Published: October 2025
The 10 Year Health Plan for England outlines an ambitious roadmap for transformation centred on digital innovation and system-wide reform. At the heart of this transformation is a strategy which, if well implemented, could have profound implications for the UK real-world evidence (RWE) landscape. Key aspects of the 10 Year Health Plan include improved data infrastructure, patient empowerment and the development of more agile partnerships with life sciences stakeholders.
Whilst it is encouraging to see that the government recognises the huge potential of the UK’s single health care system for achieving research excellence, it is important that the full transformative potential of RWE is realised. For instance, the NHS 10 Year Health Plan discusses the importance of commercialising de-identified NHS data for secondary analysis and has planned to develop infrastructure to facilitate this in the form of the Health Data Research Service (HDRS). However, researchers will be eager to fully understand the logistics of data access for secondary research and will be keen to avoid the long delays associated with current platforms.
Notably absent from the 10 Year Health Plan is a recognition of the growing role that non-interventional studies (NIS) play in addressing clinical evidence gaps. Technological advances detailed in the 10 Year Health Plan such as the NHS App and Single Patient Record (SPR), hold vast potential to decentralise and simplify recruitment for NIS, however, the lack of emphasis for this by the plan’s authors places doubt on whether this opportunity will be fully realised.
Now, three months on from its publication, the conversation has shifted from vision to delivery. Researchers, clinicians and industry are starting to test how the commitments made in the plan might translate into practice and where key challenges remain.
The UK government’s 10 Year Health Plan positions innovation as a central strategic pillar, aiming to harness digital infrastructure, integrated data systems and cross-sector partnerships to transform healthcare delivery. For RWE research, this represents an unprecedented opportunity. The UK’s single-payer system combined with unified health records, offers population-scale, representative datasets that can support insights into treatment effectiveness and safety across diverse patient groups.
Strategic partnerships between the NHS, academia and life sciences stakeholders will be essential to realise this potential. By aligning clinical research capabilities with RWE generation, these partnerships can enable faster, more efficient studies, reduce duplication and integrate patient-centric approaches that were previously difficult to scale. Importantly, the infrastructure and data assets envisaged by the 10 Year Health Plan also provide the basis for NIS, which can leverage decentralised recruitment and real-world monitoring to complement traditional clinical trials.
As such, the 10 Year Health Plan is a pivotal opportunity for RWE in the UK that can translate into actionable evidence, ultimately supporting more informed decisions across care, regulation and life sciences innovation. The plan sets a promising strategic vision, however, now the challenge is to turn this potential into practical, measurable impact for patients, researchers and the broader health system.
To capture early reactions, we surveyed UK healthcare professionals (HCPs) on their views of the plan. 133 NHS clinicians responded, the majority of whom were from General Practice (GPs) but with secondary care medicine represented by specialists in haematology, oncology, infectious disease and neurology. Screening questions explored whether respondents felt consulted and how familiar they were with the plan’s objectives (Figure 1).
Figure 1. Engagement & Awareness Survey Results
Footnotes: aN=133 respondents.
Those HCPs who expressed familiarity with the plan’s primary objectives (N=95) were then asked to rank the initiatives in order of priority according to the greatest expected improvement in current practice (Figure 2).
Figure 2. Priorities Survey Results
Footnotes: bOnly respondents familiar with the plan’s objectives answered these items;cEight respondents selected ‘DK/NA’ for all these items. These were treated as null responses and excluded from the data summaries, resulting in an effective sample size of n=87.
Abbreviations: NHS: National Health Service.
The HCPs who were familiar with the 10 Year Health Plan were then asked to what extent they believed the changes necessary to transform current practice in line with the plan are achievable within the proposed timeframe and to indicate which barriers they envisioned for implementation.
Figure 3. Feasibility & Barriers Survey Results
Footnote: aN=95 respondents.
Figure 4. Barrier Survey Results
Footnote: aN=95 respondents.
Abbreviations: NHS: National Health Service.
Taken together, the results paint a picture of cautious awareness: professionals recognise the plan’s ambitions but remain sceptical about whether the necessary resourcing, governance and workforce support are in place to deliver them.
Central to the 10 Year Health Plan’s innovation agenda are three digital platforms: the NHS App, the National SPR and the HDRS. Together, these tools lay the foundation for a more connected, data-driven healthcare system that can unlock the full potential of RWE in the UK. By integrating patient data across care settings and enabling secure, de-identified access for research, these platforms have the potential to herald a paradigm shift for RWE generation in the UK and cement a status as a global leader in RWE research.
The SPR is designed to provide clinicians with timely, comprehensive access to patient health information, including social determinants of health and wearable data. If fully implemented, these systems can support faster, more representative studies that provide regulators, providers and life sciences stakeholders with actionable insights.
The SPR feeds into the HDRS, which aims to provide de-identified data access for secondary research. It is intended as a single point of access for researchers which, if realised would make study conduct much more streamlined (Figure 5). However, it is not clear what will happen to the multitude of existing national and sub-national health research databases. Whilst this and other details, including access charges and equity arrangements, are still being clarified, success will depend on clear, proportionate governance that facilitates a broad spectrum of research, from commercial trials to non-commercial, patient-focused studies.
