The NHS Planning Guidance for 2025/2026 was published this week and is designed to put the building blocks in place for reform, supporting longer term recovery for the NHS.

The guidance places a real focus on sickness to prevention and the shift from hospital to community, including development of a neighbourhood health service. This is something we fully support, however there is naturally an important balance to be struck between what can be done in local communities and protecting quality and safety in specialist hospital services.

The guidance is clear that innovation and reform must be front and centre of our strategic plans and that in a very challenging financial environment, difficult choices will also have to be made. Systems must double down on efforts to ensure that every pound spent on healthcare is used wisely – reducing duplication and waste and improving efficiency and productivity in all areas, including support services. We support the positive gear shift in advancing digital health services.

We will be considering the guidance in detail as a Board and alongside our One Gloucestershire health and care partners. We did however want to offer some initial observations in the context of our strategic plans and the direction of travel for local services and support.

It is clear that many of the key challenges and opportunities set out in the guidance are major themes in our 5-year Joint Forward Plan (JFP), which is undergoing its annual refresh for 2025/2026. The JFP is underpinned by three strategic pillars:

Making Gloucestershire a better place for the future – we know that strong partnerships to support prevention and good health are critical and it starts early. Placing significant focus on families and the formative years of children and young people is universally recognised in Gloucestershire. Whether it’s physical or mental health – healthier young lives means a healthier NHS in the future.

We strongly support prioritisation in the guidance for mental health services, recognising the substantial increase in need in recent years. We will continue to invest in services supporting children, young people and adults in schools, communities and at home. We acknowledge the imperative and need to support thousands of people back to health, back to education and employment and back to fulfilling lives.

We will further our One Gloucestershire approach to other areas of prevention – whether that’s supporting healthy and active lifestyles, tackling hypertension, improving screening or planning for frailty – we are working across organisational boundaries to do this.

We will continue to prioritise the long-standing health inequalities that exist across our county and in turn remove the barriers to good health and services. That requires us to adapt and wherever possible tailor our support and service offer in neighbourhoods and communities (see below).

Transforming what we do – that greater shift and focus on transforming communities and strengthening community services is essential and fully supported in Gloucestershire.

In line with the guidance, we will continue to support integration from the bottom up through our dedicated and innovative Primary Care Networks, community services and Integrated Locality Partnerships – this is already helping to move the dial from sickness to prevention. We are seeing a growing emphasis on population health, proactive care and health and wellbeing hubs.

We will invest, within our means, in community support and technology, helping vulnerable people, including older people and those with chronic long-term conditions, to take an active role in their own health and care, remain independent and supported at home for longer, whilst reducing the need for hospital stays.

The health of our NHS and local people is also dependent on supporting and developing our dedicated and diverse workforce in all parts of the system, backed by fair pay. We will strive together to make the NHS in Gloucestershire the employer of choice in terms of training, education, professional development and career progression and prioritise innovative approaches to recruitment.

We will champion the drive from analogue to digital in all aspects of healthcare. There is already much to celebrate, but we must continue to capitalise at pace on the advances in technology, medicine and life sciences. We know for example, that new technologies can identify and catch health problems earlier, empower patients – giving them greater control over their healthcare, improve efficiency and reduce waiting times.

Improving health and care services today – we will work locally and nationally to tackle the underlying issues that prevent real stability and a healthy future for primary care – the bedrock of our NHS. This is essential for improving access and for the experience of patients and practice teams alike.

We recognise the need to continue to develop capacity within community services, caring for people as close to home as possible. Without doing this, we cannot truly support our acute hospital services to focus on their specialist areas of expertise and invest and innovate in those key areas.

We will make best use of the resources available to us in 2025/26 to continue to address the planned care waiting list backlog, including increased access to diagnostics, and tackle waiting times for mental health services and cancer care. Along with digital transformation, the local NHS will also continue to improve processes, for example simplifying the patient’s care journey, including appointments. We do recognise that the scale of the ask is very challenging with finite resources and will mean that we will have to prioritise programmes in 2025/26 and work with our staff to maximise delivery.

Improving urgent and emergency care means increasing support outside of hospital in the community and improving joint working and decision making in hospital. The success of our Integrated Flow Hub at Gloucestershire hospitals is proof positive that we can make better decisions and improve the experience of patients by all working as one.

The national 10 Year Health Plan 

Whilst we implement the planning guidance for 2025/2026, our system continues to help shape the emerging national 10 Year Health Plan through a programme of local engagement. This will ensure that our future strategic plans are fully aligned and continue to address the priorities of our local population.

We cannot solve the current challenges alone. We will continue to work seamlessly across public health, the NHS, social care and with a broad range of voluntary, community and public sector partners in the knowledge that prevention is better than cure and the health of the NHS and local people is dependent on building healthy communities, a healthy workforce and strong, resilient partners. If it can’t be done in Gloucestershire, it can’t be done anywhere.

We will work tirelessly – with vision and purpose – to ensure the NHS is fit for current and future generations. The publication of the planning guidance for 2025/2026 and how we use it is an important step on that journey.