Beyond Ambition: Introducing IFIC’s New Report on Global Lessons for an Integrated NHS

The International Foundation for Integrated Care (IFIC) held its 5^th International Conference on Integrated Care (ICIC05) in Birmingham back in 2005. It was the International Network for Integrated Care back then, but the goal was the same as it is today and will be when we return to Birmingham for ICIC26 in April 2026, to promote integrated care so that everyone experiences joined-up care at all points in their life.

As we prepare for ICIC26 in Birmingham, we invited contributions from different perspectives on the Government of the United Kingdom Department of Health and Social Care’s policy paper; 10 Year Health Plan for England: Fit for the Future.

We invited people from across our international network to reflect on the Plan as published in July 2025. Our contributors come from seven different countries and a variety of perspectives, from system leaders to family caregivers, to newly graduated health and care professionals. The perspectives they have shared offer a different view from the many informed and informative commentaries we have seen from different bodies in England.

We asked our contributors to focus on how the new 10 Year Health Plan for England is likely to fulfil the ambition of “a single, co-ordinated, patient-orientated service” and whether they can see any learning that can be shared across their own health and care system and the NHS in England.

Reading across the contributions, some common themes emerge.

The most common word used to describe the Plan is “ambitious”. The ambition that people refer to is in the scope, intent, vision, and the proposed three shifts in the Plan. Equally, the contributors acknowledge the necessity of this ambition, not only for the NHS in England, but in all health and care systems.

The contributors admire much in the Plan. The case for change is clear and resonates strongly with other systems around the world. The shifts from hospital to community, analogue to digital, and sickness to prevention, are welcome and essential if we are to see a meaningful shift to people- and community-centred integrated care for population health. The focus on creating the conditions for these shifts is particularly welcome.

However, most contributors caveat this admiration, many based on lessons already learnt elsewhere. They share these lessons in the contributions and invite their colleagues in the NHS in England to learn from them rather than repeat them.

One caveat has been well rehearsed in other commentaries, the 10 Year Health Plan for England is not actually a plan, it is very difficult to know what steps are being taken to execute the vision set out in the document. Our contributors encourage the NHS to prioritise what needs to happen sequentially, creating the conditions for the three shifts.

The Plan is limited to healthcare, and effectively ignores the wider determinants of health, public health, and social care. There can be no real Fitness for the Future if the plan does not capture these at a minimum as critical dependencies.

Most importantly in many ways, the plan misses what matters to people and communities. The voice of people and communities is practically silent in this document. This cannot be the way forward in an environment of growing distrust of public services when population health has never been more important.

Lessons learnt in other countries that can and should be applied in the execution of this plan include:

1. Leverage technology as an enabler of high-quality care that is coordinated and person-centred making sure to avoid further fragmentation and a task-focus that tries to “drive efficiency” but ends up doing the opposite.
2. Ensure that a greater emphasis on digital tools does not exacerbate inequalities for groups that are already being excluded from health and care.
3. A broader focus on prevention is necessary, specifically a focus that acknowledges wider determinants of health have proven more effective for population health than individual choices. The plan as it stands puts too much responsibility on individual behaviour change, genomic innovation and AI technology, where the latter are untested and potentially wishful thinking.
4. Avoid adding further complexity to an already complex system of funding that exacerbates fragmentation. Learn the lessons that other systems such as the Canterbury System in Aotearoa, New Zealand has embedded over that last two decades. In Canterbury, transparent resource allocation, simplified funding models, alliance-based accountability and investment in basic digital infrastructure, shared analytics and new care models all continue to drive improvement.
5. Shift the focus from performance management to building a learning system. The proposal to introduce patient feedback-driven payments is fraught with perverse incentives and the evidence-base for it is thin.
6. Linked to the shift from performance management to learning system, is the leadership shift from command and control to devolved power and trust in collaboration.

Enjoy these contributions. There is so much that other health systems around the world take from the NHS in England, which is rightly held up as an exemplar of the universal coverage health system. Where policy makers in England go, many around the world look to follow.

Increasingly though, we are seeing other health systems leapfrog in their ambition to make integrated care for population health a reality by learning from the English experience over the last decade since the NHS Five Year Forward View. There is an opportunity in this paper and at ICIC26 in Birmingham next April for that learning to be shared in both directions.

I would like to thank our contributors for their consideration and time in sharing their thoughts with us. I also acknowledge the contributions of our reviewers.