Government Priorities and Milestone Targets

A central focus is placed on reducing waiting times for elective treatment, with an overarching goal of ensuring 92% of patients wait no longer than 18 weeks by 2029. For the immediate future, all NHS England services must achieve a 65% target for treating elective patients within 18 weeks by March 2026, while individual Trusts are required to demonstrate a 5% improvement in their 18-week wait times compared to the previous year.

Cancer care improvements are also included, with targets set for March 2026 including achieving 75% performance on 62-day referral-to-treatment and 80% on 28-day faster diagnosis standard.

Strategic Transformation

The NHS Planning Guidance 2025/26 spells out how NHS England will deliver against the government's three strategic shifts, including:

• Shift from hospital to community settings: Supported by six core components that Integrated Care Boards (ICBs) must implement, including population health management, modernised GP services, standardised community health services, neighbourhood multi-disciplinary teams, a 'Home First' approach, and enhanced urgent neighbourhood services.
• Shift from treatment to prevention: Delivered through enhanced vaccination and screening programmes, addressing leading causes of morbidity, improving compliance with NICE guidelines for blood pressure and cholesterol management, and an expectation for GPs to treat more patients to target lipid and blood pressure levels.
• Shift from analogue to digital: Operationalised through requirements for 85% of secondary care to adopt the Federated Data Platform by March 2026, an expansion in the NHS App capabilities, and expectations for systems and Trusts to complete Electronic Patient Record procurement and upgrades and implement electronic prescribing systems.

Financial Framework

Systems will be required to maintain a balanced net financial position for 2025/26. Where systems fail to submit or deliver against breakeven plans, a deduction will be applied to their core capital allocation in 2025/26.

Base growth has been set at 4.4%, incorporating a 2% efficiency requirement. Changes in the funding formula have resulted in "fair shares" funding being redistributed by region and ICB, impacting the future convergence requirements. Significant cost reduction targets include a minimum 30% reduction in agency spending and a 10% reduction in bank staff spending.

There are also changes to the funding mechanisms. ICBs have been given more autonomy over how they spend their allocated funding, with Service Development Funding (SDF) and Elective Recovery Funding (ERF) being incorporated into core allocations. NHS England is also consulting on changes to the NHS Payment Scheme and is implementing small-scale pilots to test new payment mechanisms.

System Planning and Implementation

The planning process has been streamlined, with two key submission dates: a headline plan due by February 27th and a full plan required by March 27th. ICBs and Trusts are expected to update their Joint Forward Plans before the 2025/26 period.

Learn More

If you have any questions about the NHS England Planning Guidance 2025/26 or want to discuss how we can support your organisation in planning for Financial Year 2025/26, contact us at hello@thepsc.co.uk 

The detailed Planning Guidance documents are available on the NHS England website, including:

• 2025/26 priorities and operational planning guidance
• Revenue finance and contracting guidance for 2025/26
• Allocation of resources 2025/26
• Our new operating model: supporting you to deliver high quality care for patients
• Standardising community health services – Phase 1 codifying core community health services
• 2025/26 NHS Payment Scheme consultation