Evaluability assessment of the 10-year health plan for England

In July 2025, the Government published its 10 Year Health Plan for England. It sets out a vision for reforming the NHS. The Plan focuses on three major shifts: moving care from hospitals to communities, making better use of technology, and preventing illness before it starts. To achieve these shifts, the Plan proposes wide-ranging reforms across the health system, including how services are organised, staffed, and funded.

While individual parts of the Plan will be evaluated separately, the Department of Health and Social Care (DHSC) also wants to understand how the Plan is working as a whole. To help with this, the DHSC has asked PIRU to conduct an evaluability assessment.

This project assessed how the 10 Year Health Plan could be evaluated as a whole, including how different parts of the Plan interact and what kinds of evaluation are feasible. It did not evaluate the Plan itself, but instead aimedprovide recommendations on how such an evaluation could be designed and delivered. Specifically, we:

• Clarified the goals and expected outcomes of the Plan.

• Developed a system-based theory of change to understand how different parts of the Plan may influence outcomes.

• Reviewed existing evidence on previous major health reforms to identify lessons and gaps.

• Identified what data would be needed to evaluate the Plan and where gaps exist.

• Recommended options for evaluating the Plan, including potential methods and timescales.

This work will help DHSC and NHS England understand how to evaluate the 10 Year Health Plan as a whole, including what kinds of evidence and data are needed. It will support better planning and prioritisation of future evaluations and help ensure that the impact of the Plan can be meaningfully assessed.

To complete the evaluability assessment, we:

• Reviewed the 10 Year Health Plan itself and related policy documents to understand its goals and how it will work,

• Reviewed previous evaluations of major health system reforms in England,

• Ran workshops with key people from DHSC and NHS England to develop a theory of change and explore evaluation priorities, and

• Interviewed a wider range of stakeholders, including representatives from local government, professional bodies, think tanks, and the voluntary sector to understand their views on the challenges involved in the Plan.