Fit For The Future 10 Year Health Plan for England
An Imroc Mental Health Explainer
Introduction
In July 2025, the government published its Fit for the Future: 10-Year Health Plan for England — a wide-reaching roadmap for how the NHS should change over the next decade. It promises to shift more care out of hospitals and into local communities, embrace digital technology, and put more focus on preventing illness before it starts.
There’s a lot in the plan that could matter for mental health — but here’s the problem: it’s pretty long, complex, and not especially easy to read. Unless you’ve got time to wade through 168 pages of policy language, it’s hard to work out exactly what’s being promised for mental health services, support, and for the people who use or work in them.
That’s where this explainer comes in.
Whether you’re:
someone who uses or cares about mental health services,
someone working in the system,
or just trying to understand how mental health fits into wider NHS reform
—we’ve pulled together everything the plan says (and doesn’t say) about mental health, in one place, in plain English.
What You’ll Find in This Explainer:
Some detail about the political and social context that this plan is working within
A quick overview of what the 10-year plan is all about
A breakdown of the key commitments on mental health
What’s exciting and what’s missing
How experts and organisations have responded to the plan so far
What does Imroc have to say?
Our aim is to help make the plan more accessible, more useful, and more relevant - so you can be confident about what it actually means for mental health in England over the next 10 years.
Visual Summary of the 10 Year Plan Wider Context
Why it matters
The ten year plan provides a long term road map informing commissioners, planners and services about priorities and approaches. Reform cannot take place overnight so the plan outlines the direction, priorities and timescale for change.
Long term planning enables local systems, localities and neighbourhoods to understand levels and types of need alongside the particular strengths and resources within their geographical patch. This can be used to agree a way forward together, to generate solutions with those in most need, in a sustainable and inclusive manner. Health inequalities are increasing and are often related to level of access to services and other social indicators. By working with communities at a local level, we can begin to improve the accessibility of services, reduce inequalities in outcomes, and ensure that prevention becomes a key driver for health services.
Overview of the plan
What the plan says
There have been quite a few helpful summaries of the plan, including this one from NHS South, Central and West which puts everything into a one-page graphic.
The plan is structured around 3 big shifts:
From hospital to community
From analogue to digital
From treatment to prevention
Within these shifts, the plan outlines its commitments, with mental health featuring in each.
Key commitments on mental health
Expanding mental health support teams in schools and colleges
The plan commits to expanding mental health support teams in schools and colleges as an integral part of supporting children and young people’s mental wellbeing. A key target is to recruit 8,500 additional mental health workers to shorten waiting times for both children and adults.Embedding mental health services within Neighbourhood Care Models (community hubs)
The plan design includes mental health care as a core service offered within neighbourhood health centres that bring together diagnostics, post-op rehab, nursing, and mental health support close to home. There is also a commitment to achieving 100% national coverage for assertive outreach care and treatment over the next decade, with a focus on reducing the unacceptable inequalities embedded in mental health services.Enabling self-referral to mental health services via the NHS App
Throughout the plan, there is an emphasis on digital access—including allowing self-referral to mental health support through the NHS App as part of the analogue to digital shift. Other digital features envisioned in the plan include the use of virtual therapists providing 24/7 support for mild or moderate need, and for people with ‘more severe mental illnesses’, remote monitoring will help support a proactive response to crisis.Prevention focused approach includes mental health
Under the shift from sickness to prevention, mental health features alongside obesity, smoking, and other determinants—highlighting the importance of early mental wellbeing interventions in schools, workplaces, and communities.Care plans benefiting mental health
The commitment to personalised care plans for 95% of people with complex needs by 2027 applies to people with mental health conditions as well as other long-term conditions.Elevating mental health as in outcome-based care
The new operating model includes performance measurement based on outcomes across; mental health is explicitly named as an example of a condition addressed under the new approach.Mental Health Emergency Departments
The plan commits to investing up to £120 million to develop more dedicated mental health emergency departments to provide fast, same-day access to specialist support in an appropriate setting, offering walk-in access, receiving people via ambulance or police referrals and conducting rapid assessments typically within four hours.
Peer Support
Local areas will be given the flexibility to trial new roles and adopting existing proven models like peer support workers as they expand the capabilities of their neighbourhood teams. In the context of tackling harmful alcohol consumption, the plan states its intention to support community-level innovations that have demonstrated promise in reducing alcohol harm, including peer-led support groups, peer mentoring and coaching, and mutual aid networks, but it is unclear whether these will be paid roles for peer workers.
Personal budgets
The plan outlines the aim to expand the use of Personal Health Budgets (PHBs), which offer people choice about how they spend the money allocated to them for health support. The aim is to offer one million people PHBs by 2030, an increase of over 800,000 in the next 5 years.
Summary Table
Table Summary of the 3 big shifts
What’s exciting and what’s missing
What’s exciting
The plan is exciting for a number of reasons. Firstly, it’s hugely ambitious, beginning with the acknowledgement that big changes are needed in order to improve people’s experiences of accessing and using the NHS as well as their outcomes. The plan is really focussed on making the NHS better; the government wants to increase public satisfaction. Part of achieving this involves enabling local systems to be responsive to people’s needs and empowering people to co-design services and delivery models in their local contexts. So it's also exciting to see the foregrounding of communities in the plan and the recognition of strength in communities.
Another promising element is the focus on reducing bureaucracy, as long as this doesn’t add additional pressure to frontline staff. Despite what we might read in the media, health services are not overburdened by managers. Management should not be totally mixed up with bureaucracy.
As we said above, the plan also does have one mention of peer support workers, which demonstrates a recognition of the value of lived experience.
