The 10-Year Plan is a Bold Vision. But Will it Solve the NHS's "Last Mile Problem"?
The Government's new 10-Year Health Plan promises an AI-driven, preventative future for the NHS. Here's why solving the 'last mile problem' is key to its success.
The government’s new 10-Year Health Plan was published on 3 June 2025. It sets out a bold and transformative vision for the future of the NHS. The three core shifts envisaged are from hospital to community, from analogue to digital, and from treatment to prevention, which are goals that all working in healthcare want. The ambition is the right ambition.
But after years on the frontline and time at the heart of policymaking, I have learned that the success of any strategy is not determined by its vision but its connection to the real world and its delivery. Although the strategy is important, it risks failing at what I call healthcare's "last mile problem", the final and often-overlooked connection between a national ambition and the individual citizen.
This is not a new trend. Ambitious national programmes for digital-first primary care or data sharing have struggled to achieve scale, not because the central vision was wrong, but because they failed to successfully integrate into the complex reality of frontline service delivery. There are many reasons for this including politics. However a plan for AI-driven prevention will be ineffective without a cost-effective and trusted approach to deploying locally and at scale.
To make the 10-Year Plan's vision a reality, we must invest in this ‘last mile’ infrastructure. One, perhaps biased, approach is to empower the network of 11,000 community pharmacies to be hubs. By equipping them with technology championed in the Plan, community pharmacies could become local centres for preventative health. Imagine a patient having their blood pressure checked while waiting for a prescription, with an AI tool instantly assessing their 10-year cardiovascular risk. Another potential approach is a pharmacist using an AI-powered imaging tool to conduct opportunistic screening for suspicious skin lesions—a project I am helping to scale right now.
This is practical, real life application of advanced technology in a trusted, accessible setting. This approach does not require building a new system from scratch; it would be about upgrading what we currently have, the one that is most trusted in every neighbourhood across the country.
The 10-Year Health Plan sets the right destination. The next challenge will be to match the strategic ambition with an equal focus on solving this ‘last mile problem.’
The real work starts now.