Friday 3 July 2026

Dear colleagues,

Patients waiting for elective care have too often been left in the dark, not knowing if a referral has been accepted or if they are still on the waiting list. Some only hear about an appointment after it has already happened. This is entirely unsatisfactory and, if we are serious about improving patient experience of and satisfaction with the NHS, we have to fix the basics – and that starts with how we treat people from first contact and throughout their journey.

The Elective Reform Plan committed us to setting clear minimum standards that every trust must meet for every patient once referred to an elective pathway.

The planned care minimum standards set out in a simple and clear way the very minimum a patient should experience when their referral has been accepted in secondary care. They have been designed alongside key stakeholders, including patient groups and could also be beneficial for other pathways.

The standards (annex 1) are defined in 3 parts:

• what patients should expect at referral
• what they can expect while they are on the waiting list
• the information they can expect to receive about their appointment

What we expect from acute trusts

Trust boards should assess their current performance against each standard and set out how they will improve where they are not meeting a standard.

Trust boards are also expected to publish a statement in 2026/27 setting out their approach to complying with the minimum standards, followed by an annual statement reflecting their assessment of progress against them.

We will carry out a national stocktake in 6 months to assess progress across England and monitor the Office for National Statistics (ONS) Health Insight Survey every 4 weeks and the British Social Attitudes survey annually.

It is a trust’s responsibility to communicate the standards with patients to ensure they are aware of the minimum they should expect when on an elective pathway. To support providers to communicate these standards with patients, we will be sharing a communications toolkit in the next couple of weeks.

Why is this important?

Over the past year, we have made huge strides in improving elective performance and reducing waiting lists, but too many patients still don’t feel informed or involved while they wait for their appointments. These standards represent the minimum they must be able to expect from the NHS at what can be one of the most challenging times of their lives, and I know in many places you are going beyond what these standards set out.

Thank you for all that you are doing already and will do to continue to improve performance, and to ensure that these minimum standards are what patients can rightly expect from elective care wherever they are across the country.

Yours sincerely,

Sir Jim Mackey
Chief Executive Officer
NHS England

Annex 1: Minimum standards of patient experience – electives

When you are referred

• Standard 1: You will know within 28 days whether your referral has been accepted or what the next steps are.

While you are on the waiting list and throughout your care

• Standard 2: Communication will be clear and easy to understand. If you have specific communications’ needs, you will have the opportunity to tell your provider these.
• Standard 3: When your referral is accepted, you will get information to help you while you wait.
• Standard 4: You will get regular updates on your wait, at least every 12 weeks.
• Standard 5: Before your appointments, you will be able to tell your provider of any additional needs and reasonable adjustments you require.

Planning and understanding your appointments

• Standard 6: You will receive clear information about your appointments at least 21 days in advance.
• Standard 7: If your appointment is cancelled, by either you or your provider, a new date will be communicated within 28 days.
• Standard 8: You will be told when your care is complete and what happens next.

Publication reference: PRN02340_ii