have been calling for improved services through our blueprint for transforming child health services, and our recent report on Collaborative healthcare in England: Delivering the services children need in the community. As the system shifts toward neighbourhood health services, digital inclusion must be prioritised to avoid deepening health inequalities

The Plan does not specifically mention children or the paediatric workforce in the context of neighbourhood health centres, and this will be a crucial part of any implementation plan. For neighbourhood planning to work for CYP:

• New health centres should include dedicated paediatric services, such as child mental health support, immunisations, and developmental screenings.
• Neighbourhood care models should include investment in a mix of allied health professionals—like health visitors and school nurses - and integrate paediatric expertise through GP training and investment in the community child workforce. To support children with complex needs, the right Multi-Disciplinary Team (MDT) must be matched to the right care pathway, through a ‘team of teams’ approach.
• Commissioning and funding models must incentivise care to be delivered in neighbourhood health settings and move away from traditional funding models between primary and secondary care.

In our recently published vaccination report, we called for greater investment in vaccination service capacity for CYP and improved public information. We therefore welcome the plans to boost childhood vaccination by allowing health visitors to deliver vaccines to underserved groups and support early developmental checks. The Plan also aims to rebuild public trust in immunisation, improve school consent processes, and make it easier for parents to manage vaccinations via the NHS App. Efforts will also focus on increasing HPV vaccine uptake among young people. In terms of next steps, RCPCH would like to see:

• Development of a national immunisation data system to track and improve vaccine uptake
• Provision of standardised, multilingual, and accessible vaccine information
• Protected and committed funding for school nurses and health visitors to deliver vaccinations.

From 2026, the plan aims to improve access to children’s dental care through better use of the wider dental workforce including upskilling dental therapists and nurses to deliver preventive care like fluoride varnish and fissure sealants. It also builds on supervised toothbrushing programmes and expands community water fluoridation, which RCPCH have long been calling for. In terms of next steps:

• It is vital that there is simultaneous investment in health visitors to deliver the commitment to supervised toothbrushing programmes. 
• We would also like to see all children are seen by a dentist by the age of one to support good oral health development by expanding children’s oral health services, with a focus on equity of access with underserved communities. 
   

Sickness to prevention

What's in the plan?

We are pleased to see particular attention given to prevention in the plan, with a dedicated section on “Thriving young lives” noting clear government recognition that prevention starts with children and young people.

Recognition is given to increased complexity and the fact that the number of people living with a major condition is not solely driven by an ageing population, with increasing numbers of children and working age adults adding to this picture. The plan notes that prevention is how we change this course, by pushing poor health into later life - and helping millions more get on with their lives, raising their children and progressing their careers unimpeded by avoidable sickness.

There are several specific commitments related to children in this section of the Plan: 

• From 2026, there will be a restoration of the value of the Healthy Start scheme from 2026 to 2027. Pregnant women and children aged one or older but under 4 will each receive £4.65 per week (up from £4.25). Children under one year old will receive £9.30 every week (up from £8.50)
• Building on the ban of single-use vapes earlier in the year, the Tobacco and Vapes Bill will halt the advertising and sponsorship of vapes and other nicotine products, and provide government with powers to restrict point of sale displays, packaging and flavours, particularly those that appeal to children. 
• Manifesto commitments will be fulfilled to restrict junk food advertising targeted at children, ban the sale of high-caffeine energy drinks to under-16-year-olds, and use our revised National Planning Policy Framework to give local councils stronger powers to block new fast-food outlets near schools.
• In terms of school food, there are plans to update school food standards legislation, to ensure all schools provide healthy, nutritious food. Free school meals will be extended to all children whose parents receive Universal Credit, helping lift 100,000 children out of poverty and saving families up to £500 a year. 
• Ahead of a new strategy for physical activity, the plan announces £250 million of investment into 100 places by Sport England; at least £400 million of investment into local community sport facilities; and new partnerships on school sport.

