The local services praised in the 10-Year Plan

They are:

Neighbourhood health

• Brondesbury Medical Centre in London: This centre has transformed patient access by implementing a total triage system, including online e-consultation digital triage. This approach has significantly improved patient access, reducing routine appointment waits from 14 days to three days (with over 95 per cent of patients seen within a week), and has increased patient satisfaction from 66 per cent to 85 per cent.
• Primary Care Sheffield: A social purpose organisation founded by city GPs, it provides resilience and enhanced services at scale by supporting the 69 GP partnerships and 16 primary care networks in the city, and directly managing nine GP surgeries. It offers diagnostics, home visiting, shared back-office functions, and flexible capacity. This model has led to lower hospital use, improved uptake of contraceptive services, and increased care capacity for severe mental illness patients.
• Whittington’s community dental service in north west and north central London: This service has transformed children’s access to specialist-led dental care through a paediatric dentistry advice clinic model. A consultant dentist provides virtual support to community dental teams, enabling in-service treatment and preventing referrals to secondary care.
• Birmingham & Solihull Community Care Collaborative (specifically the Washwood Heath hub in East Birmingham): This collaborative is pioneering the shift from hospital to community care by deploying multidisciplinary teams and a data-led care model. The Washwood Heath hub has seen a more than 30 per cent reduction in accident and emergency attendances among targeted patients in the last 12 months, and a 14 per cent decrease in hospital length of stay, demonstrating effective prevention and early intervention.
• Westminster’s Community Health and Wellbeing Worker programme: This initiative employs community health workers, known as “Chewies,” who conduct monthly home visits to build relationships, identify health and social needs early, and provide personalised support. An evaluation showed significant increases in immunisation and screening uptake (47 per cent and 82 per cent respectively) and reductions in hospital admissions (10 per cent) and emergency department visits (7 per cent) for people in covered postcodes.
• Whitstable Medical Practice: Operating as a single GP practice PCN, it serves nearly 45,000 patients across three sites by delivering a wide range of services traditionally found in hospitals, such as day surgery, urgent treatment centres, and specialist clinics. It also offers extended hours, pioneers local data sharing for single patient records, and is rated “outstanding” by the Care Quality Commission.
• Tower Hamlets Women’s Hub: This hub has proven effective by providing women referred by their GP with a single point of access, triage, and direction to the right care for gynaecology services. It has reduced gynaecology referrals needing secondary care by 60 per cent, decreased average appointment waits from 27 to 11 weeks, and lowered waiting lists by 30 per cent.
• Nimbuscare – York Community Frailty Hub: This hub tackles fragmented care for older frail people by integrating general practice, acute care, social care, ambulance services, and the voluntary sector. Its crisis response team helps paramedics avoid hospital transfers in 84 per cent of cases and provides an alternative to calling 999 for early advice to frail residents and their carers.

International examples:

• Brazil’s family health strategy: This initiative uses community health workers who conduct monthly home visits to build relationships, identify health and social needs early, and provide personalised support. This model inspired Westminster’s Community Health and Wellbeing Worker (CHWW) programme.
• Canada’s ‘Pharmacy Care Clinics’: These provide a wide range of services beyond dispensing medicines, including support with minor ailments and chronic disease management, serving as a model for increasing the role of community pharmacies in the UK.
• South Korea’s National Smart Hospital Programme: This programme, exemplified by Seoul National University Bundang Hospital and Samsung Medical Centre, has transformed care and efficiency through fully digital medical record systems, autonomous mobile robots for supply transport, and AI-driven predictive analytics for resource management. These innovations have led to lower staff stress, higher patient satisfaction, and improved healthcare delivery overall.
• Denmark: This country is pioneering day-case knee operations supported by wrap-around physiotherapy, demonstrating a model for moving surgery away from requiring multiple hospital stays. Denmark, along with the Netherlands, has also implemented systems for patients to book into appropriate urgent care services via 111 or an app before attending, leading to significant benefits.
• Netherlands: This country, alongside Denmark, has shown significant benefits from implementing systems that allow patients to book into appropriate urgent care services before attending.

Analogue to digital

• RAIDR platform and the North East of England and North Cumbria Waiting Well programme: This initiative uses an interactive digital dashboard to integrate patient health information from surgical waiting lists with primary care records, allowing pre-operative assessment teams to identify opportunities to improve health before surgery and manage patient risk. The programme provides targeted support, leading to fewer surgery cancellations and postponements.

International examples:

• Estonia’s national Health Information System: This links healthcare providers’ systems and securely stores patient data in a central platform, allowing patients to review past appointments, prescriptions, receive health advice, and book appointments from a single platform. It also enables digital prescriptions to detect potential drug interactions and reduces administrative workload.

Prevention

• Wolverhampton health incentive scheme: This pilot rewarded participants with points (exchangeable for gift vouchers) for making healthy choices, successfully increasing physical activity and improving diets among participants.
• Active travel initiatives in Cambridge and Kesgrave High School near Ipswich: In Cambridge, nearly 49 per cent of journeys to work are made actively, while at Kesgrave High School, 86 per cent of students walk or cycle to school daily, demonstrating effective local strategies for increasing physical activity and reducing emissions.
• Leeds Anchor Network and its “Connecting Communities with Health and Care Careers” programme: This network brings together large organisations to make health and care careers more accessible in disadvantaged communities by using a “flipped recruitment approach”. It has supported 192 people in priority roles, with a 96 per cent retention rate after 12 months, showcasing effective recruitment from local populations.

International examples:

• Singapore’s Healthy 365 app: Developed by the Health Promotion Board, this app rewards users with health points (redeemable for e-vouchers) for engaging in healthy activities like walking, purchasing healthier food options, and participating in health screenings. It has achieved significant engagement and led to sustained increases in physical activity and health screenings.
• South Korea (alcohol labelling): South Korea has effectively addressed alcohol harm through mandatory health warning labels on alcoholic drinks, a model the UK plans to draw upon.

Operating model

• NHS in Gloucestershire (eye care): This region has advanced the shift of eye care from hospitals to neighbourhood settings by sharing hospital eye care records and images with primary care optometrists. This has reduced unnecessary hospital referrals, cut waiting lists by 14 per cent and improved patient convenience.

Workforce

• Buckinghamshire Healthcare Trust: BHT is highlighted as an exemplar in improving staff experience through dedicated career advice, a centralised reasonable adjustment process, a new occupational health and wellbeing hub, and a programme to reduce workplace bullying. These efforts have led to high staff satisfaction and reduced staff turnover.