Published on: 14,Jan 2025

Beth Colliety, Policy Manager, The Richmond Group

I joined the Richmond Group of Charities as their new Policy Manager back in October 2024, just as the government opened a consultation to inform their new 10-Year Health Plan. So, alongside learning where the tea is kept in the office and a warm welcome from our members, I got straight into our response to this plan and what we think needs to change.

Getting care right for people with multiple health conditions holds the key to a stronger NHS. The 10Year Health Plan is an unmissable opportunity to do things differently for the increasing number of people living with long-term and multiple health conditions, who need more coordinated, proactive, preventative, and person-centred care to help them live well and thrive.

Redesigning multiple conditions care

One in four of us now live with at least two health conditions, and this number is rising. But too often the health system is focused on single diseases or body parts rather than the person and what matters to them.

A dedicated improvement programme could support and accelerate the redesign of multiple long-term conditions care at a local system level, equipping busy frontline teams with the bandwidth, resources and support needed to redesign key aspects of care including risk stratification, multidisciplinary and cross-sector working, and care coordination.

While there are great examples of models of care for multiple long-term conditions, these are patchy. An overall improvement programme (within the context of the government’s move to neighbourhood health) would standardise these practices and make it a national effort to address the changing demographic needs of our society.

Tackling persistent health inequalities

People on the lowest incomes are more likely to have multiple conditions and develop them earlier.  Resources and funding must be well-targeted if we are to tackle persistent health inequalities. The 10-Year Health Plan should incentivise outreach to and co-design of services with underserved communities. Fostering trust requires determination, expert local knowledge, and genuine listening and collaboration.

Reducing unequal access to health services should start with primary care, as the front door to the NHS, and to drive this the government must re-establish leadership and accountability on health inequalities. A dedicated catch-up programme to tackle poor data quality and coverage in common long-term conditions would support more equal data collection, analysis, and associated improvement.

A preventative approach

At every stage of a person’s life, there are opportunities to prevent the development of further ill health. As the proportion of those living longer in ill health grows, more money must be invested in secondary and tertiary prevention and NHS England should expand its existing multiple long-term conditions prevention programme to maximise the possibilities to stop the development of multiple conditions in its tracks.

The 10-Year Health Plan must focus on how to equip people with the skills, knowledge, and confidence to live well with their health conditions, in ways that are meaningful to them. This increased agency would prevent people’s health from deteriorating and improve outcomes and experience of care, while also reducing demand for health and care services.

While tackling the wider determinants of health (including lack of clean air, poor housing, and insecure work) sit outside the remit of the Plan, only a truly cross-government and multiagency approach to improving the nation’s health will achieve the government’s mission goals to reduce early deaths, reduce the number of years spent in ill health, and make health a driver of economic growth.

People and systems can benefit from a more thriving and sustainable charity sector

The government’s ambition to deliver three big shifts in health and social care – from hospital to the community, from analogue to digital, and from sickness to prevention – can’t be done without the charity sector.

Health and care charities play a vital role in helping people to live well and manage their health conditions, innovatively addressing whole person needs, taking strain off the health system, and delivering value for money. But the sector faces existential challenges with increasing demand and reduced funding.

The 10-Year Plan team should work with the voluntary sector to develop a clear set of proposals to unlock and capitalise on the support it can provide to patients and systems. This includes reviewing financial and commissioning arrangements that put strain on the sustainability of the voluntary sector.

Our 14 national charities have sector-leading capability to support problem-solving, policy development and service design, and can contribute significantly to the local system transformation the 10-Year Health Plan will require.

We will be closely monitoring the new 10-Year Health Plan, to see whether it will make a real difference to the lives of people who need health and care services the most.

If you would like to hear more about our coalition’s work, please contact us. You can read about the government’s Plan here: Change NHS