The proposed shorter list of metrics is focused on the stated NHS priorities for 2025/26 as well as quality of care indicators for experience, safety, effectiveness and workforce.
The guidance states: ‘Early engagement on the NPAF framework told us that our approach is still complex and uses too many metrics. This complexity could dilute our focus on the national priorities set out in the Government's 2025 mandate to NHS England and the 2025/26 NHS priorities and operational planning guidance. We believe it is appropriate to clarify the focus of oversight for 2025/26 to fewer core measures that align with these priorities as well as a high-level view of quality of care.
‘Longer-term transformation measures that align to the NHS 10 Year Plan and the redefined roles of ICBs and the centre will be introduced from 2026/27.'
Sarah Walter, director of the NHS Confederation's Integrated Care Systems Network, said: ‘This framework sets out a series of proposals to try to address the significant operational and fiscal challenges facing the health service. Our members will welcome fewer targets, something which we have been calling for consistently to minimise the bureaucratic burden when applying the performance regime.
‘But it is vital that we strike the right balance between recovery and reform – dropping targets could result in NHS performance being assessed purely on "here and now" metrics such as A&E waiting times or waiting lists. This could leave out measures that would judge how successfully the NHS is implementing the reforms necessary to put it on a sustainable long-term footing.
‘It is also important we make sure the short timescale on consulting and finalising this does not create unintended consequences for staff and patients.
‘In addition, we have concerns about the proposals to hold ICBs accountable for all the organisations in their system while providers are not held to account for the part they have to play in system performance. This calls into question the ability of systems to achieve the three shifts.'
