NHS plan vows to end '8am scramble' for GP appointment

Rebecca Thomas, The Independent

The NHS is set for a radical overhaul with a new 10-year plan aiming to "fundamentally rewire" the health service, shifting care directly to people's doorsteps, the Prime Minister has announced. Published by the government today, the ambitious strategy outlines "three big shifts" in how the NHS will operate. These include a transition from analogue to digital services, a greater emphasis on prevention over treatment, and a significant move from hospital-centric care towards community-based provision. The plan signals an end to the "status quo of hospital by default," with a clear intention to relocate care into local neighbourhoods and individuals' homes. By 2035, the majority of outpatient services are expected to be delivered outside traditional hospital settings, reducing the need for hospital appointments for conditions such as eye care, cardiology, respiratory medicine, and mental health.

To facilitate this transformation, new neighbourhood health services are set to be rolled out nationwide. These will bring essential services like diagnostic tests, post-operative care, nursing support, and mental health teams closer to communities, making healthcare more accessible and integrated into daily life. The announcement comes as Sir Keir Starmer is also expected to unveil his own vision for the NHS later today, which will focus on "three big shifts" in the health service. The aim is to give people access to a full range of services, leaving hospitals to focus on the sickest, with neighbourhood health centres opening at evenings and weekends.

These will be staffed by teams including nurses, doctors, social care workers, pharmacists, health visitors, palliative care staff and paramedics.

New services will also include debt advice, employment support and stop smoking or obesity services - all of which affect people's health. Community outreach, with people going door to door, could also reduce pressure on GPs and A&E, the Government said. The plans also outline training for thousands more GPs, as the Government pledges to "bring back the family doctor" and end the "8am scramble" to get an appointment. Sir Keir said: "The NHS should be there for everyone, whenever they need it.

"But we inherited a health system in crisis, addicted to a sticking plaster approach, and unable to face up to the challenges we face now, let alone in the future. "That ends now. Because it's reform or die. Our 10-year health plan will fundamentally rewire and future-proof our NHS so that it puts care on people's doorsteps, harnesses game-changing tech and prevents illness in the first place. "That means giving everyone access to GPs, nurses and wider support all under one roof in their neighbourhood — rebalancing our health system so that it fits around patients' lives, not the other way round. "This is not an overnight fix, but our Plan for Change is already turning the tide on years of decline with over four million extra appointments, 1,900 more GPs, and waiting lists at their lowest level for two years. "But there's more to come. This Government is giving patients easier, quicker and more convenient care, wherever they live." Health and Social Care Secretary Wes Streeting said the plan would deliver "one of the most fundamental changes in the way we receive our healthcare in history".

He added: "By shifting from hospital to community, we will finally bring down devastating hospital waiting lists and stop patients going from pillar to post to get treated.

"This Government's Plan for Change is creating an NHS truly fit for the future, keeping patients healthy and out of hospital, with care closer to home and in the home."

In a bid to free up time, GPs will be encouraged to use artificial intelligence to take notes, while technology will be used to speed up the answering of calls to surgeries. Dental therapists, who tend to carry out some of the straightforward work of dentists, could undertake check-ups, treatment and referrals, according to the plan. And there will be a new requirement for newly-qualified dentists to practise in the NHS for a minimum period, intended to be three years, according to the Government. Ministers also want to improve access to dental care for children, such as by allowing dental nurses to give fluoride varnish to children in between check-ups. Royal College of Nursing (RCN) general secretary, Professor Nicola Ranger, said: ""A neighbourhood health service is a bold vision and it needs nursing staff in the driving seat.

"The Prime Minister must back up his plan with a clear one to turn around the shortage of nurses in all local communities. "Moving care away from overcrowded hospitals is urgent and necessary but it will prove impossible whilst this part of the healthcare workforce is so depleted and undervalued.

"Crucial teams of district nursing and health visiting staff, who keep patients well and safe at home, have fallen by thousands in the last decade or more." Thea Stein, chief executive of the Nuffield Trust, said: "Top quality community services, like district nursing, end of life care and rehabilitation, are, in pockets of the country, already working around the clock to fit care around patients' needs, working closely with GPs, charities and council staff. "This approach is essential if we want to end the disjointed ways of working that too often leave patients to do the time-consuming and often bewildering job of joining up their own care."

She said, however, that a lack of detail on how it will all work "casts doubt on whether it will stick". She added: "What's more, care closer to home doesn't mean care on the cheap.