Guidance

Change NHS: help build a health service fit for the future

Published 21 October 2024

Applies to England

Go to the Change NHS online portal to give your views on how we can make a health service fit for the future. This GOV.UK page gives an outline of the questions asked for public reference and holds the privacy notice.

Overview

The 10 Year Health Plan is part of the government’s health mission to build a health service fit for the future.

The first step in the process was Lord Darzi’s independent review of the NHS in England to understand the true scale of the challenge facing the health service. That was published on 12 September 2024. Now that we have the results of that investigation, the government is working to develop a plan to tackle the challenges it identifies.

The plan will set out how we will deliver an NHS fit for the future, creating a truly modern health service designed to meet the changing needs of our changing population. The government will co-develop the plan with the public, staff and patients through a detailed engagement exercise.

To do this, we have launched ‘Change NHS: help build a health service fit for the future’. This is a national conversation to develop the 10 Year Health Plan.

As part of this, we want the public and health and care staff in England to share their views, experiences and ideas at the Change NHS online portal. The portal opened on 21 October 2024 and will run for several months.

It doesn’t matter whether you have a little or lot to say. The online portal is open to everyone, whether you’re a member of the public or someone who works in health and care in England. There is also an area of the portal dedicated to responses from organisations. This area is an early opportunity for organisations to share insights as we begin an extensive programme of engagement to develop the 10 Year Health Plan.

This is just the beginning. Over the coming months there will be a series of events for people across the country to share their ideas and views. This includes a number of regional events with the public and health and care workers to hold more detailed discussions on how we can fix the NHS.

The Department of Health and Social Care (DHSC) is leading this work, alongside NHS England. It is the combined role of these organisations to support, protect and improve the health and wellbeing of populations in England.

DHSC has commissioned Thinks Insight and Strategy to deliver the ‘Change NHS online portal’ through the website GoVocal. Thinks Insight and Strategy is an independent research agency adhering to the Market Research Society Code of Conduct.

DHSC is also working with Kaleidoscope Health and Care who are providing expertise on workforce engagement, acting as a champion for staff voices. The Institute for Public Policy Research (IPPR) is also providing expertise on policy and implications, ensuring the engagement is informed by latest evidence.

As part of the engagement, some members of the public will be receiving letters from Thinks Insight and Strategy inviting them to register their interest in taking part in these events, having been selected at random to ensure a representative sample. If you receive one of these letters, please follow the instructions given to register your interest. If you are not invited to take part in the in-person events, there will be other opportunities where you can be involved in the discussion.

About the online portal

The government has made it its mission to develop a 10 Year Health Plan, but we cannot do it without the help of the people who use and work in the NHS. We need to learn from your experiences and perspectives and hear your ideas. The Change NHS online portal will help us to do that.

The portal opened on 21 October 2024 and will run for several months. Everyone over the age of 16 living in England can take part.

Some questions are aimed at those working in the health and care sector to ensure they can share their views and experiences. Other questions are written specifically for those who use services.

Staff and the public will both have unique insights about what needs to change in the NHS.

Go to the portal to:

• give your views on the NHS and health and care
• tell the government what you feel is working well and what needs improving
• share your experiences
• post your ideas for improving health and care in the future

The site is interactive and gives you the opportunity to engage with other people’s ideas too.

As the 10 Year Health Plan develops, we’ll be feeding back ideas and initiatives as they emerge from our work and asking you to comment and challenge our thinking and ideas. 

You can register for updates so you do not miss new content you can get involved with.

Confidentiality

Most responses will be kept confidential and will be anonymised in analysis and reporting.  

The only section where responses can be viewed by other people is ‘Your ideas for change’. You can choose to leave an idea without leaving your name, but your username will be visible if you respond here.

You can also view other people’s responses in the ‘Your ideas for change’ activity. We encourage you to read these, leave comments and vote on them. Responses to all other activities will be private and not visible to other people.

The ideas that you contribute will be considered alongside those generated through a wide range of other engagement over the coming months, including hearing from people who are less able to engage online and lots of other groups.

Alternative formats

Email changenhs@thinksinsight.com to request alternative formats, or to have your say without registering on the portal.

