Exclusive: 10-Year Plan published without delivery chapter

The draft of the Plan seen by HSJ last week included an index page which listed a ninth chapter entitled “Change begins”. The published Plan contains just eight chapters plus an introduction.

HSJ understands the delivery chapter was due to be written by the Department of Health and Social Care’s lead non-executive director, and former health secretary, Alan Milburn. Its omission has surprised many very senior NHS figures close to the plan’s development who had expected it to be included.

One told HSJ that the delivery chapter would have “focused heavily on the immediate tasks” to be undertaken by the service in the next three years and therefore might have “looked a little odd within a 10-Year Plan”.

They added: “You can be certain that there will be [a delivery plan] though.”

One suggestion is that the delivery plan might be incorporated into the NHS England planning guidance for 2026-27, which it is proposing to publish much earlier than in previous years, possibly as early as September.

However, another senior source said the delivery document could be puiblished as early as 17 July as part of NHSE’s monthly board meeting.

At the beginning of the process to develop the plan, its authors were adamant that it would explain how change would happen, rather than split the process as has often happened with previous reforms.

However, recent briefings have stressed that this approach has not been followed, and that the plan is a vision rather than a delivery document. The published document contains relatively few specific deadlines or targets within its 150-plus pages.

In an interview with HSJ published today, NHSE chief executive Sir Jim Mackey said today’s plan was intended to create “energy and enthusiasm”, rather than detailed guidance. 

He acknowledged he and government had to “keep the pace going”, however. He said detailed frameworks and guidance on several key areas would be developed with local leaders over the summer and published before winter.