The Government is preparing to publish a 10-Year Plan for NHS reform, and it is expected to prioritise a plan to deliver its third vital strategic shift from treating illness to preventing it. In anticipation of this, Darwin Group reflects on the infrastructure needed to make this vision a reality.

While prevention is widely recognised as the key to long-term sustainability, its success depends on reimagining the physical spaces where care is delivered. Without accessible and adaptable infrastructure, the ambition to shift from sickness to prevention will remain out of reach.

The challenge we raised

The NHS has long been structured around treating illness, not preventing it. Yet rising demand, workforce pressures, and widening health inequalities make this model unsustainable.

In our response to the consultation, we suggested that the NHS should invest in infrastructure that supports early intervention, community-based care, and population health management to truly shift from sickness to prevention.

One of the most promising innovations in recent years has been the Community Diagnostic Centre (CDC) model, which aims to shift diagnostic services out of acute hospital settings and closer to where people live. The goal is simple: improve early diagnosis, reduce pressure on hospitals, and enhance patient accessibility. However, despite the ambition to embed care within community sites, more than half of CDCs to date have been delivered on existing hospital estates.

According to NHS England’s data, as of 2024, over 60% of CDCs were based on or adjacent to acute hospital estates.

To make the shift to community care a reality, the NHS must prioritise seeing people where they are. CDCs are a vital part of this vision, but their success relies on community-centred delivery.

What’s changed since then?
The 2025 Spending Review reinforced the government’s commitment to modernising NHS infrastructure, with:

• £30 billion in capital investment over five years
• £5 billion earmarked for critical repairs
• A shift toward multi-year capital settlements, enabling long-term planning

These developments create a unique opportunity to embed prevention into the physical fabric of the NHS through flexible, community-based facilities that support early access to care.

Why modular facilities support prevention

Modular buildings are uniquely positioned to enable a shift toward more proactive, community-based care. By maximising off-site fit-out and significantly reducing on-site disruption and build time, modular construction ensures high-quality, consistent environments.

They offer:

• Rapid deployment of Community Diagnostic Centres (CDCs) in underserved areas, helping reduce reliance on hospital-based diagnostics.
• Flexible, relocatable facilities that can be installed alongside GP surgeries, health centres, or community hubs—adapting to population needs over time.
• Built-in design flexibility to accommodate a range of services—from diagnostics and screening to mental health, lifestyle support, and care coordination.
• Co-location of prevention services, enabling early intervention and integrated models of care.

This approach places diagnostic and preventive services closer to the communities that need them most, supporting early detection, tackling health inequalities, and improving long-term outcomes.

Looking ahead: What we hope to see in the 10-Year Health Plan

As the NHS finalises its 10-Year Health Plan, we hope to see:

• A prevention-first estate strategy: Prioritise investment in community-based infrastructure that supports screening, diagnostics, and proactive health services, especially in underserved areas.
• Scalable deployment of modular CDCs: Enable rapid rollout of Community Diagnostic Centres using off-site fit-out modular solutions that can flex with local demand and co-locate with primary and mental health services.

The future of healthcare lies in catching illness earlier, supporting healthier lifestyles, and reducing the burden on acute services. That future depends on infrastructure that is accessible, adaptable, and aligned with the needs of local communities.

At Darwin Group, we’re ready to partner with NHS Trusts, ICSs, and local authorities to deliver flexible, future-ready estates that support more agile, patient-centred care.