Questions

The questions on the portal are grouped into sections:

• Start here
• Your experiences: public
• Your experiences: workforce
• Your ideas for change
• Organisational responses
• Feedback on the engagement

The questions in each section are listed below.

You’ll need to register your name and email address to answer the questions. All questions are optional.

Start here

Changing the NHS is going to involve everyone. The government promised to put in place a 10 Year Health Plan to fix the NHS in England.

Best thing about the NHS

In your opinion, what are the best things about the NHS? Please tell us up to 3 of the best things about the NHS today.

Biggest challenge facing the NHS

In your opinion, what are the biggest challenges facing the NHS? Please tell us up to 3 challenges.

Problems experienced

In July 2024, an independent investigation of the state of the NHS in England was carried out (the Darzi report). The findings of the investigation identified several challenges facing the NHS which will need to be addressed to improve services over the next 10 years.

Which, if any, of the following have you personally experienced?

• difficulties getting a GP appointment
• waiting to access community services (for example, district nursing, community physiotherapy, community occupational therapy)
• waiting to access mental health services
• long wait times in A&E (accident and emergency)
• long waiting lists for a hospital procedure
• delays in being referred for treatment
• poor co-ordination between different health and care services
• poor communication from health services
• poor quality care
• treatments or services not available on the NHS
• other - please specify

Priority for change

Which of the challenges selected in the previous question do you think are most important for the 10 Year Health Plan to address? Please select the 3 options you feel are most important to address.

The shifts

The next questions relate to 3 ‘shifts’. These are big changes to the way health and care services work - that doctors, nurses, patient charities, academics and politicians from all parties broadly agree are necessary to improve health and care services in England:

• shift 1: moving more care from hospitals to communities
• shift 2: making better use of technology in health and care
• shift 3: focusing on preventing sickness, not just treating it

Shift 1: moving more care from hospitals to communities

This means delivering more tests, scans, treatments and therapies nearer to where people live. This could help people lead healthier and more independent lives, reducing the likelihood of serious illness and long hospital stays. This would allow hospitals to focus on the most serious illnesses and emergencies.

More health services would be provided at places like GP clinics, pharmacies, local health centres and in people’s homes. This may involve adapting or extending clinics, surgeries and other facilities in our neighbourhoods, so that they can provide things that are mostly delivered in hospitals at the moment. Examples might include:

• urgent treatment for minor emergencies
• diagnostic scans and tests
• ongoing treatments and therapies

In what ways, if any, do you think that delivering more care in the community could improve health and care?

What, if anything, concerns you about the idea of delivering more care in the community in the future?

Shift 2: making better use of technology in health and care

Improving how we use technology across health and care could have a big impact on our health and care services in the future. Examples might include:

• better computer systems so patients only have to tell their story once
• video appointments
• artificial intelligence (AI) scanners that can identify disease more quickly and accurately
• more advanced robotics enabling ever more effective surgery

In what ways, if any, do you think that technology could be used to improve health and care?

What, if anything, concerns you about the idea of increased use of technology in the future?

Shift 3: focusing on preventing sickness not just treating it

Spotting illness earlier and tackling the causes of ill health could help people stay healthy and independent for longer and take pressure off health and care services. 

In what ways, if any, could an increased focus on prevention help people stay healthy and independent for longer?

What, if anything, concerns you about the idea of an increased focus on prevention in the future?

Your experiences: public

This section of the engagement is for anyone who wants to tell us more about their experience of health and care.

Recent experiences

Please tell us about a recent experience of health and care services in as much or as little detail as you wish.

This could be an experience where you or a family member accessed care as a patient. Or it could be about the overall performance of the health and care system.

Please tell us about any positive or negative aspects of your experience and be as specific as you can.

Your experiences: workforce

This section is aimed at people currently working in health and care.

The portal is for feeding in experiences to the 10 Year Health Plan, not providing direct feedback to individual services. However, it is important that you know you are free to speak up if you are concerned. You can find routes to speak up at NHS England’s Freedom to speak up webpage.

Best thing about your role

What are the best things about your job? Please tell us up to 3 things that are great about your job.

