Members
- Penny Dash, Chair
- Louise Ansari, Non-Executive Director
- Mark Bailie, Non-Executive Director
- Duncan Burton, Chief Nursing Officer
- Paul Corrigan, Non-Executive Director
- Paul Dinkin, Director General, Strategy and Healthcare Policy
- Claire Fuller, Interim National Medical Director – Primary Care / Interim National Priority Programme Director for Neighbourhood Health
- Ravi Gurumurthy, Non-Executive Director
- Robert Lechler, Non-Executive Director
- Jim Mackey, Chief Executive Officer
- Sarah-Jane Marsh, National Priority Programme Director for Urgent and Emergency Care
- Andrew Morris, Deputy Chair
- Elizabeth O’Mahony, Chief Financial Officer
- Meghana Pandit, Medical Director – Secondary Care
- David Probert, Deputy Chief Executive Officer
- Jeremy Townsend, Non-Executive Director
Attendees
- Rob Checketts, Strategic Adviser
- Mark Cubbon, Elective Care, Cancer and Diagnostics Director
- Sue Doheny, Regional Director for South West Region
- Amanda Doyle, Director for Primary Care and Community Services
- Paul Doyle, Executive Transformation Programme Director
- Jules Hunt, Interim Director General, Technology, Digital and Data
- Jo Lenaghan, Interim Director General, People
- Katie Neumann, Assistant Director of Secretariat
- Matthew Style, Director General, System Development
- Rob Whiteman, Chair, NHS Dorset ICB
1. Welcome and apologies
1.1 The Chair welcomed everyone to the meeting and welcomed Paul Dinkin, Director General, Strategy and Healthcare Policy to his first public Board meeting.
1.2 The Chair thanked Sue Doheny, Regional Director for the South West Region and Rob Whiteman, Chair of the NHS Dorset Integrated Care Board (ICB) for hosting the Board meeting in Bournemouth.
Apologies
1.3 Apologies for absence were received from David Bennett (Non-Executive Director), Glen Burley (Financial Reset and Accountability Director) and Sam Everington (Non-Executive Director).
Declarations of Interest
1.4 No other declarations of interest were raised above those already on record, and no interests were declared in relation to the items on the agenda.
Minutes from the Board meeting held on 5 February 2026 (BM/26/01(Pu))
1.5 The minutes from the public Board meeting held on 5 February 2026 were approved as a correct record.
2. Board Committee updates (verbal)
Audit and Risk Assurance Committee (ARAC)
2.1 Jeremy Townsend, Non-Executive Director (NED) and Chair of the Audit and Risk Assurance Committee reported on the first joint Audit Committee with the Department of Health and Social Care (DHSC), which considered risks associated with transition arrangements between the DHSC and NHS England. The Committee reiterated the need to keep focus on substantive risks rather than process, calling out cyber security, primary care systems, and supply chain as material areas.
2.2. The Committee recommended a full business continuity exercise focused on cyber. The Board agreed to proceed and requested the Executive plan and run a multi‑stakeholder cyber continuity exercise and report outcomes to the Board.
Action: MB, Jamie Saunders, Tom Wechsler
2.3. On the voluntary redundancy (VR) scheme, it was confirmed Deloitte had been commissioned to audit the scheme in parallel with implementation; the Executive confirmed adjustments to governance so that a revised sub‑committee structure with non‑executive involvement could provide assurance in‑flight.
NHS England Quality Committee and National Quality Board (NQB)
2.4 Professor Sir Robert Lechler, NED and Chair of the Quality Committee highlighted improvements in GP access and patient satisfaction, progress in hypertension detection, and rapid roll‑out of the Maternity Early Warning Scheme (MOSS). The Committee noted ongoing concern about out‑of‑area placements in mental health, with commitment to eliminate these by 2028.
2.5. The National Medical Director – Secondary Care reported that the NQB had reviewed the draft Quality Strategy and supported development of Modern Service Frameworks (MSFs) for children and young people, cardiovascular disease, and sepsis. The Chief Nursing Officer reported launch of the Maternal Care Bundle and a new Maternity Inequalities Dashboard. The Board supported bringing maternity performance headline indicators into future performance reporting, drawing from MOSS data as appropriate and subject to data quality safeguards, and endorsed a deep dive on maternity at a future meeting.