Thriving Young Lives

The Plan recognises that almost half of mental health conditions develop before the age of 18. For children and young people with mental health needs, fast access to early, high-quality support is critical. The Plan commits to: 

• Work with schools, colleges and universities to better identify and meet children’s mental health needs
• Continue to roll out mental health support teams in schools and colleges, to reach full national coverage by 2029 to 2030
• Include health practitioners in the child protection teams that we will legislate to create through the Children’s Wellbeing and Schools Bill
• Ensure embedded support for children and young people’s mental health in new Young Futures Hubs, alongside a wellbeing offer, to ensure there is no ‘wrong front door’ for people seeking help
• Address longstanding issues with access to specialist children and young people’s mental health services
• Recruit 8,500 mental health staff focused on reducing long waits for both children and adults.

Ahead of the autumn publication of the Schools White Paper, which will detail the government's approach to SEND reform, the government has announced additional early intervention and support without the need for diagnosis for CYP with SEND and have committed to ensuring people with complex needs have an agreed care plan by 2027. RCPCH welcome this commitment towards a needs-led approach to support. 

Further, this summer, the Department for Culture, Media and Sport will publish a new National Youth Strategy, which will set out how this Government will support young people in all aspects of their lives including, support for mental health, wellbeing and the ability to develop positive social connections. 

The Plan also commits to work in partnership with the Department for Education to implement the NHS number a single unique identifier for every child, to enable proactive, preventative and joined-up care across different public services. We have long called for a SUI, which is crucial to enabling linked-data sets to have a transformative effect on identifying risk across cohorts of children and conducting research about service impact. Unlocking this will provide a more complete picture of children's needs in an area and gaps in provision, to inform more accurate commissioning and targeted interventions. 

Our priorities for implementation

The plan recognises the value of prevention within early years and for children and young people. We want to ensure that plans to preventative care ensure equitable access to child health services across different regions and socioeconomic groups. 

We have long been calling for the Government to take action to tackle child poverty, and the commitments in the plan are welcome. However, we still want to see stronger investment and action, including:

• Restoring the Healthy Start allowance in line with food price inflation
• Introduce universal free school meals for all primary pupils
• Addressing the wider determinants of health by restoring the public health grant, introducing a Children’s Health Investment Standard to close the funding gap between child and adult services, and implementing a Young Patients Family Fund to support families with the cost of hospital care
• Scrapping the two-child limit, will also lift thousands of children out of poverty. 

RCPCH have long called for enhanced mental health provision for CYP and welcomes the plans for full national coverage of school-based mental health support teams by 2029. The plan also expands specialist services through Young Futures Hubs and aims to recruits 8,500 staff to reduce long waits. Support will be strengthened for children in residential care with complex mental health needs. However, we would still like to see: 

• Greater investment in Child and Adolescent Mental Health Services (CAMHS) to reduce the long waits for care which are resulting in a growing number of CYP who are reaching crisis point and ending up in emergency care settings. A fair proportion of the 8,500 newly-announced staff need to be ringfenced to supporting children
• Schools-based support delivered by qualified mental health practitioners and be well linked in with community health services in order to ensure that children can access multi-disciplinary support for their mental health where needed
• The investment announcement of £120 million for new mental health emergency departments must be accompanied with proposals for what these will mean for children and young people.

A sustainable NHS depends on investment in wider public services like education, housing, and clean air and is essential to tackling the broader factors that shape child health outcomes. The Government is taking steps to improve housing standards, starting with damp and mould, and investing £13.2 billion in a new Warm Homes and Fuel Poverty Strategy. Action on air quality includes a review of the Government’s Environment Improvement Plan, closer collaboration with the health sector, and a planned consultation on emissions from domestic burning. There will also be more investment in active travel (£616 million), which aims to reduce physical inactivity and promote healthier lifestyles. In terms of next steps:

• Progress on transport is vital, but not enough to achieve the air quality improvements needed to protect public health. 
• The Environmental Improvement Plan review should include stronger policies to cut emissions, raise awareness, and boost engagement. Including clean air in the 10-year plan is a positive step, but without new funding, its impact may remain symbolic.
• More action is needed - such as a Clean Air Act aligned with WHO guidelines, expanding Awaab’s Law to all rented homes, investing in housing and health services, and introducing a UK-wide Young Patients Family Fund to support access to care.