Worst thing about your role

What are the most challenging aspects of your job? Please tell us up to 3 things that you find most challenging about your job.

Recent experiences - workforce specific

Which of the following challenges, if any, have you experienced working in the health and care system?

Please select all that apply. If none applies, please leave blank.

• low levels of job satisfaction or morale
• problems with workplace culture (for example, bullying, racism, sexism or harassment)
• staff shortages
• high levels of staff turnover
• stressful working environment
• poor mental health or burnout
• unmanageable workload
• complex administrative processes
• poor equipment
• inflexible or antisocial working patterns
• poor training
• inefficiencies in connecting services
• growing complexity of patient needs
• other - please specify

Priorities for change - workforce experiences

Which of the challenges that you selected in the previous question do you think is the most important for the 10 Year Health Plan to address? Please select the 3 options you feel are most important to address.

Recent experience

We want to learn from your experiences of working in health and care. Please tell us about any aspects of your work that you think we need to understand as we develop the 10 Year Health Plan.

These could be things you or your team find challenging, which you think should be avoided or changed in the future.

These could also be things you or your team do differently that you think could lead to improvements elsewhere in health and care.

Please share as much detail as you can and be as specific as possible about which part of the health and care system your experience relates to.

Your ideas for change

The ideas you submit will be visible to everyone taking part, and you can browse other ideas on the portal. You can vote for those you think will be the most effective. The best ideas will form part of the 10 Year Health Plan.

For the 10 Year Health Plan to be a success, it needs to draw on the experiences, skills and ideas of patients, carers, staff and members of the public. These could be:

• ideas about how other parts of the health and care system and other organisations in society could change to promote better health and/or improve the way health and care services work together
• ideas about how individuals and communities could do things differently in future to improve people’s health

On the portal, you can share a suggestion for what needs to change across the health and care system and then tag which topic or topics it relates to underneath. Please submit one idea at a time on the portal - you can add as many you like.

Your idea for change

What is your idea?

Title

Give your idea a short name that will help people understand what it is all about.

Description

Tell use a bit more about your idea:

• who is involved?
• what will change?

Topic area

Below is a long list of topics that your idea might relate to. Please click all the ones that you think your idea could affect:

• stages of healthcare:
  • keeping people healthy
  • diagnosis
  • treatment
  • aftercare and recovery
  • living with ill health
  • end of life care
• places:
  • GP surgeries
  • hospitals
  • nursing and residential care homes
  • hospices
  • community facilities
  • care in the home
• conditions:
  • long term conditions
  • short term illnesses
  • accidents and emergencies
  • mental health
  • planned (elective) care
• workforce:
  • caring for patients
  • pay and conditions
  • facilities and IT
  • management and organisation
• other - please specify

Would you say this idea is quick to do?

• quick to do - that is, in the next year or so
• in the middle - that is, in the next 2 to 5 years
• long term change that will take more than 5 years
• don’t know

Organisational responses

The government wants to hear organisations’ views from the outset as it begins work to develop the 10 Year Health Plan.

Organisations should submit responses to these questions by Monday 2 December 2024 at 5pm.

This is an early opportunity to share your insights as we begin an extensive programme of engagement to develop the 10 Year Health Plan.

Keep your total response to the questions to a maximum of 5,000 words. You can include links to reports or supplementary evidence as part of your response - these are not included in the word count.

Priorities

What does your organisation want to see included in the 10 Year Health Plan and why?

The shifts

The next questions relate to 3 ‘shifts’. These are big changes to the way health and care services work - that doctors, nurses, patient charities, academics and politicians from all parties broadly agree are necessary to improve health and care services in England:

• shift 1: moving more care from hospitals to communities
• shift 2: making better use of technology in health and care
• shift 3: focusing on preventing sickness, not just treating it

In answering the following questions on the 3 shifts, we would welcome references to specific examples or case studies. Please also indicate how you would prioritise these and at what level you would recommend addressing this - for example, at a central approach or local approach.

Shift 1: moving more care from hospitals to communities

This means delivering more tests, scans, treatments and therapies nearer to where people live. This could help people lead healthier and more independent lives, reducing the likelihood of serious illness and long hospital stays. This would allow hospitals to focus on the most serious illnesses and emergencies.

