NHS Priorities and Operational Planning Guidance 2025/6

In line with the Government Mandate, the 2025/26 priorities and operational planning guidance sets out a focused, smaller number of national priorities for 2025/26 with an emphasis on improving access to timely care for patients, increasing productivity and living within allocated budgets, and driving reform.

View our NHS Digital Framework alignment

Reduce the time people wait for elective care

Optimise referral management including through use of high quality specialist advice and guidance, triage, patient initiated follow-up (PIFU) and straight-to-test pathway approaches N/A
Provide patients with more choice and control by making at least 70% of elective care appointments (across specialties) available for citizens to view and manage via the NHS App N/A
Validate patients on a referral to treatment (RTT) waiting list after 12 weeks and then every 12 weeks in line with good practice and published guidance, maximising the use of digital tools for both patient contact and data quality N/A
Minimise unwarranted diagnostic referrals to create capacity for appointments and tests that truly benefit patient outcomes. N/A
Implement the Further Faster methodology to drive optimisation of outpatient clinic processes and clinic utilisation. N/A
Improve the experience and reduce the inequalities of care for patients receiving elective care. As part of the development of an NHS Quality Strategy we will set out plans on how the NHS will increase its focus on listening to, learning from and working with patients, carers and communities to drive improvements in the experience of all people using our services N/A
Maximising care for low-risk patients in non-cancer settings, including maintaining the faecal immunochemical test (FIT) in lower GI pathways, low-risk pathways for post-HRT bleeding, and breast pain only pathways. N/A
Improving the productivity in cancer pathways including teledermatology in urgent suspected skin cancer and nurse or allied health professional (AHP)-led local anaesthetic biopsy in the prostate cancer pathway. N/A

Improve A&E waiting times and ambulance response times

Reduce avoidable ambulance dispatches and conveyances, and reduce handover delays by:

Working towards delivering hospital handovers within 15 minutes, with joint working arrangements that ensure that no handover takes longer than 45 minutes. N/A
Improving access to urgent care services at home or in the community including urgent community response (UCR) and virtual ward (also known as hospital at home) services. N/A
Improving ‘hear and treat’ rates, increasing the proportion of Category 2 calls, and ensuring all 3 and 4 calls are clinically navigated, validated and where appropriate triaged in ambulance control centres, or in single points of access in line with existing guidance. N/A

Improve and standardise urgent care at the front door of the hospital by:

Increasing the proportion of patients seen, treated and discharged in 1 day or less using the principles of same day emergency care (SDEC). N/A
Optimising the urgent care offer to meet the needs of their local population, including the use of urgent treatment centres (UTCs). N/A

Reduce length of stay in hospital and ensure that patients are cared for in the most appropriate setting by:

Increasing the percentage of patients discharged by or on day 7 of their admission in line with existing guidance. N/A
Working across the NHS and local authority partners to reduce average length of discharge delay in line with the Better Care Fund (BCF) policy framework. ICBs should review BCF commitments to ensure they represent the best use of resources, and plan sufficient intermediate care capacity to meet demand, including through surge periods across the year. N/A

Set the foundations of the neighbourhood health model by continuing to embed, standardise and scale core components of existing practice. This includes taking a consistent, system-wide population health management approach to patient segmentation and risk stratification. NHS England has published guidelines to support this.

Improve patients’ access to general practice and improve access to urgent dental care

Put in place action plans by June 2025 to improve contract oversight, commissioning and transformation for general practice, and tackle unwarranted variation. N/A
Continue to support the delivery of modern general practice and target support to practices based on their ability to provide access and a good overall experience for patients. ExR has multiple modules applicable to providing good clinical care to patients in the primary care setting e.g. nursing consultation 360-degree videos and a cervical smear screening module.
Improve access to dental care by commissioning additional urgent appointments to deliver their share of the government's manifesto commitment to an additional 700,000 appointments. N/A

Improve patient flow through mental health crisis and acute pathways and access to CYP mental health services

Deliver the 10 high impact actions for mental health discharges and ensure that system discharge plans include mental health acute pathways to reduce average lengths of stay in the adult acute mental health pathway, improve local bed availability and reduce the need for inappropriate out of area placements. N/A
Reduce waits longer than 12 hours in A&E through: Maximising the use of crisis alternatives, including 111 mental health option, crisis resolution and home treatment teams, and community mental health services to keep people well at home. Robust system oversight, implementation of the mental health OPEL framework and use of the mental health UEC action cards N/A
Improve productivity by reducing unwarranted variation in the numbers of CYP accessing services and the number of contacts per whole time equivalent hours worked. N/A
Reduce unwarranted variation in the numbers of CYP accessing services by improving productivity and increasing the number of direct and indirect contacts per whole time equivalent hours worked. N/A
Reduce local inequalities in access to CYP mental health services, between disadvantaged groups and the wider CYP population. N/A
Expand mental health support teams consistent with the government’s aim of reaching 100% coverage by 2029/30. N/A
In line with the proposed Mental Health Act reform, ICBs should work with local system colleagues to ensure that there is high quality and accessible community infrastructure in place for people with a learning disability and autistic people. They should also ensure that admissions to a mental health hospital are for assessment and treatment that can only be delivered in an inpatient setting. N/A