Action: DB, DP
Strategy committee
2.6 The Director General, Strategy and Healthcare Policy, reported that the Strategy Committee had agreed its terms of reference, a forward‑looking role that scrutinised live work across directorates and with DHSC to ensure coherence against the 10 Year Health Plan (10YHP). Early workstreams included the Quality Strategy, children and young people, and centre‑led commercial intervention. The Board asked for a transparent pipeline view showing projects, timing, sequencing, and prioritisation to be reported at future public Board meetings.
Action: PDi, PDo
Finance and Performance Committee
2.7 Andrew Morris, Deputy Chair and Chair of the Finance and Performance Committee considered in principle a £100m NHS Online business case aimed at treating circa 8 million patients in an outpatient setting when fully developed. The Committee had requested further work by the Executive ahead of taking a final decision by correspondence.
Data, Digital and Technology Committee
2.8 Mark Bailie, NED and Chair of the Data, Digital and Technology Committee noted the Committee’s review of critical national infrastructure, resilience and cyber, and system transformation. Four themes were highlighted:
a. A transformation strategy linked to the 10 Year Health Plan (10YHP) is progressing, but requires further business alignment before integrating detailed technology solutions
b. Siloed working remains a cultural challenge, hindering delivery of cross-cutting initiatives fundamental to the 10YHP; interventions are needed
c. Investment should prioritise a subset of proven programmes with high impact, including Wayfinder
d. Capability and capacity post restructuring must match delivery ambition
2.9 The Board emphasised the need to integrate technology with pathway redesign from the outset, use integrated teams earlier in strategy work, and bring forward a concise progress overview on the major digital programmes. It was requested that the Technology, Digitial and Data and Strategy teams provide a high‑level dashboard on priority programmes and adoption at future meetings.
Action: JH, PDi
3. Chief executive officer update (verbal)
3.1. The Chief Executive Officer (CEO) reported a stronger winter position than anticipated, attributing improvements to public and staff response on flu vaccination, effective management of industrial action, and maintained operational grip, including better ambulance handovers and Category 2 response times over the Christmas–New Year period. Corridor care remained unacceptable; a programme with the Corridor Care Coalition would focus on eradication, with emphasis on improved care for people with frailty and upstream care coordination.
3.2 The CEO highlighted notable achievements in elective recovery, GP satisfaction, and cancer strategy development.
3.3 Updates were provided on key appointments, including a pending announcement for the national leader of mental health services and ongoing efforts to support the New Hospitals Programme, with further details to follow.
3.4 The CEO informed the Board of his visit to Southampton Hospital following the major fire incident. The Board recorded appreciation for the exceptional response from staff and emergency services at Southampton.
3.5 The Regional Director for the South West updated on the improvement journey at South West Ambulance Service NHS Foundation Trust, reflecting on the impact of the Trust’s Board-led improvement initiatives and strong clinical engagement.
3.6 The Board discussed the need for technology in emergency pathways to be prioritised, with the Urgent and Emergency Care (UEC) Medium Term Strategy progressing towards tech-enabled transformation, particularly to support frail and older patients. Business cases covering urgent care technology, admission, handover processes, and unified triage were in development.
4. Performance and Delivery Update (BM/26/03 (Pu))
Integrated Performance report
4.1. The Deputy CEO and Interim Director General for Performance and Delivery presented the latest operational position. Performance had improved in several areas, including reduced adult inpatient numbers for people with autism or learning disabilities, reduction in inappropriate paediatric antibiotic prescribing, higher GP satisfaction, and increased access to children and young people’s mental health services.
4.2 The Board considered the areas where performance remained challenged. Cervical screening rates had fallen, and measles, mumps and reubella vaccine uptake remained below recommended levels at approximately 83%. Emergency department 4‑hour performance and 12‑hour waits remained below trajectory, and waits over six weeks in diagnostics had risen to nearly 22%. Significant concerns were noted around long waits for community services, particularly community paediatrics and neurodiversity assessments, where previous system plans had not delivered the expected reduction in the longest waiters. Members requested clearer data on numbers waiting, conditions involved, workforce and productivity measures, in order to support effective oversight.
Action: DP, PDo
4.3 Targeted work on vaccines was requested, with proposals to be brought to the Board on addressing variation in vaccination uptake and how to learn from behavioural insights to improve uptake.
