NHS 10-Year Plan: From sickness to prevention and what this means for industry and ICSs

Chapter four of the NHS 10-Year Plan makes an urgent and ambitious argument – the UK must shift decisively from a reactive sickness model to a proactive prevention model.

The evidence is overwhelming – one out of every five deaths in England are preventable. Yet the vast majority of NHS spending still goes on treating illness, not preventing it.

The plan’s aim is bold – to make the healthy choice the easy choice, using national policy levers, digital tools, early intervention and place based partnerships to keep people well for longer.

But once again, the challenge lies in turning theory into reality. Without funding, capacity or accountability, the rhetoric of prevention risks becoming another unfulfilled ambition.

From a frontline perspective and from the vantage point of suppliers trying to engage the NHS, the prevention agenda is full of promise but hampered by structural limitations.

What’s needed now is a practical, operational model of prevention that can work in real neighbourhoods, real systems and real time.

Why prevention is back on the NHS agenda – and what’s different this time

Prevention is not a new idea. Public Health experts, clinicians and even industry partners have been advocating for a shift toward early intervention for decades.

What’s changed is the political framing as prevention is now being positioned as essential to NHS sustainability and economic productivity.

This chapter identifies six key enablers of prevention:

• Healthier environments through national regulation, e.g. restricting smoking, HFSS (High Fat, Sugar, and Salt) advertising.
• Empowering individuals with personalised advice and tools.
• Proactive detection of high-risk individuals, e.g. using data, genomics and AI.
• Workplace and school-based health interventions.
• More accessible local support, especially for smoking, weight and mental health.
• A refocus on population health in NHS commissioning and planning.

All are sensible priorities. But for General Practice and neighbourhood teams, the problem isn’t knowing what to do, it’s being resourced and empowered to do it.

Why GPs are vital to the NHS prevention plan – but struggling to deliver

GPs remain the single most important asset in the prevention landscape. They know their populations, hold trusted relationships and are often the first to spot early signs of disease.

But prevention takes time. Time to talk, follow up, support behaviour change and engage in non-medical interventions. Most GPs don’t have it.

Several GPs I work with describe feeling like they’re being asked to “fix prevention” while firefighting endless acute demand. There’s frustration that the plan celebrates General Practice in principle while under resourcing it in practice.

GPs are willing and able to deliver more preventive care but not without headroom, support and a shift in workload expectations.

The ambition to deliver more care in neighbourhoods must come with honest conversations about capacity, contracts and continuity. Otherwise, prevention will remain just out of reach.

How ICSs are being asked to lead on prevention – and why it’s a gamechanger

One of the most promising developments is the elevation of prevention to a system level responsibility. Integrated Care Systems (ICSs) are now expected to commission, plan and measure services through a population health lens.

This aligns with the wider shift from transactional to transformational commissioning, a theme explored in both my new book Embedded and some of my earlier blogs on my website.

This means:

• ICBs must take accountability for reducing preventable illness across their patch.
• Systems must develop metrics that reward upstream action, not just downstream throughput.
• NHS providers and partners must co-design services that engage people earlier and differently.

This is where medtech, pharma and diagnostics companies can play a bigger role, by developing pathway embedded solutions that identify risk early and enable targeted intervention, especially in cardiovascular, metabolic, respiratory and mental health conditions.

But ICSs cannot do this alone. As recent experiences with NHS Long Term Plan targets show, the lack of a clear operational mechanism for funding and scaling prevention services is a consistent blocker.

Prevention without funding? The missing piece in the NHS puzzle

Once again, the prevention chapter is clear but there is no new ringfenced funding for prevention. All progress must come from “reprioritisation” within existing system budgets.

In practice, this puts ICBs in an impossible position. Prevention services often take years to demonstrate measurable savings. But budget holders are under pressure to manage immediate risk, especially rising demand in emergency care, diagnostics and mental health.

With no short term headroom, few ICS leaders feel they can afford to prioritise long term returns.

For Primary Care Networks and GP practices, this funding gap is even more acute. Preventive services such as social prescribing, lifestyle coaching or long term condition management often sit outside the core contract and rely on patchwork funding or goodwill.

Without a change in how prevention is commissioned and paid for, much of the plan’s ambition will struggle to leave the page.

