Briefing for Impact Statement: 10 Year Health Plan for England (January 2026)

Read the full impact assessment here

See the PDF here

Introduction and purpose

This briefing explains the DHSC’s Impact Statement for the 10 Year Health Plan for England, published in January 2026, and outlines its relevance for social care providers. The impact statement accompanies the 10 Year Health Plan and is intended to explain the rationale for reform, the evidence base supporting it, and the potential costs, benefits, and risks. It is not an implementation plan and does not set out firm funding commitments or delivery models.

The impact statement makes clear that many proposals are still under development and will be designed and implemented locally over the next decade. Although the plan is formally an NHS strategy, it repeatedly identifies social care as essential to delivering its ambitions, particularly in relation to community-based care, prevention, and support for people with complex needs.

 

Overall direction of reform

The impact statement presents the current health system as under increasing strain and no longer sustainable in its present form. It identifies rising demand from long-term conditions, workforce pressures, and widening health inequalities, alongside a system that is heavily reliant on hospitals and reactive responses to illness.

In response, the plan proposes three long-term shifts intended to reshape how care is delivered:

• a shift from hospital-based care to care delivered in community settings
• a shift from analogue systems to digitally enabled services and data sharing
• a shift from a primary focus on sickness to a stronger emphasis on prevention

These shifts are described as mutually reinforcing. The plan assumes that meaningful improvement will only occur if all three are pursued together, supported by changes to workforce models, financial flows, and system governance.

For social care providers, this direction implies a future in which care is increasingly organised around people’s day-to-day lives and needs, rather than around institutional boundaries between health and social care.

 

Shift from hospital to community care

The neighbourhood health service

The most significant structural proposal in the plan is the development of a neighbourhood health service. This is described as a new service model rather than a single organisation. Neighbourhoods are expected to cover populations of around 50,000 people, with some services organised over larger areas where necessary.

The neighbourhood health service is intended to:

• Deliver more care, including prevention, in primary and community settings
• Reduce avoidable hospital attendances and admissions
• Focus particularly on people with complex needs and those who experience poor outcomes under the current system

Care within neighbourhoods is expected to be delivered through multidisciplinary teams rather than through separate, profession-specific services.

 

Role of social care within neighbourhood teams

The impact statement explicitly states that social care staff are expected to be involved in multidisciplinary teams operating at a neighbourhood level. Their contribution is described as particularly important in supporting regular monitoring of people’s health and wellbeing and in reducing exacerbations of long-term conditions.

Social care involvement is framed as necessary because health outcomes are shaped not only by clinical factors but also by:

• People’s living conditions and housing
• Functional ability and daily support needs
• Social isolation, employment, and wider determinants of health

The impact statement recognises that bringing social care more fully into neighbourhood models will not be cost-neutral. It acknowledges that this will increase the scale and scope of social care activity and will require investment in workforce capacity, training, and support for new ways of working. It also highlights transition costs associated with integrating functions that are currently delivered separately and helping staff adapt to new roles.

 

Personalised care and care planning

A key feature of the neighbourhood health service is an expanded approach to personalised care, particularly for people with complex needs. The impact statement notes that current coverage of care planning is low and sets an ambition to reach up to 95% of people with complex needs by 2027.

This ambition implies:

• A significant increase in coordination activity across health and social care
• Greater involvement of social care providers in care planning and review
• Closer alignment between personalised care approaches and ongoing support services

The plan also supports expanded use of personal health budgets. Evidence cited in the impact statement suggests that, for some people with high needs, these budgets can reduce hospital use and overall spending. However, the statement also notes the risk that such budgets could be cost-additive if not carefully designed and integrated with existing services.

 

Workforce and system capacity

The impact statement repeatedly stresses that the proposed reforms represent a scale of change that has not previously been achieved. Evidence cited in the impact statement suggests that reductions in hospital use following community-based interventions often take several years to emerge. During this period, demand for community and social care services may increase rather than decrease.

This creates a particular risk for social care providers, as additional responsibilities may arise before funding and resources are fully rebalanced across the system.

The impact statement also highlights wider system pressures, including major organisational changes to integrated care boards. These changes are expected to improve strategic commissioning in the long term, but in the short term, they may reduce local capacity to lead complex integration work involving multiple partners.

 

Shift from analogue to digital systems

The plan’s digital ambitions are presented as essential to enabling integration, productivity, and improved patient experience. A central proposal is the creation of a single patient record covering all care settings.

Importantly for social care, this record is intended to include:

• Information from social risk assessments
• Data relevant to wider determinants of health
• Information that supports coordination across services

The impact statement recognises that including social information within shared digital systems will create both capital and ongoing revenue costs. These include system development, staff training, and ongoing administration. It also identifies risks related to data governance, public trust, and workforce confidence in using new digital tools.

For social care providers, this signals an expectation of increased participation in shared information systems, alongside the need for adequate support to ensure digital change improves rather than hinders care delivery.

 

Shift from sickness to prevention

Prevention is presented as a central pillar of the plan, driven by evidence that a significant proportion of illness and early death is avoidable. The impact statement argues that improving population health is essential for long-term NHS sustainability and for reducing health inequalities.

However, the impact statement also emphasises that prevention is challenging to deliver in practice. It notes that:

• Many people are not highly motivated or able to self-manage without support
• Prevention often requires sustained engagement rather than one-off interventions
• Benefits may take years to materialise and may not reduce demand in the short term

As a result, prevention is likely to increase the need for ongoing support in community settings. For social care providers, this may translate into greater expectations to support behaviour change, manage risk, and address the social and environmental factors that influence health.

The impact statement for the 10 Year Health Plan for England sets out a long-term vision that places social care at the centre of future service delivery, even though the plan itself is framed as an NHS reform programme. It assumes deeper integration between health and social care, expanded roles for social care staff within neighbourhood teams, and a stronger emphasis on prevention and personalised care.

At the same time, the statement is explicit about uncertainty, delivery risk, and the absence of detailed costings at this stage. For social care providers, the plan signals increased responsibility and visibility within the health system, but also raises significant questions about funding, workforce capacity, and sustainability. How these issues are addressed through local design and future policy decisions will be critical to whether the ambitions of the plan can be realised in practice.