Action: Catherine Frances
4.4 The Board noted that life expectancy was reducing. Members discussed the absence of analysis mapping 10YHP measures against this trend and the further work that could be undertaken with public health colleagues on this. Consideration was given to secondary prevention, especially the management of care for people with diabetes and hypertension, given their impact on life expectancy and avoidable morbidity. Management confirmed changes in the GP contract would strengthen focus on the eight diabetes care processes. The Board asked for clearer separation of effectiveness and experience metrics, inclusion of international healthy life expectancy comparators, and sharper insights on secondary prevention along with clear action plans to address.
Action: PDi, DP, PDo, Catherine Frances
4.5 The Board highlighted variability in data quality and timing. Members supported greater transparency and increased use of the Federated Data Platform for reporting. A review of data quality and a standing commitment to continuous improvement were agreed.
Action: DP, PDo
4.6 The Board noted progress on Antimicrobial Resistance and welcomed the forthcoming MSF for sepsis. Members emphasised balancing data on infection control with data on prevention measures such as vaccination.
4.7 The Board requested that future reports include data on emergency department admissions for people aged over 65, together with enhanced reporting on infection control measures.
Action: DP, PDo
4.8 The Board considered the pace at which elective waits could reduce, noting ongoing work on Advice and Guidance, faster clinical assessment, and ambient voice technology. Members also noted the impact of Neighbourhood Health in reducing hospital referrals.
4.9 The Board reviewed sickness absence, which had increased slightly. Members noted the 10 Year Workforce Plan commitment to reducing absence from 5% to 4.1% over ten years, equivalent to approximately forty thousand staff returned to work. The Board noted that sickness levels drove bank and agency expenditure and needed close monitoring. Members requested that future reporting distinguish clearly between short‑term and long‑term sickness, as the drivers and mitigation strategies differed by staff group, and that sickness absence was tracked against the planned downward trajectory set out in the Workforce Plan.
Action: DP, PDo, JL
Month 9 Financial Position 2025/26
4.10 The Interim DG, Finance reported that at month 9 the NHS was broadly on track to balance year to date and at outturn, albeit with bumps at the quarter. 17 systems and 61% of providers were delivering plans, a marked improvement on the prior year. System overspends were mainly attributable to slippage on efficiencies and unplanned workforce costs. A contribution toward industrial action costs for November–December had been distributed, funded through NHS England and DHSC moratoria.
4.11 13 systems were currently off track for deficit support funding (DSF) in Q4. Options under consideration with Regional teams and through the Finance and Performance Committee included conditional earning of a proportion of DSF on demonstrable run‑rate improvements and potential redistribution to systems delivering plans. The Board stressed avoiding actions that mortgage next year and requested a breakdown of the recurrent vs non‑recurrent savings delivered in-year and planned in 2026/27.
Action: EOM
4.12 The Board noted material variation in workforce growth and opportunities highlighted by benchmarking packs. The Executive confirmed interventions with systems showing significant workforce cost growth misaligned to activity. On specialised commissioning, lower than forecast spend on specialist drugs and devices was reported with no impact on aggregate patient access. The Board emphasised transparency where service changes affected patient care and asked that quality impact assessments be closely monitored.
5. Productivity plan – update (BM/26/04(PU))
5.1 The Interim DG, Finance provided an update on the latest productivity delivery, planned improvement for 2026/27 and longer term ambition.
5.2 The Board noted encouraging productivity trends: circa 2.7% improvement in the acute sector in 2024/25 and similar gains in early 2025/26, with reductions in length of stay, more same day emergency care, and significant reductions in temporary staffing. A monthly trust‑level productivity publication and a detailed method guide would be released to support transparency.
5.3 The Board requested greater clarity on:
a. The “frontier shift” opportunity by major pathway (how far performance could realistically move if you combined technology with pathway redesign in the MSFs);
Action: EOM, Phill Wells, Meghana Pandit
b. A prioritised list of no regrets, for example scalable interventions such as Wayfinder and DORA AI with an adoption plan;
Action: EOM, Phill Wells, Julian Hunt
c. A one-, three-, five- and ten-year year view linking investment, technology, left shift, and operational improvement to measurable outcomes, including healthy life expectancy for Neighbourhood Health.
Action: EOM, Phill Wells, Claire Fuller
5.4 The Executive was requested to bring back an integrated Productivity Plan that sets out the “what” and the “how”, including incentives and contracting models that also help to address fixed cost barriers starting with in outpatients.
