In a letter to integrated care boards and NHS trusts, Sir James Mackey, chief executive officer at NHS England, has outlined expectations for providers on performance and finance for the year ahead, and how the 10 year health plan can be realised.
Sir Mackey notes the particular focus on how “technology and digital solutions are going to be vital for longer term transformation and unlocking our productivity”, adding that “cutting back on investments in these areas to help with short-term challenges will undermine longer-term sustainability and improvement”.
On financial planning, Mackey highlights key pressure points for organisations falling behind, including to deliver planned efficiencies or manage unplanned workforce costs. He notes elective and urgent and emergency care performance “has drifted a little over the summer”, and adds the “need to take urgent action to ensure delivery returns to plan by the end of quarter 3”. Impacting factors listed here cover industrial action, higher than expected demand, financial pressures, and challenges on rates of pay.
For elective care, trusts not on plan to achieve activity targets are required to submit revised trajectories for return to plan by December. For urgent and emergency care, Mackey notes the “need to improve our position on 4 hours, 12 hours, and ambulance handovers ahead of winter”.
On primary care, the focus is on 1 October 2025, from when practices will be required to “keep their online consultation tool open for the duration of core hours for non-urgent appointment requests, medication queries and admin requests”, to support system pressures.
Mackey moves on to highlight the need for robust plans to maximise vaccination rates across all cohorts; having a paediatric specific plan for when respiratory viruses cause a surge in demand for primary care, 111 and A&E; ensuring primary care access is maintained over the Christmas period; engaging with local authorities and social care providers so that discharge capacity surges at times of peak demand; targeted occupancy reductions in the run-in to the Christmas period; and stepping up personal visibility and leadership.
Looking ahead, Mackey notes the need for ICBs and trusts to develop their strategies for the years ahead, aligning with the 10 year plan. Further elements of the planning framework will be published shortly to support these plans, with “technology and digital solutions to be vital for longer term transformation”.
Wider trend: tech in health system transformation
We were joined for a recent HTN Now panel discussion focusing on the move from reactive to proactive care by experts from across the sector, including Dan Bunstone, clinical director at Warrington ICB; Patrick Denston, PCN digital transformation and change manager at Frimley ICB; Pete Thomas, CCIO and executive director of digital development at Moorfields Eye Hospital; and Joseph Waller, director at Aire Logic. The session looked at how NHS organisations are beginning to make the transition to proactive care, the kinds of data and digital tools required to make the change, and the impacts beginning to be seen on patient care, outcomes, and operational pressures.
For another of our HTN Now panel discussions, we were joined by Antonia Frost, CNIO at Sussex Community NHS Foundation Trust; Jen Tomkinson, assistant director of primary and community care development (urgent response and acute deterioration) at NHS England (SW region); and Roisin Reade, product manager at Civica, to discuss innovation in community healthcare. The session covered how innovation supports a future model of community care, the role of digital and what needs to be the focus in order to modernise services. We also explored what good looks like, looking at short-term goals and how the recent 10 Year Health Plan will shape the future direction.
Alder Hey Children’s NHS Foundation Trust has published an AI Strategy, outlining current and future AI work along with plans for benefits realisation, implementation, AI workforce development, infrastructure and data architecture. Driving the transformation are four key themes: enhancing children and young people centred care; empowering colleagues and freeing up time using intelligent automation, AI assistants, and smarter workflows; transforming outcomes for children and young people by delivering precision care through AI-optimised pathways, predictive analytics, and remote monitoring tools; and revolutionising paediatric diagnostics with “cutting edge” innovation.