Analogue to digital, and innovation to drive reform

What’s in the plan?

The push for a ‘digital by default’ NHS within the 10 Year Health Plan includes key initiatives like the Single Patient Record (SPR) as a future patient passport, expansion of the NHS App, and an Innovator Passport to streamline technology adoption. Five transformative technologies—data, AI, genomics, wearables, and robotics—are set to personalise care, improve outcomes, and boost productivity. 

Most notably, the plan announces a 'My Children' addition to the NHS app, with the aim of helping parents collect their children’s health information in one convenient place - a 21st century alternative to the ‘red book’. It will provide advice and support throughout childhood, on weaning, maintaining healthy habits, or where to find support for concerns about mental health. Over time, more information and functionality will be added to support parents to record feeding times, monitor sleep, or use AI analytics to understand the best way to care for their child if, for example, they have developed a new rash.

The Plan also confirms genomics as one of it’s “five big bets to drive healthcare reform”. The Generation Study, a partnership between the NHS and Genomics England, will continue recruiting and sequencing the genomes of 100,000 newborn babies with parents’ consent. This will facilitate earlier identification and treatment of rare genetic conditions and allow assessment of the risks and benefits of storing and tailoring care around an individual’s genome over their lifetime. Insights from this study will inform a longer term ambition to make genomic sequencing at birth a universal offer, including development of comprehensive guidelines for childhood genomic testing and treatments and interventions that are available. This will enable early identification and intervention for individuals at high risk of developing common diseases. 

Genomic testing at birth, with consent, will allow science to reveal the nature of a baby’s genome, giving parents and clinicians the ability to unlock the secrets of a child’s future health. Patients will increasingly have access to their personalised health risk scores on the NHS App, drawing from genomic, demographic and lifestyle data. Treatments and medicine decisions will be genetically informed, making them more effective and reducing NHS spend on adverse drug reactions or inefficient care.

Other plans announced that aren’t specific to children include:

• Make wearables standard in preventative, chronic and post-acute NHS treatment by 2035 for all patients
• Greater use of ambient voice technology (‘AI scribes’), digital triage and the Single Patient Record to end need for tasks like clinical note taking, letter drafting and manual data entry. 
• ‘My medicines’ functionality in the NHS app, aiming to make repeat prescriptions easier to manage and use advances like pharmacogenomics to guide safe medication use and reduce adverse drug reactions, which currently cost the NHS up to £2.2 billion annually. 

Our priorities for implementation

More detail is needed to make this shift work for children and young people. This includes: 

• Supporting digital maturity across NHS organisations, addressing digital poverty, and developing a strategy for empowering local innovation. 
• Ensuring wearable technology is developed with children and young people in mind, with clear systems to ensure their quality, safety, and long-term use and transparency around data-sharing with third-party providers.
• Ensuring AI-technology meets assurance standards
• Recognising the unique needs of CYP in medicines management, and any app must support safe use and reduce anxiety for families. This includes access to records for multiple children, reliable guidance like that from Medicines for Children, and regulation to ensure trusted sources such as the BNF-C are used.

The ‘My Children’ app functionality offers an opportunity for parents and families to manage their children’s health. RCPCH welcome this inclusion of CYP in moves to the NHS App and have long called for digitalisation of the red book. We support the plans to further develop the app to provide information, advice and support throughout childhood. RCPCH have advocated to invest in improving the quality and accessibility of online health information and resources for families. As a next step, there is a need to ensure that the NHS App is age appropriate for CYP and there is clarity on information sharing of CYP health records. There should be a push to ensure relevant providers are part of this development, including social workers and teachers. 

