What NHS leaders need in 2026/27

Asked what support would be most helpful from government and national leaders in 2026/27, trust and ICB respondents want backing to make difficult decisions, particularly when it comes to reconfiguring local services where there is likely to be opposition from the public. 

They also want more supportive public messaging and greater clarity and consistency from government on what local leaders should be prioritising 
this year. 

These themes, especially the desire for clarity, also emerged in free-text 
answers and interviews with finance directors. 

Exploring this in more detail, leaders shared their frustration about a 
lack of clarity about how trusts and systems should balance meeting key operational performance targets, delivering financial balance and longer-term transformation efforts. For example, in January 2026, the Secretary of State for Health and Social Care outlined that while the NHS was improving its financial sustainability, “parts of the service have over-steered and are therefore under delivering on elective activity”.

We also hear from ICB leaders that they are too often subject to contradictory instructions to fund community and prevention-focused services, while at the same time being asked to prioritise financial support for acute trusts in deficit. 

Trusts and systems would welcome further clarity from the centre on the 
prioritisation of delivering government’s key objectives for the health service.

GP respondents similarly want clarity and consistency from national leaders, and supportive public messaging, and are also calling for lighter touch regulatory intervention. A chief executive of a GP provider called for “absolute clarity on the five-year mission”, while a PCN clinical director stressed the need for “stability and increased core investment.”