Landmark plan to rebuild NHS in working-class communities
Source: gov.uk (2025-06-24)

The 10 Year Health Plan will set out how the government plans to tackle inequalities in people’s health through fundamental reforms to our health system.

- Billions freed up to move critical resources like medicines and equipment to regions that most need them
- Major changes to how GP funding is distributed to help working-class communities and coastal areas
- Health Secretary to speak in Blackpool on 10 Year Health Plan’s focus on closing health inequalities
People living in working-class communities and areas where medical resources are desperately needed are set to benefit from a huge boost in support, with billions of pounds diverted to deprived areas, as the government’s 10 Year Health Plan takes unprecedented action to tackle the nation’s stark health inequalities.

After years of neglect, areas where people need the NHS most often have the fewest GPs, the worst performing services and the longest waits - a phenomenon dubbed the ‘inverse care law’. People in working-class areas and coastal towns spend more of their lives in ill health, and life expectancy among women with the lowest incomes has fallen in recent years, after decades of progress.

The 10 Year Health Plan will set out how the government plans to rebuild the NHS and tackle widening inequalities in people’s health through fundamental reforms to our health system, putting an end to a postcode lottery of care.

In recent months, the NHS has driven trusts and integrated care boards (ICBs) hard to cut out wasteful spending and tackle projected deficits. By driving out the culture of deficits, around £2.2 billion previously set aside for deficit support will be freed up, so it can be reinvested in critical resources like staff, medicines, new technology and equipment where they are most needed. This will support millions of people in parts of England that have historically been left behind, such as in rural communities, coastal towns and working-class communities.

The Health Secretary will announce the change during a speech in the North West.

Speaking in the North West today [25 June], Health and Social Care Secretary, Wes Streeting, is expected to say:

The truth is, those in greatest need often receive the worst quality healthcare. It flies in the face of the values the NHS was founded on. The circumstances of your birth shouldn’t determine your worth. A core ambition of our 10 Year Plan will be to restore the promise of the NHS, to provide first class healthcare for everyone in our country and end the postcode lottery.

Last year we sent crack teams of top clinicians to hospitals in parts of the country with the highest waiting lists and levels of economic inactivity. It has seen waiting lists in those areas falling twice as fast as the rest of the country, helping get sick Brits back to health and back to work.

Thanks to the reforms we’ve made to bear down on wasteful spending, we can now invest the savings in working-class communities that need it most. Where towns have the greatest health needs and the fewest GPs, we will prioritise investment to rebuild your NHS and rebuild the health of your community.

Over the past 14 years, NHS trusts have relied heavily on deficit support, with the taxpayer forced to cover the shortfall in their budgets, even when finances have been managed badly. Since becoming NHS England Chief Executive, Jim Mackey has driven down billions in planned deficits, cutting out spending on agency staff and back office costs.

This year, the £2.2 billion in deficit support funding will not go to systems that fail to meet their agreed financial plans. Deficit support funding will be phased out entirely from financial year 2026 to 2027, with no more reward for failure. Instead, the government will introduce a transparent financial regime for this year that properly holds leaders to account over financial plans. Struggling trusts will be required to set out activity and costs so they can take steps to improve. The tougher financial regime will free up funding that will be reinvested in frontline services in working-class communities.

The government’s 10 Year Health Plan will also address the inequalities in GP services across England. Currently, GP surgeries that serve working-class areas receive on average 10% less funding per patient than practices in more affluent areas. Royal College of General Practitioners (RCGP) data (https://www.rcgp.org.uk/News/research-statement-conference-2024) shows that practices in some of the country’s poorest areas have roughly 300 more patients per GP than the most affluent regions.

Through the 10 Year Health Plan, the government will review the formula through which GP funding is allocated across the nation, so working-class areas receive their fair share of resources.

Dr Amanda Doyle, NHS England National Director for Primary Care and Community Services, said:

It is essential that GP practices serving our most deprived communities, where health challenges are often greatest, receive a fair share of resources that reflects their need.

The NHS is committed to ensuring people can access the help they need as quickly and easily as possible, and ensuring funding reflects this will help us to do just that.

This work will look at how health needs are reflected in the distribution of funding through the GP contract, drawing on evidence and advice from experts such as the Advisory Committee on Resource Allocation (ACRA), and in consultation with the GP committee of the British Medical Association (BMA) and other stakeholders.

The government has already sent top doctors to support hospital trusts in areas where more people are out of work and waiting for treatment. The crack teams have been sent into NHS hospitals serving communities with high levels of economic inactivity, helping trusts go further and faster to improve care in these areas, where more people are neither employed nor actively seeking work for reasons including ill health.

Earlier this year, the government struck a new agreement with the independent sector as part of the government’s plans to end the hospital waiting list backlog, giving patients in more deprived areas, where NHS provision is more limited, a greater choice over where they are treated.

This comes after the Health and Social Care Secretary announced a series of new measures to tackle inequalities in maternity care earlier this week. The rapid national investigation will provide truth and accountability for impacted families and drive urgent improvements to care and safety. It will also focus on inequalities in maternal care, which see Black women almost 3 times as likely to die from childbirth as White women.

Jacob Lant, Chief Executive of National Voices, said:

Lord Darzi said in his review last summer that the inverse care law was still very real, with those who need the NHS the most often living in areas that have gotten the least investment.

The NHS 10 Year Plan needs to turn this completely on its head if the government is to achieve its election promise on health inequalities and halve the gap in healthy life expectancy between different communities by 2035.

Shifting the money is only half the battle. We need to see outcomes on health inequalities used as one of the key success measures for NHS leaders as a new culture of accountability is developed post publication of the plan.

Councillor Louise Gittins, Chair of the Local Government Association, said:

Across the country, councils are working tirelessly to incorporate fairness into housing, employment and public health initiatives, often in the face of significant challenges.

Health inequalities are the stark and often unjust differences in health outcomes seen across various communities. These disparities may present themselves as variations in life expectancy, the prevalence of chronic diseases and access to healthcare services.

Addressing these issues requires concerted efforts and targeted support. Health inequalities are estimated to cost the NHS an extra £4.8 billion a year, society around £31 billion in lost productivity, and between £20 and £32 billion a year in lost tax revenue and benefit payments. Health is therefore a major determinant of economic performance and prosperity.

Councils are pivotal in addressing health inequalities. By collaborating closely with local communities, businesses and organisations, local authorities and the NHS, we can develop targeted interventions to improve health outcomes.