Policy Overview
A central objective of the latest NHS plan is to significantly reduce delays in elective care, with a goal of ensuring 65% of patients receive treatment within 18 weeks by March 2026. In addition to this target, improving response times for Accident & Emergency (A&E) departments and ambulance services remains a priority, particularly as the need for urgent care continues to grow.
The plan also underscores the role of digital innovation in streamlining operations and reducing delays - something flagged very early on in Labour’s governance by Health Secretary Wes Streeting. A key target is to manage 70% of elective care appointments via the NHS app by 2025, reinforcing the shift toward digital-first patient engagement and more efficient service delivery.
Furthermore, the guidance seeks to empower local Integrated Care Systems (ICSs) to ensure health and social care services can better meet the unique needs of their communities. This localised approach aims to foster a more responsive and equitable health and social care system; tackling disparities, reducing waste and improving overall care accessibility.
Strategic Choices for the Future
The NHS operating plan sets out important objectives that could play a key role in shaping the future of health and social care services. To support these ambitions, the plan includes measures to streamline costs, including a 30% reduction in spending across healthcare systems and a review of expenditure related to agency and non-frontline staff.
The guidance also states that ‘NHS organisations will need to reduce their cost base by at least 1% and achieve 4% improvement in productivity, in order to deal with demand growth. NHS England will transfer a higher proportion of funding than ever before directly to local systems and minimise ringfencing, allowing local leaders maximum flexibility to plan better and more efficient services. And, to be clear, all parts of the NHS must now live within their means.’
Changes to women’s health hubs, child vaccination targets, and annual health checks for people with learning disabilities have sparked discussion, with some health experts and charities highlighting the importance of maintaining focus on these areas to support vulnerable populations.
Health Secretary Wes Streeting and other NHS leaders have emphasised that the new directives aim to address public concerns, particularly by prioritising efforts to reduce waiting times.
“It has never been more important that we continue to ensure taxpayers money is spent wisely. This will require a relentless focus on operational performance, recovering productivity, tackling unwarranted variation, and reducing delays and waste. In many places radical reform and reprioritisation will be the right answer.” NHS Chief Executive, Amanda Pritchard.
The Road to Recovery
At the same time the NHS operational planning guidance was unveiled, the Labour government also released its Road to Recovery mandate to address the problems highlighted in Lord Darzi’s report. The mandate sets out plans to bring health services “back to basics” by cutting waiting times, improving emergency care services and access to primary care, and reforming the existing operating model to drive greater productivity and efficiency.
“I want to empower NHS leaders to deliver the innovation and reform required to fix the NHS, rather than overload them with targets which have failed to deliver better outcomes for patients,” said Wes Streeting.
“This new approach will see the NHS focus on what matters most to patients – cutting waiting list, getting seen promptly at A&E, and being able to get a GP appointment.”
The mandate will remain in place until a new version is published, aligning with the government’s broader 10-year plan for health and social care reform, due to be published this Spring.
Opportunities for Further Development
The NHS operational plan and mandate outline key priorities for system-wide reform, with significant investments to drive improvements. As the health and social care landscape evolves, there are opportunities to provide further clarity on certain areas to maximise impact and ensure sustainable progress.
Social Care
The government has announced an independent commission to transform adult social care, alongside £3.7 billion in additional funding for local authorities in 2025/26. While these are positive steps, further details on implementation could help ensure this investment effectively addresses workforce challenges, strengthens integration with health services, and enhances care quality. Providing a clearer roadmap for these reforms would reinforce social care as a key pillar of the wider health system.
Mental Health
The 2025/26 Operational Plan streamlines key performance targets, reducing them from 32 to 18, reflecting a focus on prioritisation. While specific mental health and dementia care goals are not explicitly outlined, the government has reaffirmed its commitment to continued investment in these areas. Given the increasing demand for mental health support, further emphasis on service accessibility and waiting times could help ensure ongoing progress in meeting patient needs.
Prevention
A core priority of the operational plan is shifting care from hospitals into the community to reduce pressure on acute services and improve access to quality care, particularly in deprived areas. Integrated Care Boards (ICBs) play a crucial role in driving this transition by coordinating services at the local level. There is an opportunity to further define how resources and support will be allocated to strengthen community-based services, ensuring that the shift leads to improved health outcomes and addresses inequalities effectively.
Technology
Technology remains central to the NHS’s digital transformation, with £3.4 billion allocated for IT modernisation and data-driven care in 2025. Virtual Wards and Hospital at Home initiatives have already demonstrated success in optimising resources and improving patient flow, as seen in the South East region evaluation.
What’s more, a case study on the North East London Foundation Trust (NELFT) shows that virtual wards can act as a practical alternative solution to hospital care, with the Trust reducing hospital admissions by as much as 30%, while optimising resources and improving overall patient flow.
Expanding on how these models can be further integrated across the system could help unlock their full potential. Similarly, advances in ethical AI and technology-enabled care offer valuable opportunities for predictive insights and proactive patient monitoring. Additional guidance on embedding these innovations could further enhance their impact.
Primary Care
The operational plan acknowledges the need to improve primary care access, with an additional £889 million allocated for the 2025/26 GP contract. This includes reducing QOF targets from 76 to 44 and expanding the Additional Roles Reimbursement Scheme (ARRS) to include practice nurses.
GPs are crucial in coordinating specialist care, including social and mental health services, while district and community nurses play a vital role in preventing hospital admissions, reducing corridor care, and cutting waiting times by managing long-term conditions in the community. With over 31,000 unfilled nursing vacancies in the UK, ensuring the workforce is sufficiently supported will be key to attracting new recruits whilst retaining existing staff.
The 10-Year Plan: A Vision for Health and Social Care Reform
The upcoming 10-year plan for health and social care presents an opportunity to address the long-standing challenges that prevent the system NHS from working as it should. While details have yet to be released, there is hope that it will provide a clear roadmap for transforming services; ensuring better integration between health and social care, and shifting focus from reactive to proactive care.
Key to this transformation must be a commitment to strengthening community-based care, supported by technology such as virtual wards and remote monitoring to reduce hospital admissions and improve patient outcomes.
Investment in digital infrastructure and data utilisation will also be essential in enabling more efficient care coordination, easing the burden on acute services, and driving allowing preventative healthcare to be pursued and to flourish.
The financial landscape presents a significant challenge in achieving these ambitions. With a focus on cost-efficiency, the NHS and social care sector will need to make strategic investment decisions between now and 2028, when the social care reform plan is set to take effect. Ensuring long-term sustainability will require careful prioritisation of resources, workforce support, and service integration to maximise the impact of available funding.
If these areas are prioritised, the 10-year plan may well deliver the sustainable, responsive, and patient-centred health and social care system the UK so desperately needs.
