NHS Oversight Framework 2025/26

NHS England (NHSE) published its NHS Oversight Framework for providers and integrated care boards (ICBs) on Thursday 26 June 2025. The publication follows NHSE’s recent consultation on a draft oversight framework, which we responded to on members’ behalf.

There are some changes from the consultation version that we produced a full briefing on.

In particular, members should note:

• A methodology manual is included, setting out more about the scoring process and the approach to final segmentation.
  
  
• The list of metrics includes both some that will be scored to arrive at segmentation, and others which will be assessed but will not count towards final segmentation. The scored metrics focus on achieving the planning guidance priorities for the year, with metrics around, for example, improving population health and reducing health inequalities assessed but not counting towards segmentation. NHSE say all metrics are based on current targets and use publicly available information.
  
  
• There is a clearer articulation of ICBs’ role and responsibilities as strategic commissioners. A worked example of how ICBs can use their commissioning levers to performance manage providers against contractually agreed targets is now included.
  
  
• The capability assessment process remains in development during Q2.

Initial assessments of providers under the framework will take place in July, with ICB assessments not taking place in 2025/26 due to their restructuring.

NHS trust leaders have long called for a more consistent and transparent approach to how their organisations are assessed and it’s positive that this is front and centre of the new operating framework. It’s also positive that the new framework sets out a clear range of agreed metrics for trusts, which will be reviewed next year to take account of the 10-year health plan.

However, there is also scope for improvement. While it would have been helpful for the capability assessment to have been published at the same time as the new framework, trust leaders will now hope that NHS England undertakes a thorough consultation ahead of publication.

It is also vital that the next iteration of the framework sets out better measures for ambulance, community and mental health services which reflect the breadth and depth of the services they provide.