More health services would be provided at places like GP clinics, pharmacies, local health centres and in people’s homes. This may involve adapting or extending clinics, surgeries and other facilities in our neighbourhoods, so that they can provide things that are mostly delivered in hospitals at the moment. Examples might include:

• urgent treatment for minor emergencies
• diagnostic scans and tests
• ongoing treatments and therapies

What does your organisation see as the biggest challenges and enablers to move more care from hospitals to communities?

Shift 2: making better use of technology in health and care

Improving how we use technology across health and care could have a big impact on our health and care services in the future. Examples might include:

• better computer systems so patients only have to tell their story once
• video appointments
• AI scanners that can identify disease more quickly and accurately
• more advanced robotics enabling ever more effective surgery

What does your organisation see as the biggest challenges and enablers to making better use of technology in health and care?

Shift 3: focusing on preventing sickness not just treating it

Spotting illness earlier and tackling the causes of ill health could help people stay healthy and independent for longer and take pressure off health and care services. 

What does your organisation see as the biggest challenges and enablers to spotting illnesses earlier and tackling the causes of ill health?

Ideas for change

We’re inviting everyone to share their ideas on what needs to change across the health and care system. These could be:

• ideas about how the NHS could change to deliver high quality care more effectively

• ideas about how other parts of the health and care system and other organisations in society could change to promote better health and/or improve the way health and care services work together

• ideas about how individuals and communities could do things differently in the future to improve people’s health

Please specific policy ideas for change.

Please include how you would prioritise these and what timeframe you would expect to see this delivered in, for example:

• quick to do - that is, in the next year or so

• in the middle - that is, in the next 2 to 5 years

• long term change that will take more than 5 years

Integrated care systems

We’re asking integrated care systems (ICSs) to help develop the 10 Year Health Plan by sharing insights from their communities.

We want to build on existing activity in 3 main ways:

• national level discussions with health and care system and local government leaders
• regional events with clinical, operational, local authority and public health leaders
• local engagement through patient groups and wider system partners, supported by content developed in partnership with ICSs

In mid November 2024 we will provide a ‘workshop in a box’ to support ICSs to gather insights and share them with the government to help develop the 10 Year Health Plan. This is being designed with input from local health and care systems so that this engagement builds on ICS expertise of engaging the public, staff, under-represented groups and stakeholders, allowing ICSs to share existing and future insights.

Privacy notice

Summary of initiative

The Secretary of State for Health and Social Care has initiated an extensive engagement exercise to help develop a 10 Year Health Plan that will reform the NHS and make a health service fit for the future in England.

DHSC is working with an external supplier, Thinks Insight and Strategy, to launch an online survey portal under the name ‘Change NHS: a health service fit for the future’. This portal is hosted via GoVocal, a contracted supplier of Thinks Insight and Strategy. The portal consists of surveys to collect the views, ideas and experiences from the public and health and care staff on health care in England.

There will also be a series of deliberative events as part of this engagement, with a separate privacy policy available for this.

Data controller

DHSC is the data controller.

What personal data we collect

The online portal will ask you to register using your name and email address.

On completing the first survey, you have the option of sharing information about yourself including:

• age
• sex
• gender
• postcode
• region where you live
• ethnicity
• nationality
• whether you have a long term health condition
• health services accessed in the last 12 months

Those who work in the NHS will also have the option to share:

• their role
• type of organisation they work for
• length of time working in their role

Individuals can provide personal experiences of using and, for staff, working in health and care. Individuals may volunteer to share information that relates to individual physical or mental health conditions, and information relating to sexual orientation. Individuals will be asked to ensure that the responses they submit to the portal questions do not contain any identifiable personal data.

As part of using the GoVocal platform, if you provide permission by accepting cookies on the platform, they and their third party processors acting on their behalf collect information about the usage of the platform to assess its proper functioning and security. As a result, GoVocal may collect technical information about you such as your internet protocal (IP) address and browser details. GoVocal may also gather usage data to improve its services. You can opt out of this collection at all times in your cookie settings.

