The 10-Year Health Plan

Why is TTE concerned?

It's not common for the TTE office to be outraged by the antics in healthcare. However, the release of the NHS plan takes the nonsense to an entirely new level.

Fit for the Future: The 10-Year Health Plan for England states that it will reinvent the NHS through three radical shifts: from hospital to community, from analogue to digital, and from sickness to prevention.

However, there is nothing radical about these three. The "hospital to community" NHS plan was published in 2012. NHS England aimed to transform healthcare through the use of digital technologies. But oops, they're for the chop. As for sickness and prevention, it was even one of Matt Hancock’s visions to transform the government's approach.

Having clarified, there is nothing new in this plan; what we observe is a plan for future treatments and technology, rather than implementing what works.

There will be more genomics, more precision medicine, and more AI, all of which are largely untested. Indeed, it appears the document has been generated by AI, given the absurd ideas it contains and the nonsensical, odd sentences, such as “That is why the NHS now stands at an existential brink,” and “by the end of the plan wherever feasibly possible.”

Also, large language models work by predicting the next word in a sentence; they are more likely to use common words like “the”: There’s a lot of them in the text.

The government considers it will get “upstream of ill health” - we've now lost the “leapfrog” with the advent of more technobabble.

The End of the NHS Revolutionaries

To achieve this, it will utilise precision medicine. The idea of identifying subpopulations that differ in terms of disease risk, drug responsiveness, and treatment outcomes isn't new. More than a decade ago, its failures were recognised. However, it remains a favourite of pharma to deploy ineffective treatments. To the old geezers this idea also has the faint whiff of eugenics.

“Upstream” (presumably a consultant term for which we paid thousands or more) remains unexplained like “leapfrogging”. Does leapfrogging mean testing embryos at say 10 weeks gestation? And then what?

One of the main plans is to deploy a Neighbourhood Health Service.

“At its core, the Neighbourhood Health Service will embody our new preventative principle that care should happen: as locally as it can; digitally by default; in a patient’s home if possible; in a neighbourhood health centre (NHC) when needed and in a hospital if necessary.”

Spelling mistake apart (there is no tat in prevention) if this sounds familiar, it's because it is.

In 2015, the NHS focused on developing neighbourhood hubs as part of the broader "new care models" initiative, outlined in the NHS Five Year Forward View, to improve integration and community-based care. These hubs aimed to bring together various healthcare professionals, including GPs, community nurses, and social care providers, to coordinate care for defined populations better and reduce reliance on hospitals.

There's so much to discuss in this forward-looking plan that we need to take stock in the TTE office.

In future posts, we’ll examine the analogue-to-digital malarky, the 'MY everything' app that promises to cure everything. The “moonshot” to end the obesity epidemic - a favourite strategy of Boris’s that’s now in Wes’s plans. The private company that’ll get you running more, the “genomics population health service”, and the new labels that might appear on your pint glasses as part of the latest standards for alcohol labelling strategy.

On that note, we’re off for a drink.

Two old geezers wrote this post, who can't quite believe how bad this plan is.