NHS ‘reset’ promises end to short-term thinking

The NHS Medium Term Planning Framework – Delivering Change Together (2026/27 to 2028/29) aims to strip out layers of bureaucracy, remove complicated and unnecessary rules, and free up local leaders to get on with the job of delivering for patients.

It signals an end to ‘short term thinking’ holding back frontline services and will break the cycle of ‘just about managing’ – giving the NHS the certainty and headroom it needs to fix the fundamental problems we face today and be truly ambitious for the future.

The three-year roadmap sets out the NHS plan to get back to delivering against its constitutional standards on elective care, which will see 2.5 million fewer patients waiting more than 18 weeks for treatment by March 2029.

It will ensure 85% of people with a cancer diagnosis receive their first treatment within two months of a referral – up from 70% today. NHS analysis suggests just over 300,000 cancer patients will get their first treatment within 62 days of receiving a referral in 2028/29, up from 226,939 last year (2024/25). While 96% of patients will begin treatment within one more of a cancer diagnosis by 2028/29.

Meeting these ambitious targets will be achieved by transforming how services are delivered – shifting more care out of hospital, freeing up capacity to drive down waiting times – and major improvements in health service productivity. As part of the biggest shake up of the NHS financial regime in more than a decade, hospitals will be financially incentivised to ensure more patients are treated out of hospital, instead receiving the care they need from local neighbourhood teams and in community diagnostic centres.

This will start with immediate action to improve GP access and tackle unwarranted variation between practices – consulting on a new priority to deliver same day appointments, whether face to face, online or by phone, for all clinically urgent patients. The Framework also sets an ambitious target for 80% of community health service activity within 18 weeks – tackling long waiting times for community services, which have seen a surge in the number of adults and children waiting for more than two years for care.

This will be supported by shifting more resources into community services for people with highest needs – such as frailer older people – reducing unnecessary hospital admissions and helping them manage their health at home.

In line with the ambitions of the 10 Year Plan, the framework sets targets to make sure 95% of appointments after triage are available via the App and ensure all providers are leveraging the full potential of the Federated Data Platform by the end of 2028/29.

More patients will get appropriate care as part of the ‘Advice and Guidance’ scheme which allows GPs to get specialist clinical advice from leading experts at the touch of a button – rather than sending the patient for a hospital appointment which sometimes isn’t needed.

Sir Jim Mackey, CEO of NHS England said: “For too long the NHS has been stuck in a doom-loop of not being able to properly plan beyond each financial year and responding to overly-bureaucratic processes that have stifled local leadership and innovation. We have to get out of the trap of short-term thinking and break the cycle of ‘just about managing’.

“Today’s publication – the product of intensive work over the summer by the NHS leadership community – resets how the NHS works, aligns incentives to delivering more care and creates a clear route map by which the NHS can meet its commitments on improving access to care and get waiting times back to where patients want and need them to be. The NHS needs to win back the confidence of the patients and communities it serves – so starting from now, every provider across the NHS will be required to more carefully measure what patients are telling them about their experience of care and act swiftly to fix the things that matter to them.”