NHSE vows to end ‘bombardment’ of trusts

NHS England has vowed to “reduce duplication and prevent providers from being bombarded with conflicting instructions”, including by removing integrated care boards’ performance management role.

A new draft NHS Performance Assessment Framework, published today, promises to “streamline oversight” by “providing consistent and co-ordinated oversight to reduce duplication and prevent providers from being bombarded with conflicting instructions”.

The document attempts to set out how integrated care boards and trusts will be regulated by NHS England, starting from July. 

It confirms that NHSE, not ICBs, will be responsible for provider performance management – a move announced late last year but met with anger from many ICBs.

The new paper says: “Discussions about performance will be led by colleagues at NHS England, who are experienced in addressing delivery challenges.”

The proposal that NHSE performance management will be carried out “with and through” ICBs — included in earlier versions of the framework — has gone.

In addition, trusts’ performance “segments” will no longer take into account wider system performance, nor a proposed judgement of their “capability”, as they will “solely [be] linked to delivery metrics”.

ICBs will still have to “hold their partners to account using the system levers that bind them together, such as their joint system plans, partnership agreements, joint committees and collaboratives”, however.

The framework is subject to consultation, and new NHSE CEO Sir Jim Mackey told its board today it was likely to be changed. There will “absolutely be some things we need to change and adjust”, he said. “This isn’t something that can be perfect at the first go.”

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Source: HSJ, 27 March 2025