Sir James Mackey, chief executive at NHS England, has outlined next steps on planning and priorities for 2026/27 in an open letter to ICB and trust chief executives.
Mackey starts by congratulating execs on progress toward operational targets on referral to treatment and urgent and emergency care, adding: “What we absolutely need to avoid is the risk that, while we are rightly focused on making 2026/27 a success, we miss maximising the opportunity the multi-year planning process gives us to stretch ourselves over the medium term and really bring the benefits of the 10 Year Health Plan to life.”
Executives are therefore asked to begin to build out strategic commissioning narratives to focus on what strategic commissioning means for the local system and how it will be developed over the next three years; plans around neighbourhood care; whether changes to financial flows or payment are sought to help with delivery; and what more can be done at the centre to help drive pace of change locally. ICBs should provide a single document via regional teams to summarise the above points by 15 May.
The letter also highlights eight key areas where collective progress can help support the next set of “big leaps” such as a full reset of outpatient care. These include a shift away from the traditional outpatient model by expanding Advice and Guidance and reducing unnecessary follow-ups, work to reduce hospital bed days for the highest risk cohorts by implementing proactive care models in neighbourhoods, and making it easier to book urgent care appointments to reduce avoidable emergency attendances.
The roll-out of other technologies like ambient voice technology, tools for theatre utilisation, RTT validation, community waiting lists, and electronic prescribing, will be supported at national level to promote tech-enabled productivity improvements, it continues. The role of the NHS App will be expanded as the digital front door to the NHS, supporting more effective triage and navigation for patients; the payment system will be realigned with planned service changes to include new payment models for urgent and emergency care; a new quality strategy will place quality back at the centre; and a new Leadership College will be launched as “the most radical change to leadership development and talent management that the NHS has seen in over a decade”.
Wider trend: The NHS of the future
HTN was joined for a webinar exploring the role of the CIO now and in the future by a panel of experts including Ravi Sahota Thandi, interim operational CIO at The Dudley Group NHS Foundation Trust; Kate Warriner, chief transformation and digital officer at Alder Hey Children’s NHS Foundation Trust and #1 in the CIO 100 rankings; and Rhian Bulmer, chief customer officer at Radar Healthcare. Our panel shared their own experiences, discussed the role of the CIO in supporting and developing digital maturity and skills, delivering 10-Year Plan priorities, and what the next 5 – 10 years will look like. Also noted were emerging technologies and opportunities, along with ways of realising digitally-enabled system working.
For another webinar we welcomed a panel including Ciara Moore, EPR operations director at Bath, Salisbury and Great Western Group, Stuart Cooney, CTO at Royal Berkshire NHS Foundation Trust, and Julian Wiggins, healthcare solution director at Rackspace Technology, for a discussion focusing on cloud adoption, AI maturity, and cyber resilience. Panellists explored how healthcare organisations are tackling delivery, legacy systems, and rising digital expectations, and what this means for future strategy and plans. We also looked at the fragmented cloud landscape, integration pressures, legacy infrastructure, AI, and the growing urgency around cyber resilience, finishing by asking where NHS leaders should prioritise investment and focus in 2026.
NHS England has published its medium term planning framework to outline the priority deliverables ICBs and providers should focus on for the next three-to-five years. The framework sets out a new operating model, a revised foundation trust model, the creation of integrated health organisations, changes to the financial framework, and opportunities for greater local autonomy through a neighbourhood health approach.
Elsewhere from NHSE, plans have been shared for the reprocurement of the cyber operations external attack surface management system, launching a market engagement process. The engagement intends to brief the market ahead of procurement of a solution to protect IT systems that are internet-facing against cyber threats, with the scope to be delivered as a national service to NHS organisations.