The Government announced plans for universal newborn genomic testing and population-based polygenic risk scoring alongside other emerging diagnostic tools. It is essential that in the rollout, it prioritises data protection and informed consent, particularly in the context of predictive testing during childhood. The voices of children and young people must be included in these decisions, especially when genomic testing is being considered on their behalf. Additionally, the plan should go further and incorporate provisions for access to genomic counselling later in childhood, when the full implications of the genomic information can be better understood.

Wider commitments in the plan

A new transparency of quality of care

The last comprehensive strategy to improve quality was High Quality Care for All, published in 2008. The plan notes the urgent need for a refreshed strategy, fit for the next 10 years. This centres on revitalising the National Quality Board (NQB) and tasking it with developing a new quality strategy by March 2026. 

The NQB will bring together senior clinical and managerial leaders from the NHS and regulatory bodies, along with patients and patient representatives. It will be responsible for the oversight of quality measurement, transparency and improvement. The NQB will provide a single and authoritative determination of quality. All other bodies, including Royal Colleges, will feed into the NQB. 

The Plan also notes support for the more detailed recommendations in Dr Penny Dash’s report on patient safety across the health and care landscape, including on the role and responsibilities of a revitalised NQB, and on the importance of clinical leadership in driving quality improvement.

Changes to NHS/Healthcare systems and finances

The plan sets out the new operating model for the NHS in England with a change in how the health system will be structured and governed. It simplifies the current arrangements by clarifying responsibilities and accountability to all levels involved in health services.

The merger between NHS England and Department of Health and Social Care (DHSC) hopes to provide a more streamlined approach to national oversight. The proposed future structure of DHSC includes a national priority programme on women, children and young people. While this is welcome, the restructuring of DHSC and wider NHS structural reforms will take time, so the Government must ensure that child health does not become deprioritised throughout this period. 

The Plan confirms that:

• Providers will be given increased autonomy which is supported by changes to how local services are planned and commissioned. ICBs will be more strategic commissioners responsible for improving population health, tackling health inequalities and building new neighbourhood services. This will also see the abolition of integrated care partnerships (ICPs) and reinforce the separation of roles between commissioning and provision. 
• There is a renewed push for NHS trusts to achieve foundation status with a stronger focus on partnership working and population health for the new generation of foundation trusts. For those foundation trusts that are already high performing, they will gain more autonomy by becoming integrated health organisation (IHOs) with management of the whole health budget for their local population. 
• Changes to funding models and mechanisms with a new financial framework will be published later this year. Moving to multi-year funding allocations for both day-to-day spending and capital should allow for better planning and investment in services. By replacing block contracts and trialling several new payment mechanisms it is hoped that providers and services can become more flexible to patient demand or service changes.

As part of reform, it is welcome to see the Plan state that the NHS’ existing commitments set out in Delivering a Net Zero Health Service - including achieving net zero by 2040 for the emissions the NHS controls and by 2045 for the emissions it can influence – will continue to be prioritised.

Workforce considerations

A new 10 Year Workforce Plan will be published later this year and will replace the 2023 long-term workforce plan. However, it will have less emphasis on growing the workforce and more on shifting staff skill mix and harnessing technology to free up staff time to care. 

The plan recognises the need to create 1,000 new speciality training posts over the next three years, with a focus on specialities where there is greatest need. This is a positive step, but how decisions will be made on which specialities will get an increase in training posts is still unknown. 

It also acknowledges the pressure facing staff but wants the NHS to be ‘the best employer’ to help retain current staff and recruitment more. The plan outlines a range of reforms aimed at improving the culture and wellbeing for staff working in the NHS in England.

The Plan commits to working with professional bodies and the Royal Colleges to develop capability frameworks for innovation for all staff, introduce joint clinical research and innovation fellowship posts with industry, and expand the Clinical and Patient Entrepreneurs Programme, already the world’s largest entrepreneurial workforce development programme.

It is disappointing not to see the paediatric workforce specifically mentioned in the Plan, given the unique needs of children and young people. RCPCH will be examining this section in more detail in advance of feeding into the 10 Year Workforce Plan development.