We asked Sarah D., Head of Department at a leading London NHS Trust to write a piece about the NHS's 10-Year plan and what it means for you entering the job market it 2025.
If you’re stepping into your first NHS role or finishing your final placement, you’re arriving at a watershed moment. In July 2025, the government released England’s 10-Year Health Plan with a bracing message — reform or die — and a clear direction of travel: from hospital to community, from analogue to digital, and from reactive to preventative care. It’s not a slogan; it’s a new operating system for how we deliver physiotherapy across pathways, places, and professions.
As someone who interviews and hires physios every year, and is regularly in contact with NHS recruiters, I want to talk plainly about what this decade will ask of you and why it’s the most exciting time in a generation to choose physio - and, still, be positive about the NHS.
1/ From hospitals to communities: where physios lead, not follow
Musculoskeletal (MSK) problems drive almost a third of GP appointments. The NHS has been expanding First Contact Physiotherapist (FCP/FCPP) roles in primary care so that adults can book directly with skilled MSK physios with no GP referral needed. That shift isn’t theoretical; it’s already changing patient flow and job design for Band 6-7 physios. Recent studies report strong outcomes, including high proportions of patients not needing further GP reattendance within 12 weeks after an FCPP appointment, and evidence of reduced workload on general practice.
Community care also now includes virtual wards and Hospital at Home teams: acute care delivered where patients live, enabled by remote monitoring and rapid response. The evidence base is maturing: virtual wards can safely avoid or shorten inpatient stays when they’re well-governed and multidisciplinary, with AHPs (including physios) as core contributors. If you’ve loved the buzz of a ward but wanted more autonomy and continuity, these teams are where you’ll thrive.
2/ From analogue to digital: less typing, more treating
The Plan is blunt: we will use AI where it helps clinicians care. One of the clearest near-term wins is AI-enabled ambient scribing (sometimes called ambient voice technology). With patient consent, these tools listen during the consultation and draft structured notes for your review. NHS England has issued guidance for safe adoption and procurement... this is not the Wild West; it’s moving into assured, clinical-safety-first territory.
Why does this matter to you, as a newly grad, Band 5 physio? Because the admin burden is real. A 2025 national study of UK resident doctors found roughly 4 (!) hours of admin for every one hour with patients. But physios feel versions of the same squeeze: referrals, outcome measures, safety-netting, letters... And that's without that typical Friday pm MSK patient you have to send to A&E! If ambient scribing reliably trims that burden, it means more time for gait re-education, exercise progression and shared decision-making; things only you can do.
You’ll see this technology embedded in NHS-approved platforms. For example, Accurx has partnered with Tandem to deliver AI scribing features designed against NHSE assurance requirements. The detail matters: data protection, clinical safety cases, and MHRA classification because the difference between “cool demo” and “safe deployment” lives in the governance. Learn to ask good questions about it; your patients will.
In a recent meeting with a Band 6 physio in the community, they told me about an ambient scribe they had tried on home visits. She said she could move on from generic quads work to a targeted STS programme with sit-height tweaks and pacing, simply from having the headspace for it. The tech didn’t make her kinder; it made space for her to be present.
3/ From reactive to preventative: physio as a public-health force
The Plan’s third shift is prevention. For physio, that’s not just “exercise is good” posters. It’s measurable population health: fewer falls, faster return to work after back pain, better COPD self-management and getting people moving earlier after surgery: tracked and improved at PCN, place, and ICS level. This is where NQPs who love data and behaviour change will shine.
We also need your advocacy, your help in designing all of this . External pressures (workload, closures, and service redesign) are reshaping primary care access. Prevention loses when services are brittle; it thrives when physios help design neighbourhood hubs, MSK “first-contact-plus” models, and group clinics that keep people out of hospital.
4/ What should newly qualified physios and students do this year to be “reform-ready”?
Choose at least one community-first placement or rotation. If your university/Trust offers FCP exposure, take it. If not, ask to shadow. Notice the different skill mix: advanced practice physios, pharmacists, health coaches, social prescribers. Learn the referral thresholds and safety-netting language that keeps people well without over-medicalising.
Get fluent in virtual-ward basics. Learn escalation criteria, how to set and interpret remote monitoring thresholds, and how to adapt outcome measures for the home. Understand what makes these models safe (named clinical accountability, daily review, documented discharge).
Build digital professionalism early. Read the NHS ambient scribing guidance. Know where audio is stored, how consent is recorded, and what “human-in-the-loop” means for your accountability. If your team trials an AI tool, be the physio who can explain it clearly to patients and who can spot when to switch it off.
Treat documentation as a clinical skill. Whether you use an AI scribe or not, clear notes are patient safety. Practise concise, structured entries with functional outcomes and safety-netting that another clinician can act on. If a tool drafts your note, you are still the author.
Make prevention visible. Pick one metric you can move in your service: falls risk score completion, proportion of back-pain patients receiving first-line advice within 48 hours, or return-to-work timelines. Start small, share results, iterate. That’s quality improvement and it’s career accelerant.
Protect your bandwidth. The admin time stats are stark. If your team is drowning in clicks, raise it. Trial templates, batch tasks, or ambient scribing with governance. Burnout helps no one; productivity that returns minutes to patient care is professional, not optional.
5/ Two mindsets to carry into interviews (and day one)
“I am a system connector.” The best new physios don’t just treat the knee in front of them; they connect people to the right place in the system: community exercise, pain management groups, social prescribers... You will be hired for your hands and head, but you’ll be valued for your navigation skills.
“I am outcomes-curious.” Ask your interview panel what outcomes they track beyond throughput. If they say, “We’re trying to reduce avoidable GP reattendance after FCP appointments,” lean in that’s your playground. Bring an example of how you’d measure and improve something you control.
6/ Why this decade belongs to physio
The 10-Year Plan imagines an NHS that prevents more illness, treats people closer to home, and uses digital tools that give time back to care. That vision stands or falls on professions that can work across boundaries, are comfortable with data, and never lose the human touch. That is physiotherapy at its best.
Your craft; coaching movement, restoring function, preventing deterioration; is exactly what a community-first, prevention-driven NHS needs. Bring your curiosity. Bring your ethics. And bring your willingness to learn the digital, governance, and population-health skills that let you practise at the top of your licence.
Because “reform or die” isn’t about institutions; it’s about whether we build a service where your best 20 minutes with a patient aren’t squeezed out by the other sixty. Help us make the next ten years the decade when physios didn’t just adapt to reform -we led it.
References (selected)
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Fit for the Future: 10-Year Health Plan for England (policy and executive summary).
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NHS England guidance on AI-enabled ambient scribing (assurance, safety, and procurement considerations).
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Time Allocation in Clinical Training (QJM, 2025): high administrative load relative to patient-facing time.
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First Contact Physiotherapists—NHSE overview; outcomes and reattendance evidence (BJGP 2024; 2025 cohort data).
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Virtual wards/Hospital at Home—NHSE operational framework, GIRFT guidance, and NIHR evidence collection.
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Accurx Scribe/Tandem—meeting NHSE requirements and NHS deployments.
Note: Patient vignettes are composite and anonymised to protect privacy while reflecting real practice patterns.