Blog post: Why NHS reform matters
Each new government introduces a fresh wave of NHS reforms, reinforcing a perception that the health service is something broken that needs fixing. A persistent myth suggests that if we could simply align every part of the NHS machinery perfectly, it would function flawlessly for everyone, every time. But the truth is far more complex. The NHS is a huge, dynamic system, continuously adjusting to political priorities, a challenging landscape shaped by workforce shortages and financial constraints, and evolving demands, such as a rapidly ageing population.
What is changing?
The 10-year NHS plan, launched in July 2025, is part of the Government’s initiative to build a health service fit for the future. It is based on 3 radical shifts:
Hospital to community
Analogue to digital
Sickness to prevention
Immediate priorities involve cutting waiting times, boosting productivity, and stabilising finances. This includes a target for Integrated Care Boards (ICBs are the part of the system that commissions healthcare) to reduce running costs by 50% in order to maximise the funding available for delivery. A consequence of this is a seismic shift in how healthcare is organised in Gloucestershire, which will imminently be ‘clustered’ with Bristol, North Somerset and South Gloucestershire (BNSSG) ICB.
When is this happening?
Work to bring the two ICBs together is already underway and Shane Devlin, previously Chief Executive of BNSSG ICB has been appointed CEO of the wider ‘cluster’ from 1 October 2025. A senior leadership team is anticipated to be in place within this financial year, with further posts to be finalised in 2026/27. This means that, from some point next year, Gloucestershire and BNSSG are expected to begin operating as a single ICB.
Why is this relevant to you and me?
NHS reform is about more than policies and structures - it’s about people. Whether you’re a patient, a VCSE employee, or simply someone who values a strong public health system, these reforms will shape the future of healthcare and affect us all. They have brought upheaval to ICB staff, who are working to implement the organisational changes while managing a high level of personal uncertainty.
At the core of the changes is the Government’s commitment to ensuring the NHS is there when people need it most. The current reform programme is intended to lay the groundwork for keeping that promise, while also safeguarding the financial sustainability of the health service.
Community-based Care Is the Future
For VCSE organisations, the reforms present both a challenge and an opportunity to take on a more central role in shaping community health. The NHS is moving away from hospital-focused models and placing greater emphasis on care within communities.
Many VCSE organisations have prevention at their core, tackling the root causes of health inequalities, and supporting people with long-term conditions to live well for longer. As the reforms take shape, the NHS is expected to look increasingly to the VCSE sector to lead initiatives that help people stay well - building on the sector’s proven strengths and deep connections within communities.
The insights, networks, and grassroots reach of VCSE organisations are vital for designing services that truly reflect community needs. A key role for the VCSE sector will be to ensure that the voices of under-served groups are heard and influence reform discussions.
At the same time, reform places greater emphasis on data-driven decision-making and measurable outcomes. This means VCSE organisations will need to show their impact more clearly, making investment in evaluation and digital reporting a priority.
What steps can we take together?
Despite the ambitions set out in the 10 Year Plan, there is still no clear national framework for integrating the VCSE sector as a strategic partner within the NHS. At a local level, relationships between the VCSE sector and the NHS are strong, with recognition of the sector’s vital strategic role. However, there are concerns that these connections could be diluted as Gloucestershire becomes part of a much larger ICS.
Right now, there is a window of opportunity for the VCSE sector to come together and shape how we build a more mature, collaborative relationship with the NHS. This will be a key priority for the Gloucestershire VCSE Strategic Partnership in the months ahead.
It is also a crucial time for deeper engagement with the ICS. Now is the moment to make that extra effort—by attending meetings, joining advisory groups, and strengthening relationships with commissioners. If you are interested in being part of the conversation, email jill.parker@glosalliance.org.uk