Radical Transparency In The NHS: What Chapter 6 Of The 10-Year Plan Means For Suppliers, GPs And Systems

The NHS 10-Year Plan sets out a vision that is both simple and ambitious for better care, with much greater transparency, for all.

In chapter six, the focus turns to the quality of care and asks how patients, professionals and systems can understand, improve and be held accountable for the care delivered across settings.

This chapter proposes a significant expansion in the use of data and transparency to drive improvement in outcomes and experience. It includes specific commitments to publish neighbourhood level quality data, improve personalised outcome measurement and make variations in care visible and actionable.

While the aims are laudable, implementation brings with it a high level of complexity. Many of the GPs and NHS leaders I work with worry about the double bind of being asked to improve outcomes in high need areas, with limited support, under the spotlight of a new quality regime.

And for industry partners, the shift toward more localised, outcome led quality metrics presents both a challenge and an opportunity, especially when traditional adoption models are no longer enough.

Why variation in NHS care is still so hard to fix

The NHS has long struggled with variations in quality between geographies, providers and patient groups. Some of this is due to structural inequality, workforce pressure or service design. But often, the real problem is no one can see what’s really going on.

Chapter six outlines how limited visibility over quality and outcomes has contributed to fragmented care, unmanaged variation and system inefficiency. For example:

• People living in deprived areas are more likely to receive uncoordinated, reactive care.
• Patients with multiple conditions report poor experience and lower confidence in managing their health.
• Significant differences in access, outcomes and continuity exist even within ICSs and boroughs.

This is not new. But the plan proposes a new remedy; radical transparency.

Quality dashboards are coming, but will they help or hinder?

Under the new approach, the NHS will define core outcome measures and publish quality dashboards at system, place and neighbourhood level.

These include:

• Nationally agreed patient-reported outcome measures (PROMs) for people with multiple conditions.
• Continuity of care metrics, especially in primary care.
• Publication of data on avoidable harm, access and experience.
• Shared standards across mental and physical health for care quality.

This transparency is intended to drive professional accountability for GPs, hospitals and providers who will see where they sit compared to peers. It should also promote public engagement, where patients and communities will be able to compare and question local care, and system learning where ICSs and Places can focus on unwarranted variation and support improvement.

On paper, it’s a great idea. In practice, it creates pressure and risks unintended consequences.

GPs say; don’t benchmark us without backing us

Many GPs are already working at capacity. When I speak with practices, PCNs and federation leaders, they express two consistent worries:

1. You’re benchmarking me without resourcing me.
2. You’re measuring what’s easy, not what matters.

They point out that metrics without context can punish teams working in tough conditions. A practice in an area of deprivation may have lower continuity scores, not because they lack commitment but because recruitment and retention are harder, patient complexity is higher and service demand is more volatile.

There’s also concern about metric overload. With more and more dashboards being published from CQC to NHS England to ICBs, frontline staff feel like they’re managing to a spreadsheet, not to a patient.

For transparency to improve care, it must come with support, not just scrutiny, improvement tools, not just performance notices and measurement of what matters, not just what’s available.

Neighbourhood level accountability brings opportunity and risk

The plan commits to making neighbourhood level quality data visible. This is an important and necessary shift but it comes with workload implications for General Practice, community providers and local authorities.

Neighbourhoods are being positioned as key engines of improvement. Yet many have no data analysts, no digital infrastructure and no headroom for service redesign. Even where data is available, few have the capability to translate it into actionable change.

Here’s where medtech, diagnostics and data solution providers can play a vital role. Not just by supplying the tools but by enabling whole pathway visibility, empowering proactive care and providing the wraparound support to interpret and use data in a way that reduces, not adds to, workload.

What NHS suppliers must now prove to win adoption

For companies supplying the NHS, this new era of transparency presents a clear shift. No longer is it enough to demonstrate safety, efficacy and cost-effectiveness. Now, suppliers must be ready to show:

• How your solution improves a published outcome measure.
• How it helps reduce unwarranted variation at local level.
• How it enables the system to measure, understand and improve care.
• How it fits into a multi-condition, multi-provider, integrated delivery model.

As I explore in my new book Embedded, success now depends on being part of the quality improvement ecosystem. That means designing outcome aligned services and contracts, providing evaluation support and impact dashboards, investing in real world evidence that tracks neighbourhood level benefit and offering training, workflow integration and population segmentation tools.

If you can prove your intervention makes quality visible and better, not just for the patient but for the team delivering care, then your value proposition strengthens exponentially.

Transparency without support risks backlash and burnout

However, transparency carries risk. If not handled with care, it can feel more like surveillance than support. There’s a very real danger that practices, PCNs and neighbourhoods may feel shamed or penalised for systemic issues they cannot fix.

We’ve seen this before; league tables that ignore context, improvement plans with no funding and dashboards that report the problem but don’t solve it.

ICSs and national bodies must ensure transparency is used to direct investment, identify and share good practice, focus QI efforts where they’re most needed and strengthen system wide learning, rather than to punish.

Industry, too, has a role in this. Companies should approach local systems not with critique but with collaborative insight, offering to co-develop solutions that meet emerging quality standards and reduce variation, not just flag it.

How transparency can drive equity – if done right

Transparency, when done well, also supports equity. By making differences in outcomes visible across population groups, by age, ethnicity, deprivation and disability status, the system can start to act on long standing disparities.

But again, metrics must reflect what matters. Many GPs tell me national frameworks still miss the nuance of real care and the complexity of managing multi-morbidity, the trade offs between access and continuity and the real world pressures facing teams.

A central message of Embedded is this; unless metrics reflect reality, the solutions they reward won’t solve the problems they measure.

Companies can support the equity and personalisation agenda by:

• Building in patient reported outcome tools.
• Using data that stratifies population needs.
• Designing interventions for the highest need groups.
• Ensuring digital tools and services are inclusive, accessible and culturally relevant.

The message to pharma is clear; this is a roadmap to sales success

“A New Transparency of Quality of Care” is a welcome chapter. It acknowledges long standing issues and proposes a bold, data driven future. But as with much of the NHS 10-Year Plan, it’s not the ambition that’s in question; it’s the means of delivery.

The frontline wants better care and better data. But without time, support and context, transparency can do more harm than good. For GPs, ICSs and suppliers, the challenge now is to move from monitoring to mobilising, from data as audit to data as action.

For suppliers, the message is clear, you must help the system improve quality, reduce variation and empower people, and then you’ll be embedded for the long term.

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.