The NHS 10-Year Plan: opportunities and risks for independent providers

The Labour Government’s 10-Year Health Plan for England: Fit for the Future promises a greater role within the NHS for independent healthcare providers. The plans envisage a move away from hospital to community services, changing the emphasis from treating sickness to prevention, using a plurality of providers (not just in elective care), with an increased focus on patient choice through the NHS App. Critically, the document lists the independent sector as a key partner with the “ideas, networks and drive to transform outcomes for patients”.  These reforms present an opportunity for independent operators to provide more public services, and even work exclusively for the NHS in areas such as technology, infrastructure and medicines, including private cybersecurity firms to protect NHS digital assets. 

Digital transformation

One of the core pillars of the plan is the transformation from NHS analogue to digital systems in order to improve efficiency, patient outcomes and data-driven decision making. However, this shift will bring new legal, regulatory and insurance risk challenges for healthcare providers. Sabrina Meetaroo, Head of Legal, Risk and Claims Advocacy at Howden Health & Care, explained: “The NHS 10-Year Plan represents a major step forward in integration and innovation — but it must be matched by equally modernised legal and risk governance structures. Providers that proactively review contracts, data governance, and insurance arrangements will be best positioned to adapt safely and sustainably.

“Digital transformation heightens exposure to cybersecurity threats, data breaches, and system outages. With patient data being one of the most sensitive categories of information, providers must ensure compliance with the GDPR and the DPA 2018. Breaches may result not only in regulatory action by the ICO but also civil litigation from affected individuals.”

Where digital platforms or a third-party technology supplier is used, contracts need to clearly define who is responsible for data processing, system security and continuity of service in order to avoid disputes and uninsured losses if something goes wrong. Healthcare providers should regularly review their insurance coverage for cyber liability, professional indemnity (PI), and technology errors and omissions, stress-testing policies to ensure they cover digital service failures and system-integrated clinical risks. However, delivering this level of digital maturity will be challenging for many providers. Workforce shortages, limited funding allocations, and variation in digital capability across the sector may slow progress. Smaller organisations, in particular, may struggle with the upfront investment required for interoperable IT systems, staff training, and cyber resilience measures. There are also significant knowledge gaps in data governance and AI oversight, increasing the risk of inconsistent standards and potential regulatory breaches. Acknowledging these structural and financial hurdles — and planning strategically to overcome them — will be essential if the transformation outlined in the NHS 10-Year Plan is to be implemented safely and sustainably.

Sabrina Meetaroo said: “Insurers will increasingly expect to see evidence of cyber resilience, including penetration testing, staff training, and incident response protocols. As the NHS continues its digital evolution, the line between clinical and technological accountability will blur. In my view, providers who integrate their legal, clinical governance, and IT risk frameworks — rather than treating them as separate domains — will be best placed to manage this emerging risk landscape.” 

Prioritising patient choice

This digital transformation extends to allowing patients to select their preferred healthcare provider through the NHS App in a bid to improve access to services and empower patients to make their own choices. This change also represents a fresh opportunity for independent healthcare providers but also introduces new legal, reputational and governance risks.  

Sabrina Meetaroo explained: “From a legal standpoint, providers must ensure that all information displayed through the NHS App — such as service descriptions, clinician details, and treatment options — is accurate, transparent, and compliant with consumer protection and healthcare advertising laws. Misrepresentation or outdated information could lead to complaints or enforcement under the Consumer Protection from Unfair Trading Regulations 2008.” 

Furthermore, private providers featured on the NHS App must also comply with Care Quality Commission requirements and NHS contractual standards. They also require clear governance processes, eligibility checks and escalation pathways to prevent patients choosing services that do not provide appropriate triage or referral, which could result in misdiagnosis, delayed treatment, or inappropriate care. 

Sabrina Meetaroo added: “From an insurance viewpoint, private providers must ensure that their professional indemnity and cyber insurance policies explicitly cover activities conducted via the NHS App and associated digital platforms.

“This development fundamentally changes how patients engage with healthcare. Providers who combine transparency, digital governance, and proactive risk communication will not only mitigate exposure but also build trust and a competitive advantage in an increasingly open healthcare market.”

Managing risk

In addition, self-referral shifts part of the clinical risk traditionally held by NHS doctors onto the service providers, potentially exposing them to claims. For example, in mental health services, the lack of initial clinical triage may lead to a failure to identify high-risk individuals requiring urgent or specialist intervention. This risk can be mitigated somewhat by implementing robust triage protocols and decision-support systems, while maintaining clear escalation procedures to handle complex or high-risk cases. Healthcare providers should also conduct ongoing audits to monitor the appropriateness of self-referral services and identify emerging risks, in addition to ensuring all staff involved in initial contact and triage are properly trained and supported.  From a legal perspective, accurate records of patient interactions and decision-making processes will be critical in defending any claims of negligence. The increase in patient self-referral could alter a provider’s risk profile from an insurance perspective. 

“Providers should discuss these changes with their brokers to ensure that their clinical negligence, PI, and medical malpractice policies are appropriately structured and priced to reflect evolving exposure”, Sabrina Meetaroo said. 

“Self-referral models reflect the NHS’s push toward accessibility, but they also redefine the boundary of duty of care”, she added. “Providers who align clinical pathways with robust legal defensibility — embedding governance, documentation, and insurance planning at every stage — will be better protected against this emerging class of risk.”