The government's "Fit for the Future: 10-Year Health Plan for England" has landed. It is, without exaggeration, the most significant attempt to rewire the NHS in a generation. For every Practice Manager, every GP Partner, and every practice in the country, this is a moment of profound importance.
This plan is ambitious. It paints a compelling picture of a future NHS that is more integrated, proactive, preventative, and digital. A future where care moves from hospitals into the community, where a Single Patient Record empowers patients and staff, and where funding rewards improved health outcomes, not just activity.
If it succeeds, it could be transformative.
But we are all seasoned professionals. We know that the road from a 10-year plan to reality is fraught with challenges. Implementation is the biggest hurdle. Funding, workforce capacity, and political will are all significant, real-world risks that could derail even the best-laid plans.
This leaves you at a crossroads, facing a stark choice. But the one option you don't have is to wait and see.
Your survival depends on your next strategic move
The 10-Year Plan is not a menu of optional changes. It is a fundamental redesign of the environment you operate in, and it poses an existential challenge to the traditional GP partnership model.
The direction of travel is irreversible: towards larger, at-scale providers operating across entire neighbourhoods. The plan will drive this through new provider contracts, scheduled to begin rolling out in 2026, which are specifically designed for these larger entities. This is reinforced by a new CQC "failure regime" with the power to intervene in underperforming practices, and even transfer control to larger providers.
The question is no longer if you will work at scale, but how and with whom.
Making the wrong choice—or no choice at all—could see your practice left behind, unable to compete for new contracts, and vulnerable to a forced, disorderly merger where you are at a significant disadvantage. Your autonomy, your finances, and your future role are all on the line.
The smartest move is proactive alignment
We believe there is a powerful, strategic path forward that prepares you for success without forcing you into a premature, irreversible decision.
That path is proactive PCN alignment.
Let's be clear: we are not talking about a full merger. We are not talking about giving up your practice's identity or independence.
We are talking about a deliberate, collaborative effort with your PCN colleagues to get your houses in order, together. It means methodically aligning your core operations:
Your HR policies, staff salaries, and pension arrangements
Your financial processes and reporting
Your clinical pathways and procedures
Your technology stack and data management
Your governance and risk frameworks
The more you align now, the stronger your position will be, whatever the future holds.
Build flexibility, de-risk your future
This strategy is powerful because it gives you options.
If the 10-Year Plan succeeds, you are in pole position. You will have built deep, trusted relationships with your PCN peers. You will have a cohesive, efficient, and well-governed collective that can confidently bid to become a new neighbourhood provider. You will have demonstrated to commissioners that you are proactive, forward-thinking leaders. Any future merger becomes a calm, orderly process of your own choosing.
But what if the plan falters? What if the funding doesn't materialise, or the political will evaporates?
This is where the genius of alignment lies. You haven't locked yourself into a suboptimal, large-scale structure. You have simply made your own practice, and those of your neighbours, more efficient and resilient. You have built invaluable professional relationships. You have lost nothing. You end up stronger, regardless of the outcome. It is the only strategy that prepares you for both success and failure.
A call to arms: Let us help you prepare
At My Practice Manager, we have been pouring over the 10-Year Plan and its implications since it was announced. We see the immense operational challenge this presents, but we also see the clear pathway to navigate it.
We believe we are uniquely placed to help you on this alignment journey. Our existing tools for managing compliance, HR, and practice operations are the perfect foundation. We have access to a network of trusted experts in primary care finance, law, HR, and estates planning. We have AI-powered technology that could be repurposed to analyse and streamline the alignment of policies and procedures, drastically reducing the manual workload.
We want to channel this into a dedicated PCN Alignment Support Package. A toolkit designed specifically to help you and your PCN colleagues manage this process efficiently and effectively.
But we will only build it if you need it.
This is a call to action. If you see the existential need to act now; if you believe that proactive, non-committal alignment is the most sensible strategy; if you want to be in the driving seat of your own future—we want to hear from you.
Register your no-commitment interest in a PCN Alignment Support Package by emailing us at:
pcn-alignment@mypracticemanager.co.uk
If we see sufficient interest from practices who are ready to take control of their destiny, we will be in touch.
The coming years will be defined by the strategic choices you make right now. Choose to lead the transformation, don't be left behind by it.
Disclaimer: This article is for informational purposes only and reflects our understanding as of July 2025. It does not constitute legal or financial advice. Practices should consult with relevant professional bodies or legal counsel for specific circumstances and always refer to the latest official NHS England guidance and contractual documents.