The NHS is standing at a crossroads.
The newly published 10-Year Health Plan for England sets out a bold vision for reform, built on three radical shifts: from hospital to community, from analogue to digital, and from sickness to prevention. For Finance Departments, this is not just a policy update. It is their chance to take the wheel and drive the NHS into the future.
Finance leaders now have the opportunity to do more than just balancing books. They are at the base of shaping a new model of care that is proactive, personalised and digitally enabled. This requires a fundamental rethink of how resources are allocated, monitored and optimised.
If there is one message the 10-Year Health Plan makes clear: the current model is unsustainable. Waiting lists have ballooned; staff morale is low, and outcomes lag behind international peers. Without good planning the NHS risks becoming a declining, reactive service. Finance Departments are central to avoiding that outcome.
As someone who has worked within NHS finance and now supports Trusts throughout the financial year, I see both the pressure and the potential. The shift to neighbourhood health services will be a complex shift taking place over several years. Traditional incremental budgeting approaches will not work. There will be a need to model scenarios across a long -term timeframe, incorporating the impact of significant changes to activity, workforce and income upon costs.
Senior Finance staff will need to be able to control assumptions model changes and produce outputs, from an integrated tool, rather than cobble together information from multiple spreadsheets. It is not easy.
At LOGEX, we have seen a very similar transformation happen in Sweden. We saw Swedish social & healthcare organisations struggle, because the information required for coming up with an integrated plan was scattered across departments and insights were therefore lacking.
But tools alone are not enough. Finance Departments must become strategic partners. They need to work closely with clinical, operational and digital leads to co-design plans that reflect local needs and national ambitions. They must help boards understand the financial implications of shifting care into communities, investing in digital infrastructure and expanding preventative services.
The plan also introduces new financial mechanisms, such as patient power payments and earned autonomy for high-performing providers. These innovations will require robust financial governance and agile planning capabilities. Finance teams must be ready to adapt.
There is also a clear emphasis on transparency. The NHS will publish league tables, quality indicators and patient-reported outcomes. Trusts must ensure that budgeting supports not just efficiency, but quality and equity.
This is a decade of transformation. The NHS will become more devolved, more digital and more patient-centred. Finance Departments have a unique opportunity to lead that change – to move from cost control to value creation.