Prevention and health inequality – why targeted action matters most

A strong theme in this chapter is inequality. The plan rightly points out that the largest gains from prevention come from narrowing the health gap between communities.

People in the most deprived areas live on average a decade less in good health compared to the least deprived. For this reason, prevention efforts must be proportionately resourced to meet greatest need.

Data driven targeting is key. The NHS App, combined with data from primary care, genomics and public health surveillance, offers real time insight into population risk. But insight must translate into action.

Too often, predictive models identify at risk cohorts with no clear pathway for what happens next. Primary Care may not have capacity to follow up. Community Services may be overstretched. And social determinants, like poor housing, food insecurity or digital exclusion, remain outside the NHS’s direct control.

For prevention to be real, NHS systems must build strong links with local government, education, housing and voluntary sector partners. That means co-commissioning, pooled budgets and shared goals.

The new role for pharma and medtech: embedding prevention into NHS pathways

Pharma, medtech and device companies have a critical role to play in the prevention revolution. But the rules are changing.

No longer is it enough to offer “awareness campaigns” or product leaflets. What the NHS needs now are:

• Pathway embedded interventions with tools that sit inside existing clinical pathways, e.g., risk stratification tools, remote monitoring, early diagnostic panels.
• Outcome aligned partnerships, offering solutions that can demonstrate impact on system metrics, e.g., reduced cardiovascular events, earlier detection of diabetes or CKD.
• Prevention at scale with offers that can be embedded through PCNs, neighbourhood hubs, or virtual clinics and not just single practice pilots.
• Support for system transformation, which includes capacity building tools, staff training and digital integration, all of which reduce the burden on frontline teams.

This is the model described in Embedded, a shift from promotional activity to co-delivery. If you want your product to be part of the prevention future, it must reduce workload, improve health equity and align to ICS outcomes.

How industry can help make healthy choices easier

One of the most powerful lines in this chapter is the idea that people will make healthy choices when the system makes those choices easy.

This has major implications for how health interventions are offered. If the default is passive identification, e.g. “your blood pressure is high”, the impact will be limited.

But if the system actively supports the person, through follow-up, coaching, referrals, digital nudges and community resources, then prevention becomes possible.

Here’s where digital health, diagnostics and device companies can help:

• Automated nudges via the NHS App or practice systems to remind patients about checks, tests or risk factors.
• Community based diagnostics delivered in local hubs, pharmacies or via home kits.
• Remote coaching or education for lifestyle change, integrated into neighbourhood, PCN or VCSE pathways.
• Real time dashboards for practices, neighbourhoods and PCNs to identify and prioritise high risk individuals.

But these tools must be designed for inclusion. That means ensuring language support, accessibility, low-tech options and clear pathways to follow-up support.

Why prevention won’t work without easing frontline pressure first

There’s a risk here that we keep promising prevention while asking the same people, especially General Practice, to deliver it without support.

As one PCN Clinical Director told me recently: “We can do prevention. We want to. But we can’t do it as well as everything else. Something has to give.”

Prevention won’t happen unless we relieve the acute pressure on frontline services. Otherwise, the healthy choice may remain the hard choice, for patients and providers alike.

Chapter four sets the right tone, where prevention is a necessity for the NHS’s long term future. But the gap between policy and practice remains large.

The opportunity for pharma, medtech and device companies is equally large, if they can align with systems, support the workforce and embed themselves in real pathways.

If you’re ready to stop selling and start solving, prevention may be your most powerful opportunity yet.

At www.scottmckenzieconsultancy.com, we work directly inside the NHS, supporting provider organisations, commissioners and system leaders to implement real change. We then help pharma, medtech and device companies interpret what’s happening, so they can engage the right stakeholders, align with NHS priorities and get their innovations embedded into care pathways.

With 10 years in pharma and more than 20 years working within the NHS, Scott brings a unique dual perspective, now captured in his upcoming book, launching September 2025, Embedded: How Pharma, MedTech, and Device Companies Can Get Their Products into NHS Pathways and Stay There, which distils everything he’s learned into a practical playbook. Whether you’re launching a new product or trying to unlock stalled adoption, Embedded shows you how to reframe your offer, align with NHS priorities and make change stick.