PwC comments on the NHS 10 Year Plan

• The NHS must outsmart, not outspend, to drive prevention

• We’ve sleepwalked into a sickness economy: the NHS must help drive economic and health recovery

• Ambitious reform risks falling short without long-term funding plans

• Community health: The NHS’s quiet engine for national-to-neighbourhood reform

Rachel Taylor, government and health industries leader at PwC, said:

“The NHS 10-Year Plan is bold in ambition but to succeed, it must be ruthless in execution and clear on funding, especially over the next two years. Trusts can’t plan transformation without financial certainty.

“Three levers will determine success: a digitally skilled workforce, a care model that reaches beyond hospital walls, and a funding system that matches the scale of change. Without a digital skills plan across all NHS functions, not just a workforce plan, we risk building tomorrow’s NHS with yesterday’s tools.

“Technology should redesign care, not digitise old processes. That means rethinking outpatient clinics, embedding AI triage, and using the NHS App to drive prevention. If food and alcohol companies can influence behaviour, so can the NHS - if it chooses to outsmart, not outspend.”

Economic inactivity

Katie Johnston, local and devolved government leader, said:

“We’ve sleepwalked into a crisis where ill health is now the number one reason people can’t work. Over a million more people are out of the workforce due to sickness than in 2020. It’s draining billions from our economy and wasting opportunities for people to thrive.

“The 10-Year Plan finally confronts the question ignored for too long: why doesn’t our health system help keep people in work? If a patient walks out of a GP surgery and ends up on long-term benefits, the system has failed twice. The NHS must do more than treat symptoms. It must drive recovery, not just medical, but economic. Employment must be a core health outcome, embedded from primary care to mental health to digital services.

“But this can’t fall on the NHS alone. Employers are also on the hook. Local services must connect. And citizens need the right support, and the right expectations. This isn’t just about getting people off benefits. It’s about giving people back purpose, pride and a future. A modern health system must help people not just survive, but belong, contribute, and work their way to recovery.”

Financial sustainability

Iain Alexander, health industries leader at PwC, said:

“The real test of the NHS 10 Year Plan will be whether it’s matched by sustainable funding. Without long-term investment, even the most ambitious reforms risk falling flat.

“NHS organisations are walking a tightrope: trying to recover services while managing deep financial constraints. The challenge isn’t just balancing the books - it’s shifting spending from crisis response to long-term transformation. That’s where the real value lies.

“Crucially, funding flows must evolve to support new models of care. Clarity on who commissions services and who is accountable for delivery is critical amid uncertainty around NHS England and ICBs. Governance and financial reform must go hand in hand.”

Community care

Dr Raees Lunat, clinical lead at PwC, said:

“Community health services are the quiet engine of the NHS, handling around 200,000 patient contacts daily, yet they remain underrepresented in national planning. If we are serious about easing hospital pressures, this figure must rise. That means care going to the patient, not the other way around, with integrated teams working across A&E, primary and community settings.

“The NHS 10-Year Plan rightly commits to delivering more care in the community and closer to home. To realise this, the soon to be updated Longterm Workforce Plan needs to enable staff to work flexibly across boundaries and geographies. Commissioners must recognise the value of these services—not just in cost savings, but in outcomes, independence, and system resilience.

“Technology and data are no longer confined by geography, and our services shouldn’t be either. A single electronic record is essential to ensure continuity of care and improve both patient and staff experience. A truly place-based strategy must also consider how we use existing estate and explore new models, including public-private partnerships, to bring care closer to where people live and work.”