What’s missing
While it is a very welcome plan, there are quite a few missing details. This could be read as a wish list rather than a plan because there is little mention of resources to fund implementation and no detail about implementation and delivery. There is as much to understand by what is not said in the plan as what is said: Does investment in neighbourhood services mean that investment in hospital building will cease? Does the focus on reducing waiting lists mean that investment in long term conditions will reduce? Is this more about trade-offs than overall improvement?
How will we get from hospitals to communities? Moving services from hospitals to communities is a huge shift that will need to be resourced and carefully thought through. Increasing accessibility for diverse communities will only be successful if plans are co-produced with local communities, especially those who have poorer life and health outcomes.
The plan describes an intention to create more ‘Foundation Trusts’; Trusts that hold more financial control (and potentially the whole health budget) for a defined population as an Integrated Health Organisation (IHO). This would afford more power to large NHS organisations within systems which potentially reduces the resources available to build a system of support with and within communities. Coproduction gets a brief mention but there isn’t much detail on how communities and services will work together.
How will changes be funded? There isn’t a lot of detail about how the big shifts will be funded, and there is a risk that initiatives that are currently being rolled out will lose their funding as they are not highlighted in the plan. For example, funding for school teams has to come out of local areas funding allocations, which may be easier for some areas than others.
Are there risks in moving toward tech-based services? The plan presents a very optimistic view of the role of technology and pharmaceutical companies in the NHS, but there needs to be some thought about how this is evaluated as it is a big leap into the unknown, funded by taxpayer money. There needs to be a human way of introducing and supporting people to use tech. There is also the issue of outdated IT systems and a basic level of tech support needing to be reached within the NHS alongside thinking about innovation in tech
Economic growth or population health? There is an understandable concern from the government about the NHS consuming more and more of the national budget. So parts of the plan are about reducing demand for the NHS as well as actively using the NHS as a vehicle for economic growth. It is hoped that forging a closer partnership with technology and pharmaceutical companies will enable the NHS to contribute rather than consume economic growth, but is it possible to achieve economic growth through the NHS and is this becoming the main driver rather than population health?
What will the role be for lived experience and co-production? While patient groups are involved in App development and bereaved families in maternity care, the integration of lived experience throughout mental health service reform is not explicitly detailed, and neither is an understanding of the importance of co-producing services with communities.
And the mental health element? The plan does not elaborate on pathways and support for the broader life domains integral to recovery. We know that mental health is inextricably linked to social indicators, so health planning needs to work across all sectors (housing, transport, law, employment, environment, transport etc). It is also troubling that there is no mention of support for autistic and neurodiverse populations in the plan at all.
Some responses so far:
The NHS 10-year plan has prompted a range of responses, balancing recognition of its ambition with criticism about its feasibility and implementation. While the commitment to shifting care closer to local communities and addressing waiting lists is welcomed, many have raised questions about the significant challenges involved. In particular, the plan’s lack of detail regarding delivery, resource requirements, and implementation strategies is highlighted (Nuffield Trust, 2025). The King’s Fund (2025) also underscores the need for transparency about the potential “trade-offs” the public may face in their care.
There is widespread support for the government's move towards a neighbourhood health approach, especially in relation to mental health. However, mental health charities, including Mind and Rethink (2025) stress that the plan must be backed by clear delivery strategies, particularly to address the ongoing mental health crisis and mental health waiting lists. Their responses, alongside others, draw attention to the disparity between mental and physical health. Reflecting this concern, the Centre for Mental Health (2025) notes that the plan offers little detail on how the gap between physical and mental health care will be addressed.
Mental health organisations welcome the focus on prevention, community-based care, and the delivery of innovative, and accessible support. However, they continue to call for a comprehensive, cross-government strategy to reduce service pressures and support people to “live mentally healthy lives” (Mental Health Foundation, 2025, Centre for Mental Health, 2025). The plan also faces criticisms over its response to occupational health and staff wellbeing, with concerns that proposed measures may not adequately meet the real and growing well-being needs of NHS staff (Pulse, 2025). More broadly, there are growing calls for increased investment and a coordinated, long-term approach to meet the scale of mental health challenge (Mind, 2025).
Where does Imroc stand?
Imroc welcomes the NHS 10-year plan and supports its ambitions. In particular we believe that living well with mental health conditions happens in communities, not in services. We know that most of us build relationships and roles within our local communities and the more accessible and supportive those communities are, the more likely we are to engage in activities, connect with others like us, feel a sense of belonging and be able to contribute – things that are good for our emotional and physical wellbeing.
Imroc has demonstrated the value of coproduction in generating solutions, developing implementation plans and continually building systems of support. This is effective within communities – to ensure the particular needs of a marginalised community are identified and addressed, and across communities and sectors. Coproduction is not just about bringing different services together, but bringing whole communities together to build on the roles that all play in improving everyone’s wellbeing. This includes funders, commissioners and managers alongside providers and local people from different sectors – health and social care, but also housing, employment, faith communities, leisure, sports, local businesses, emergency services etc. It is by pooling ideas and working together that essential social, economic, physical and emotional needs can be addressed, not by working in silos that create duplication and gaps. Imroc does support the ambition “analogue to digital” and holds on to the hope that personal and relational focus of the NHS are not sidelined. Most recovery (however the word is used) is based on relationships and personal contact.
The fact that there is no additional money is the “elephant in the room” and not surprising given the climate and the UK’s economic situation. It should not however be dismissed in terms of ongoing conversations especially in relation to mental health care. Given the burden of mental ill health on society and the public purse the NHS plans should include at least a discussion about equal funding for mental health services. The fact that funding for mental health services is not equal to the level of need does mean that the ambition around parity of esteem is less likely to come to fruition. No additional funding, including to the wider VCSE sector and other partners is a gap in the plan and will hinder the work on hospital to community and prevention.