The 10-Year Plan: Leading the Way with Community Care

These latest hardships are only aggravating the long-standing challenges the healthcare system in the UK faces when it comes to bed capacity and discharging people on time. In 2023–24 alone, over 1.7 million hospital bed days were lost due to delayed discharges - the equivalent of more than 4,700 beds being occupied each day by people fit to leave. The NHS has shown immense resilience in maintaining patient flow and the growing demand on acute services over the years, but it can’t be expected to walk this tightrope forever. That’s why the government is now looking to carry out one of its boldest and most impactful moves yet - shifting away from hospital-centric care toward a more community-led model that prioritises prevention.

Hospitals are the bread and butter of the NHS, but they’ve also become the default option for many people seeking care for issues that could be better treated closer to home - particularly where those who suffer with mental illness and long-term conditions such as frailty, heart disease, or respiratory issues like COPD are concerned.

While these demographics are equally as important as those with more acute care needs, they account for nearly 70% of hospital stays and they’re also the ones that tend to experience disjointed care, the longest waits, and reactive instead of proactive treatment. Neighbourhood care might be a more viable solution to hospital admittance for these individuals, but community services are and continue to be highly underfunded and undervalued – meaning they’re often overlooked.

Addressing these imbalances is something the government has heavily emphasised in the 10-Year Plan through something known as “the left shift” which the NHS defines as “the shift of activity out of hospitals to those delivered closer to home” – largely provided by primary or community services and wider system partners.

Neighbourhood Health Centres are also being established to act as central, regional hubs for multidisciplinary care. This will not only make it simpler for people to get coordinated help in their local communities, it will also reduce the reliance on acute services.  

The entire left shift model will be achieved through a combination of investment, staff expansion, and developing multidisciplinary teams locally to improve outcomes and patient satisfaction.

Integrated Neighbourhood Teams (INTs) are a core roll-out of this transformational initiative and comprise GP professionals, community nurses, mental health clinicians, adult social care staff, and partners in the voluntary sector. Working across place-based geographies, INTs are designed to provide continuity of care, rapid response when needed, and a shared view of each person’s needs.

The 10-Year Plan has positioned INTs as the default model for delivering community-based support - especially for people with complex or ongoing needs. With these newer and safer neighbourhood teams in place, it is hoped that there'll be more capacity in both hospital and local settings to deliver care in a more personalised and proactive way.

The expansion of virtual wards and remote monitoring models is also on the government’s agenda to help drive both the community shift and the shift to digital. While there haven't been any official announcements to funding or to what scale virtual wards are expected to expand, they’ve already exceeded the target of 10,000 beds per capita the NHS set in 2023. As of March 2025, there were 12,825 virtual ward beds in England. This is an increase of 11,856 beds in March 2024, showing that capacity is improving naturally and they’re still high up on the list of NHS priorities.

Early evaluations of virtual ward models elsewhere have also shown promising results. This week, elderly patients in Scotland praised how the NHS Hospital at Home model had “changed their lives” by allowing them to receive care without needing to leave the comfort of home. A recent report found that in the last year alone, virtual wards had saved services over £50m and kept over 15,500 people out of hospital.

HSJ reported that the government plans to procure a single virtual wards solution that will tie in with the neighbourhood health service model. This will rely on data from the NHS app and new Single Patient Record to facilitate earlier intervention and reduce the likelihood of someone being admitted to hospital.

With the delivery chapter expected to be published in winter, it is hoped that virtual wards and home-first models will receive a hefty slice of the funding pie - their ability to reduce hospital capacity cannot be understated, and the results in both England and Scotland just goes to show how important these models are for preventing people from entering hospital in the first place, while ensuring they get care in the environment they prefer.

Embedding healthcare in the community will better position the system to tackle the wider determinants of health and intervene earlier. The 10-Year Plan states that this will mean working more closely with social care, housing, education, and VCSE organisations in order to support people before their needs reach crisis point and create sufficient wraparound care.

Local insight is another super power that will be unlocked as a result of community-led models. Place-based systems will have a chance to mature, which will allow for the co-design of services with communities rather than for them – a much-needed cultural and structural shift that reduces health inequalities through locally-tailored solutions.

Delivering this shift at scale will require more than just structural change - it demands sustained investment, digital enablement, and a significant boost in the community workforce. While the delivery chapter is still in development, what is acknowledged in the Plan is how these pressures set out milestones for service expansion, NHS team integration, and improved access.

Local systems, such as Integrated Care Boards, will be held to account through delivery plans that emphasise outcomes over activity. Progress is likely to be monitored via metrics that track community capacity, unplanned hospital use, and patient-reported experiences of care.

The hospital-to-community shift isn’t about reducing standards in one setting to prop up another. It’s about re-centring the system so care happens where it makes the most difference. It’s about empowering patients to be cared for in familiar environments, supported by professionals who understand their circumstances. And it's about making health and care truly local; as a route to better, fairer, more responsive care.

The 10-Year Plan vision may be ambitious, but it’s an absolute necessity. Investment in digital infrastructure, and sustained support for the community workforce is essential if we are to get it right, and if pulled off correctly, the shift could make a significant difference to not just how care is accessed, but in how communities are engaged, supported, and empowered to shape their own health and wellbeing.