New ‘simpler’ NHSE performance regime for acutes has 50% more metrics

The number of metrics used to measure the performance of acute trusts by NHS England has been increased from 23 to 35.

The changes come despite NHSE claiming the updated National Oversight Framework is “simpler” and more “disciplined”.

The 2025-26 NOF was used to determine the provider league tables introduced by former health secretary Wes Streeting. The updated framework will fulfil the same purpose.

Four of the NOF’s five domains have seen increases in the metrics included within them.

The most significant increase is in the effectiveness and efficiency domain, which has increased from four to 10 metrics. Among the new metrics is one entitled “NHS staff survey advocacy rate” – which combines the results of two survey indicators: whether staff would recommend a trust as an employer and as a care care giver. 

A new indicator tracking the “rate of pregnant women with a delayed planned induction per 1,000 deliveries” is a reflection of the high profile of maternity service quality. The new NOF also includes two metrics measuring readmissions after 14 and 30 days.

The metric tracking the “average number of days from discharge ready date to actual discharge date” has been replaced by two metrics covering “mean length of stay for older adults” and the percentage of “intermediate care beds occupied by patients without criteria to reside”. 

The other domain to see a big rise in metrics is “people and workforce”, which increases from just two to five metrics. New measures include “healthcare worker flu vaccination rate” and “temporary staffing costs”.

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Source: HSJ, 15 June 2026