NHS England: 2025/26 priorities and operational planning guidance (30 January 2025)

Summary

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. To support this, systems will have greater control and flexibility over how they use local funding to best meet the needs of their local population.

Content

The national priorities to improve patient outcomes in 2025/26 are:

• Reduce the time people wait for elective care, improving the percentage of patients waiting no longer than 18 weeks for elective treatment to 65% nationally by March 2026, with every trust expected to deliver a minimum 5% point improvement. Systems are expected to continue to improve performance against the cancer 62-day and 28-day Faster Diagnosis Standard (FDS) to 75% and 80% respectively by March 2026.
• Improve A&E waiting times and ambulance response times compared to 2024/25, with a minimum of 78% of patients seen within 4 hours in March 2026. Category 2 ambulance response times should average no more than 30 minutes across 2025/26.
• Improve patients’ access to general practice, improving patient experience, and improve access to urgent dental care, providing 700,000 additional urgent dental appointments.
• Improve patient flow through mental health crisis and acute pathways, reducing average length of stay in adult acute beds, and improve access to children and young people’s (CYP) mental health services, to achieve the national ambition for 345,000 additional CYP aged 0 to 25 compared to 2019.

In delivering on these priorities for patients and service users, ICBs and providers must work together, with support from NHS England, to:

• Drive the reform that will support delivery of our immediate priorities and ensure the NHS is fit for the future. For 2025/26 we ask ICBs and providers to focus on:
• Reducing demand through developing Neighbourhood Health Service models with an immediate focus on preventing long and costly admissions to hospital and improving timely access to urgent and emergency care.
• Making full use of digital tools to drive the shift from analogue to digital.
• Addressing inequalities and shift towards secondary prevention.
• Live within the budget allocated, reducing waste and improving productivity. ICBs, trusts and primary care providers must work together to plan and deliver a balanced net system financial position in collaboration with other integrated care system (ICS) partners. This will require prioritisation of resources and stopping lower-value activity.
• Maintain our collective focus on the overall quality and safety of our services, paying particular attention to challenged and fragile services including maternity and neonatal services, delivering the key actions of ‘Three year delivery plan’, and continue to address variation in access, experience and outcomes.