NHS England and NHS Operational Planning Guidance 2025-26

I am today laying in Parliament the Government mandate for NHS England, and NHS England is publishing the operational planning guidance for the NHS.

This Government won the election to deliver change. The mandate and operational planning guidance mark a significant step on a long journey to get the NHS back on its feet, and drive the reform that is needed to make it fit for the future.

The mandate and operational planning guidance address the urgent challenges facing the NHS, as highlighted by the Darzi investigation. They put the NHS on the road to recovery and reflect patient priorities: cutting waiting times, improving access to primary care and improving urgent and emergency care. They reflect the need for the NHS to live within its means, and ensure that investment in the NHS, against a challenging economic and fiscal backdrop, is matched with reform to the operating model and a sharp focus on improving efficiency and productivity.

Patients need high-quality elective care delivered in a timely fashion, and should have choice and control over their care. I am re-focusing the NHS on making progress towards the 18-week standard, and the steps to achieve this were set out in our elective reform plan. This mandate supports the modernisation of primary and community care that will help patients get timely access to a GP appointment. The mandate is the start of us delivering our manifesto commitment to provide 700,000 urgent dental appointments to address our dentistry crisis.

Right now, patients are not receiving urgent and emergency care when they need it. Today’s changes will put patients at the centre of delivery, focusing on safety, experience and outcomes, and we will tackle variation in services delivered across the country, bringing the best of the NHS to the rest of the NHS. These changes come ahead of publishing, in 2025, our strategy to fix urgent and emergency care.

Patients’ priorities will be delivered through a new operating model, which will devolve power closer to the frontline and allow the best performing providers and integrated care boards to earn more autonomy to provide services needed by their local communities—all while ensuring a focus on efficiency and productivity to support the NHS to live within its means.

This year’s operational planning guidance puts these objectives into practice with fewer targets, giving local systems greater control and flexibility over how local funding is deployed to best meet the needs of the people they serve. I am instructing the NHS to focus on the fundamentals and get back to basics. We are giving local leaders clear directions to prioritise cutting elective care waiting lists, improve A&E and ambulance wait times, improve access to GPs and urgent dental care, and solve the mental health crisis.

2025-26 must be a year of financial reset for the NHS. The budget settlement for the NHS is welcome and we will ensure it is spent wisely, through financial rigour, to deliver services for patients. NHS providers are being asked to undertake a 1 % reduction in cost base, while raising their productivity and efficiency by 4%.

Making decisions like these are never easy, but when I joined the Department, I pledged to make sure that every penny was spent in a way that provides the best value for the patients. Together we will bring reform to the NHS and get it back on its feet.

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