Keir Starmer's plan to 'rewire' NHS explained – why you won't have to go to hospital

Most people don’t like going to hospital.

Whether it’s the smell, people smoking around the entrance or simply the trepidation of what you are going in there for. NHS buildings are generally old and outdated and while the care delivered in them can be excellent, the hospital experience is one few look forward to. A&Es are often full of people going through mental health crises, waiting hours lying on trolleys in brightly lit corridors. The Government’s Ten Year Health Plan aims to change hospitals by taking much of NHS care away from them - so they are freed up to carry out operations and treat the most seriously ill - and become more streamlined, pleasant places to get care.

The plan has been billed as "one of the most fundamental changes in the way we receive our healthcare in history". Tests, rehabilitation, mental health and lifestyle support will now be offered in local centres.

Sir Keir Starmer, whose wife works as a nurse, says his plan will “fundamentally rewire and future-proof our NHS so that it puts care on people’s doorsteps”. Here’s what the new ‘Neighbourhood Health Service’ will mean for you.

READ MORE: 6 million hours of A&E time taken up by people with minor ailments such as colds

Neighbourhood Health Centres

Patients will be offered scans, checkups, straightforward treatment, and broader life help at around 300 new local health centres.

Every area will be slightly different but centres will include doctors, nurses, dentists, pharmacists, counsellors, physios, health visitors, weight-loss specialists and even job advisers. The centres will be open in the evenings and on weekends. Currently Mondays are the busiest day of the week for A&Es and GP surgeries because of the reduced service at weekends.

Brits are now living longer but with multiple chronic health conditions, often spending more of our lives in ill health. Different parts of the NHS currently treat each condition - despite them often affecting each other - leading to patients being “passed from pillar to post”.

The centres will treat the whole patient for all their ailments and aim to keep them well, out of hospital and living independently for as long as possible. By 2027 at least 95% of people with complex needs will be given personalised care plans. Neighbourhood health teams will be encouraged to go door-to-door to spot illnesses early.

The centres will carry out cancer tests and other diagnostics, post-operative care and rehab services. By 2035 most outpatient hospital appointments will take place away from hospitals.

Return of the Family Doctor

These neighbourhood health centres will sometimes include GPs but in many cases will work in parallel to the local GP surgery. They will take a lot of the burden off overstretched GP practices which will also see a recruitment drive to attract thousands of new family doctors in England.

Crucially, the government is promising a return to an expectation that you will see the same named GP on each visit.

Health Secretary Wes Streeting explained: "We want to bring back that family doctor relationship, that continuity of care that particularly matters to people with a range of different health conditions, with ongoing health conditions, who are fed up of explaining themselves over and over."

It comes after surging demand for GPs and unmanageable workloads led to an exodus from the profession during the last decade, with just over 28,000 now compared with 29,500 in 2015.

Artificial intelligence (AI) systems will be used to take down GP notes during your appointment, and draft follow-up letters. The Government calculates that every 90 seconds saved per GP appointment could save the same time as adding 2,000 more doctors into general practice.

AI call management systems will also see GPs phone lines answered quicker so patients can be better triaged. This is aimed at ending the "8am scramble" to get an appointment.

Most people will come to rely on the NHS App

The vast majority of us will soon routinely interact with the NHS via its app which will become a “doctor in your pocket”. The NHS App will undergo a huge upgrade process in the coming years as part of the Government’s promise to move the health service “from analogue to digital”.

For the first time patients will be able to book, move and cancel all their appointments on the App to end the 8am scramble for a GP The App will use artificial intelligence to provide instant advice for patients who need non-urgent care, available 24/7. Patients will be able to self-refer on the App to mental health talking therapies, musculoskeletal services, podiatry and audiology.

The idea is that this frees up GPs’ time from being the gatekeepers to these treatments. People will be able to manage their medicines and book vaccines from their phone, connect with a clinician for a remote consultation, and even leave a question for a specialist to answer without making an appointment.

Health and Social Care Secretary Wes Streeting said: “The NHS App will become a doctor in your pocket, bringing our health service into the 21st century.”

The new App will include a digital 'red book', ensuring that their children’s medical records are available to them in their pocket, so they do not have to carry their red books to every appointment. It will also provide advice and support throughout childhood, offering guidance on weaning and healthy habits. It will eventually be able to record feeding times, monitor sleep, and use AI analytics to understand the best way to care for children when they are unwell.

Experts have raised concerns that this could leave behind the most vulnerable and frail if they are unable to navigate systems. Ministers insist that most using the app will free up phone lines for those who are uncomfortable using the tech.

A Single Patient Record

The plan will finally introduce a new Single Patient Record which has been an aspiration for the NHS for years. It will bring together all of a patient's medical records into one place so patients do not have to repeat their medical history to each clinician they see.

The Government will legislate to give patients access to their record and from 2028 patients will be able to view it on the NHS App. Over time that data will also include a personalised account of health risk, drawing from lifestyle, demographic and genomic data to help prevent ill health.

Medics will have secure access and patients can control who else they share it with and will have an audit trail of who has accessed their record.

Prime Minister Keir Starmer said: “For far too long the NHS has been stuck in the past, reliant on letters, lengthy phone queues and even fax machines. Through our new App – a digital front door for your care – parents will be able to keep track of their children’s health through an online ‘red book’ fit for the 21st century, and we will put a stop to patients having to endlessly repeat their medical history thanks to a single patient record.”

But will we see drastic NHS improvements without fixing social care?

Currently 12,000 hospital beds are filled every day with elderly and frail people who are medically fit for discharge. So-called “bed blockers” are taking up much of our hospital beds because of a collapse in social care.

Hospitals have a responsibility not to discharge people if there is nowhere safe for them to go. This usually means they may need a care home place or home visits arranged to help the elderly live independently.

The Government has made bold promises on reforming social care but the timeline for substantial changes may run into the next Parliament. It has launched an independent commission into adult social care, chaired by Baroness Louise Casey, tasked with setting out the plan for implementing a National Care Service. It will produce a first report by 2026 but only make “longer-term” recommendations for the transformation of adult social care by 2028.

Professor Martin Green OBE, chief executive of Care England, which represents care homes, said: “This is a plan that talks our language – prevention, personalisation, community-based care. But we’ve heard similar aspirations before, and the challenge has always been implementation.

“Neighbourhood Health Services could transform how people experience care. But without social care at the centre, they risk becoming a brilliant idea lost in translation. If we’re serious about delivering care closer to home, we must start by backing the sector already delivering it.”