NHS England: NHS Oversight Framework 2025/2026

Summary

The new framework describes a consistent and transparent approach to assessing integrated care boards (ICBs) and NHS trusts and foundation trusts, ensuring public accountability for performance and providing a foundation for how NHS England works with systems and providers to support improvement.

This 1-year framework sets out how NHS England will assess providers and ICBs, alongside a range of agreed metrics, promoting improvement while helping us identify quickly where organisations need support.

The framework is supported by a focused set of national priorities, including those set out in the Planning guidance for 2025/26, aiming to strengthen local autonomy. These are presented alongside wider contextual metrics that reflect medium-term goals in areas such as inequalities and outcomes.

The assessment will be the starting point for how we work with organisations throughout the year and will help us determine how we can support them to improve. We will do this by considering an organisation’s segment score, as set out in this framework, and leadership capability.

The framework will be reviewed in 2026/27 to incorporate work to implement the ICB operating model and to take account of the ambitions and priorities in the 10 Year Health Plan.

Content

As part of the process trusts must first self-assess against a set of criteria across 6 domains derived from The insightful provider board (2024):

• strategy, leadership and planning
• quality of care
• people and culture
• access and delivery of services
• productivity and value for money
• financial performance and oversight

Trusts must return this completed self-assessment and associated evidence underpinning it (for example, a board paper) to their regions. Regions will then use this self-assessment along with the trust’s historic track record of delivery and any relevant third-party assessment to arrive at a view of provider capability, which will be shared with the trust. As the year progresses, oversight teams will monitor the trust’s track record against these self-assessments, taking account of any relevant information as it emerges in order to maintain a real-time view of provider capability to inform the relationship with the organisation.

See also: Assessing provider capability: guidance for NHS trust boards