Figure 5. Current NHS Data Flow vs Proposed NHS Data Flow
Abbreviations: CPRD: Clinical Practice Research Datalink; HDR: Health Data Research; HDRS: Health Data Research Service; HES: Hospital Episode Statistics; ICNARC: Intensive Care National Audit & Research Centre; NCRAS: National Cancer Registration and Analysis Service; NHS: National Health Service; OPCRD: Optimum Patient Care Research Database; QResearch: QResearch Primary Care Database; RCGP: Royal College of General Practitioners Research and Surveillance Centre; SPR: Single Patient Record; TARN: Trauma Audit and Research Network; THIN: The Health Improvement Network; UK: United Kingdom.
Maximising access and reducing administrative barriers will be vital for HDRS to achieve its transformative potential. By enabling timely, efficient research, the UK can leverage its single-payer system to compete with established real-world data markets such as the US.
Survey findings show that data sharing and interoperability is consistently viewed as least important by HCPs. This may be a symptom of the lack of upfront engagement with care delivery staff or point to a misunderstanding amongst HCPs of how integral this initiative is to the plan. Our survey results suggest that digital interoperability, while critical for RWE, may struggle to gain traction without parallel investment in people and resources.
The integration of the NHS App with the Be Part of Research platform, supported by the broader rollout of the SPR, presents a unique opportunity to streamline non-interventional studies (NIS) and enhance recruitment through decentralised, patient-centric approaches. Traditionally, NIS in the UK can involve lengthy contracting with hospital sites, often delaying start-up, increasing costs and limiting participant diversity.
While site contracting is essential for interventional studies, where clinician involvement, intervention delivery and safety monitoring are required, it is unnecessary for many NIS. Sites can unknowingly act as gatekeepers, especially problematic in rare disease research, where only a handful of patients may be treated at any one location. Additionally, engagement at sites tends to be low, as clinical trial priorities often overshadow NIS, which may offer fewer immediate benefits or attract less funding.
Through upcoming integration with the Be Part of Research platform, the NHS App could allow patients to:
This patient-led model has the potential to:
For studies where a site-based approach is essential, expanding the National Contract Value Review (NCVR) to settings outside of hospitals opens new research opportunities in non-traditional environments – such as community hubs and niche primary care services – where research infrastructure or resources have historically been limited. Presently, researchers tend to rely on secondary care providers for site-based clinical research, often due to logistical barriers in settings where their intended population may be more abundant. The NCVR expansion could increase access to more suitable settings and to more representative populations, as well as free up resources in secondary care to conduct studies that, clinically, need to be targeted there.
Properly implemented, this could be transformative for RWE study design. By combining digital infrastructure with expertise in study operations and site management, sponsors could implement flexible, patient-centred models that maximise recruitment, improve efficiency and generate high-quality evidence. The 10 Year Health Plan’s emphasis on digital integration and patient empowerment creates a framework for more inclusive, scalable and impactful RWE studies if these opportunities are strategically realised.
The 10 Year Health Plan recognises the systemic challenges that have historically slowed progress: a demoralised workforce, patients caught in bureaucratic processes and uneven adoption of innovation. Its innovation pillar is a step toward reversing these trends, aiming to empower staff, centre patients and leverage technology to create new pathways for research and care.
Three months post publication of the plan, the tension between ambition and realism is clear. Respondents see the plan’s goals as directionally right but difficult to achieve without tackling staffing shortages, resource constraints and governance complexity head-on.
Real transformation depends on moving beyond ambition to effective delivery. Tools like the SPR, NHS App and HDRS must be designed not only for implementation but for usability and accessibility for patients, researchers and life sciences stakeholders alike. This requires data access models that are streamlined, proportionate and fit-for-purpose, while maintaining transparency, public trust and meaningful collaboration across all sectors.
Early engagement with RWE experts and researchers will be critical to ensure that these digital platforms are suitably structured to support diverse study types, including decentralised NIS, while maintaining high standards of patient privacy and data integrity.
With the right approach, the 10 Year Health Plan could not only modernise healthcare delivery but also establish the UK as a global hub for patient-centred, real-world evidence generation. By combining strategic partnerships, rich national datasets and patient-centred, decentralised study models, the NHS could create a system that delivers timely, representative and actionable evidence. For the RWE community, this represents an opportunity to influence service design, accelerate research timelines, improve efficiency and raise the profile of RWE studies, ultimately enhancing patient outcomes and strengthening the UK’s position on the global research stage.
At Costello Medical, our Real-World Evidence team is focused on helping life sciences stakeholders navigate this evolving landscape. As the NHS moves from plan to practice, we will continue to track developments and share insights from the RWE community, ensuring that the voices of researchers and clinicians remain central to how innovation is delivered. The 10 Year Health Plan for England is ambitious, but with thoughtful execution, it has the potential to move the UK from being a data-rich nation to a global leader in evidence-driven healthcare.
If you would like any further information on the themes presented above, please get in touch, or visit our Real-World Evidence page to find out how our expertise can benefit you. Miranda Townsend (Study Management Lead) created this article on behalf of Costello Medical. The views/opinions expressed are her own and do not necessarily reflect those of Costello Medical’s clients/affiliated partners.
