‘Integration is not enough’, NHSE demands ‘credible, affordable’ local plans

New five-year plans to be drawn up by all NHS organisations this autumn must be “credible, deliverable and affordable”, and boards must actively challenge them rather than them “simply endorsing the final version”, NHS England has said.

Draft guidance sent to local leaders in recent days kicks off work on the next wave of service development and finance plans, which NHSE says must be submitted later this year. Initially they will cover 2026-27 to 2030-31, and then be refreshed annually.

The document, seen by HSJ, seeks to set out the more robust approach to local planning that NHSE’s chair and CEO, Penny Dash and Sir Jim Mackey, want to introduce.

It states: “The boards of individual ICBs and providers are ultimately accountable for the development and delivery of their plans.”

These plans must be “evidence-based and realistic in scope”, states NHSE: “Having an aligned, integrated plan is not enough – the plan must also be credible, deliverable and affordable [and able to be] realistically executed with the available resources and operating environment”.

The NHSE guidance adds: “Boards are expected to play an active role in setting direction, reviewing drafts, and constructively challenging assumptions – rather than simply endorsing the final version of the plan.”

Meanwhile, the framework says the Department of Health and Social Care and NHSE are currently working to “translate the 10-Year Health Plan and spending review outcome into specific multi-year priorities and allocations”.

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Source: HSJ, 21 August 2025