68: The 10-Year Health Plan a year on: perspectives from three NHS leaders – with Birju Bartoli, Paul Dinkin and Amanda Sullivan

Can reform ambitions meet delivery reality? What's going on? What needs to happen next? And is anyone noticing at the patient level? And we really do have a stellar panel here today from different parts of the healthcare system.

We have, uh, Paul Dinkins, who's the director general for strategy and healthcare policy at NHS England, give us a top-down view about how the system is, uh, working.

And then we have Amanda Sullivan, who is the chief executive of an ICB in, and this is a very long name, Derby and Derbyshire, Lincolnshire, and Nottingham, and Nottinghamshire.

And then we also have Dr. Birju Bertoli, who is the chief executive of Northumbria Healthcare NHS Foundation Trust.

I've been, uh, knocking around health policy since 1990, and I must say I've seen masses of plans starting with working for patients under Ken Clarke.

And I think if you stack them up, there's around 50 since then.

There's been pretty similar ingredients in a lot of them.

The left shift, analog to digital, the prevention aim, and also the aim to push, uh, more investment into primary care and integrated care.

Those things have always been, I think, more or less the same for all of that time.

And then overlaying that is some sort of narrative.

So between 1990 and 2012, there was the competition and choice narrative that really the thing to do to prod this big beast of the NHS into more activity and more action and, and progress, you needed to have a bit of competition to ginger them up.

And then after Lansley, it became much more about integration and collaboration with all the integrated care and the commissioning arrangements that took place there.

And then more recently, the 10 Year Plan, it's got a bit of everything of that in it, both of those two paradigms.

The biggest smattering on technology is the big hope to try to help improve sustainability of the NHS as a model, but also improve quality of care for everyone.

So last year, election in July '24, Darzi report October.

Good diagnostic, I thought, particularly big, strong tilt to technology.

We had the NHSE, DHSC chainsaw massacre in March 2025.

Then we had last July, the 10 Year Plan, not forgetting also the life sciences plan that came out at the same time.

We've had the operating framework after that.

We've had numerous pieces of guidance to help people along the way.

We've got the bill, and underneath everything we've got an exacting, uh, 2025 spending review target of 2% efficiency.

And underneath all of that, we have very committed public servants and very committed, um, clinicians trying to do their very best to make all of this work and improve care for patients.

So, um, with that as our sort of background, I really want to now give way to our panel.