How we use your data (purposes)

Data collected via the online portal provided by GoVocal will be thematically analysed by Thinks Insight and Strategy and Yonder Data Solutions, with the purpose of informing the 10 Year Health Plan.

All data taken from the portal will be anonymised before it is shared with Yonder Data Solutions, DHSC and NHS England. This means that your personal data will be removed, and you will no longer be identifiable. This data can be used to provide broad analyses of the findings. Anonymised data may be published as part of the final engagement report and used to inform future policy development in DHSC and NHS England.

Your username will be visible for any contributions you make to the activity ‘Your ideas for change’, alongside your name if you choose to enter this. This personal data will not be included when data is taken from the portal but your username and name, if entered, will remain visible on the portal for any ideas you choose to submit.

Legal basis for processing personal data

Under Article 6 of the United Kingdom General Data Protection Regulation (UK GDPR), the lawful basis we rely on for processing personal data is: (e) the processing is necessary to perform a task or function in the public interest or for our official functions and the task or function has a clear basis in law.

This is in line with the Secretary of State’s duties in relation to the promotion and provision of the health service in England (including public health functions), and the improvement in the quality of services, as outlined in part 1 of the NHS Act 2006 (as amended by the Health and Social Care Act 2012).

It is necessary for DHSC and NHS to consult views from members of the public and those that work in the NHS about the future of it. The data involved covers Article 9 (special categories of data) and under part 1 Schedule 1 of the Data Protection Act 2018 number 4(c).

In addition, we are also processing special category data under the following conditions as per Article 9 of the UK GDPR:

• (g) reasons of substantial public interest (with a basis in law)

• (h) health or social care (with a basis in law)

• (j) archiving, research and statistics (with a basis in law)

Data processors and other recipients of personal data

DHSC has commissioned an external supplier, Thinks Insight and Strategy, to help run the engagement for the 10 Year Health Plan. The portal is hosted through an online platform, GoVocal, which is a contracted supplier of Thinks Insight and Strategy. See GoVocal’s privacy notice.

Yonder Data Solutions will be responsible for thematically analysing and coding the open text questions on the portal, who are a contracted supplier of Thinks Insight and Strategy.

DHSC will share data collected from the portal with NHS England to inform policy development.

International data transfers and storage locations

Information will be processed and stored in the UK and EU.

Retention and disposal policy

Personal information will be deleted 12 months after the portal closes. All data will be anonymised before it is shared with DHSC and NHS England to inform future policy development.

How we keep your data secure

Personal data will be securely stored by Thinks Insight and Strategy and GoVocal. Anonymised data that has been processed by Thinks Insight and Strategy and Yonder Data Solutions will be securely kept by DHSC and NHS England.

Your rights as a data subject

By law, data subjects have a number of rights, and this processing does not take away or reduce these rights under the EU General Data Protection Regulation (2016/679) and the UK Data Protection Act 2018 applies.

These rights are:

• the right to get copies of information - individuals have the right to ask for a copy of any information about them that is used

• the right to get information corrected - individuals have the right to ask for any information held about them that they think is inaccurate to be corrected

• the right to limit how the information is used - individuals have the right to ask for any of the information held about them to be restricted - for example, if they think inaccurate information is being used

• the right to object to the information being used - individuals can ask for any information held about them to not be used. However, this is not an absolute right, and continued use of the information may be necessary, with individuals being advised if this is the case

• the right to get information deleted - this is not an absolute right, and continued use of the information may be necessary, with individuals being advised if this is the case

Comments or complaints

Anyone unhappy or wishing to complain about how personal data is used as part of this programme should contact data_protection@dhsc.gov.uk in the first instance or write to:

Data Protection Officer
1st Floor North
39 Victoria Street
London
SW1H 0EU

Anyone who is still not satisfied can complain to the Information Commissioner’s Office. Their postal address is:

Information Commissioner’s Office
Wycliffe House
Water Lane
Wilmslow
Cheshire
SK9 5AF

Automated decision making or profiling

No decision will be made about individuals solely based on automated decision making (where a decision is taken about them using an electronic system without human involvement) which has a significant impact on them.

Changes to this policy

This privacy notice is kept under regular review. This privacy notice was last updated on 21 October 2024.