Address inequalities and shift towards prevention

It remains critical that ICSs explicitly agree local ambitions and delivery plans for vaccination and screening services and services aimed at addressing the leading causes of morbidity and mortality such as cardiovascular disease and diabetes. ICBs and provider trusts are expected to work together to reduce inequalities in line with the Core20PLUS5 approach and ensure plans reflect the needs of all age groups, including CYP. ExR has a cervical screening module to facilitate and support the training of this procedure. Additionally, nursing consultation videos of chronic conditions such as asthma and diabetes are available which will aid clinicians in identifying and modifying risk factors to promote disease prevention.

Making the shift from analogue to digital

All providers proactively offer NHS App-first communications to patients (with due regard to digital inclusion), by default through the NHS Notify service. N/A
All GP practices have enabled all core NHS App capabilities. These include health record access, online consultations, appointment management, prescriptions management, online registration, and patient messaging. N/A
All systems adhere to the ‘Federated Data Platform (FDP) First’ policy, connecting their own digital and data infrastructure to the FDP. NHS England will support adoption of the FDP to 85% of all secondary care trusts by March 2026. N/A
All providers shift to the national collaboration service NHS.Net Connect where feasible. N/A
All systems complete planned electronic patient record (EPR) system procurements and upgrades, and all trusts without an EPR continue to work to procure and implement one as quickly as is safely possible. N/A
All providers deploy the Electronic Prescription Service wherever possible. N/A
All providers integrate systems with the NHS e-Referral Service. N/A
All providers achieve and maintain compliance with the NHS Multi-Factor Authentication Policy and act to strengthen their cyber security. N/A
All systems mitigate against digital exclusion, including by implementing the framework for NHS action on digital inclusion. ExR have demonstrated our alignment with the framework for digital inclusion.

Live within our means, reducing waste and maximising productivity

Reduce spend on temporary staffing and support functions by:

Achieving close to 100% delivery of planned core capacity before accessing premium capacity, including the use of agency and premium bank rates, waiting list initiatives, and insourcing arrangements, managing to tariff prices as a guide. N/A
Reducing agency expenditure, as far as possible as part of optimising cost and productivity. As a minimum all systems are expected to deliver a 30% reduction based on current spending, with further reductions over the Parliament. N/A
Reducing bank use, with all systems expected to deliver a minimum 10% reduction. Bank rates should be optimised as far as possible with collaborative arrangements in place across and between systems. N/A
Conducting a robust review of establishment growth and reduce spend on support functions to April 2022 levels. N/A

Improve procurement, contract management and prescribing by:

Working to accepted operating models and commercial standards, making full use of the consolidated supplier frameworks agreed through NHS Supply Chain. N/A
Optimising medicines value and improving the adoption of and compliance with best value frameworks in medicine and procurement. N/A
Reducing unwarranted variation in prescribing, implementing the guidance on ‘Low value prescribing’ and ensure that patients are prescribed the best value biological medicine where a biosimilar medicine is available. N/A
Reducing unwarranted variation in all age continuing care spend and placement pricing through standardised complex care specification(s), improved sharing of placement data and integrated ‘at scale’ commissioning practices. N/A
Optimising energy value. Trusts are expected to procure energy through the new national contract developed with Crown Commercial Services (CCS) and use green plans to identify and achieve savings from sustainable energy funding. ExR contributes the the NHS net zero agenda by helping organisations: save on travel for training, save on disposables for training and save on sterilisation needs. ExR have completed the NHS’ Carbon Calculator and switching to ExR services will save Trusts 55kT of CO2. Continuing with trainings as standard costs 57kT of CO2 whereas ExR services utilise only 2kT of CO2. ExR is certified B-Corporation, meeting high standards on environmental and social performance.

Drive improvements in operational and clinical productivity. Providers are expected to:

Develop plans that address the activity per WTE gap against the pre-Covid level. N/A
Avoid duplication and low-value activity, including a renewed focus on minimising inappropriate spend against evidence-based intervention (EBI) procedures. Commissioners are expected to work with providers to ensure that payment depends on meeting the relevant criteria. N/A
Systematically implement all elements of the People Promise to improve the working lives of all staff and increase staff retention and attendance and implement the 6 high impact actions to improve equality, diversity and inclusion. The evidence is clear that engaged, motivated staff improve productivity and patient outcomes. ExR facilitates ‘We are always learning’ from the People Promise, and promotes ongoing CPD and training through a wide variety of medical, nursing and AHP educational resources.