Action: EOM, Phill Wells, Mark Cubbon
6. Improvement in the NHS (BM/26/05/Pu))
6.1 The Board welcomed the report on the model for and approach to improvement in the NHS, with a core focus on enabling providers and systems to be self-improving. It was discussed that under the approach NHS England would: codify best practice and identify opportunities; strengthen leadership and management capability for improvement; deliver a small number of nationally-led improvement priorities each year through learning and improvement networks led by high performing chief executives; and target responsive support to the most challenged providers via the Getting It Right First Time Programme and the new National Provider Improvement Programme.
6.2 The Board requested:
- alignment with the Quality Strategy and Modern Service Frameworks to ensure technology and pathway redesign and improvement proceed together.
- better reach to key staff groups such as ward sisters and charge nurses, and a shift away from pilot dependence by building a pervasive improvement culture.
- reporting on early examples of “big leaps” and their spread, and clarity on how data and FDP tools will put actionable insights in the hands of teams.
Action: SJM, EOM, PDi
7. A new era of transparency – progress update (BM/26/06(Pu))
7.1 The Interim DG, Technology, Digital and Data summarised the proposal for on moving to open by default data, with recent publication of Oversight Framework segmentation and league tables and plans to open up the Model Health System content. The Board supported extending transparency across non‑acute services and patient experience datasets and linking information to patient choice tools.
7.2 Further work was requested to:
a. publish the next tranche of open data and bring forward options to enhance My Planned Care style information with granular, pathway‑level insights that enable meaningful choice
Action: JH
b. through the Quality Committee/NQB, to consider publication of clinical outcome metrics by specialty, with proposals returned to the Board.
Action: JH, MP, CF
8. Public questions and answers
8.1 The Board received questions from members of the public in advance of the meeting with responses provided by Executive leads.
8.2 Question 1: Given the pressures currently facing hospitals and the role of the 111 triage system, what are the considerations or barriers for implementing a comprehensive triage system at hospital entrances to improve patient direction and reduce the demand on A&E departments?
8.3 Response: The National Priority Programme Director for UEC explained that all patients arriving at an emergency department should receive clinical triage, streaming and redirection on arrival to ensure they are assessed promptly and directed to the most appropriate service. While this already occurs in many departments, the Board acknowledged that variation in practice remains. A new Model Emergency Department document would be published shortly to promote a more consistent national approach.
8.4 Digital tools were identified as an important part of long‑term reform. The Board noted that better digital triage would reduce unnecessary attendances by supporting patients to reach the right service before travelling to hospital. This would form a cornerstone of the medium‑term UEC Medium Term Strategy, which aims to ensure that emergency departments are used as a destination when clinically necessary, rather than a default entry point for urgent care.
8.5 In the meantime, members of the public were encouraged to use NHS 111, supported by the national Directory of Services, which helps redirect people to more appropriate care settings where this is clinically suitable.
8.6 Question 2: How does NHS England ensure that public-facing mental health information on nhs.uk reflects current clinical understanding, aligns with mental health standards, and avoids stigmatising terminology such as “habit” for recognised mental disorders?
8.7 Response: The National Medical Director – Primary Care advised that editorial content on the NHS website is reviewed systematically, with all material subject to clinical and editorial review at least every three years. Evidence updates and user or stakeholder feedback are considered on an ongoing basis, and content is amended immediately where necessary. Users are able to provide feedback directly through the website, and the Board thanked the questioner for raising their concerns.
8.8 It was noted that the NHS uses the International Classification of Diseases (ICD) to describe conditions. Under ICD‑10, trichotillomania is classified as a habit and impulse disorder, terminology that is now recognised as outdated and potentially stigmatising. The updated ICD‑11 reclassifies trichotillomania as a body‑focused repetitive behaviour disorder. The NHS is moving to the updated classification system, and corresponding updates will be made to the website as part of this process.
8.9 Question 3: Following the Levy Review, when will NHS England be commenting on the failings detailed and Levy’s recommendations? Additionally, when revising the specification(s), will NHS England commit to using plain language based on biology?
8.10 Response: The DG, System Development, thanked Dr David Levy for leading the independent review of adult gender dysphoria clinics. NHS England had commissioned the review to understand how to reduce long waits, address variation between services, and improve quality, safety, clinical effectiveness and patient experience. Dr Levy’s final report was published in December, alongside NHS England’s initial response outlining actions already underway.
8.11 The Board was informed that priorities included: establishing a National Improvement Programme; commissioning a new service in Cheshire and Merseyside and progressing a fourth service for the East of England by April 2026; creating a single national waiting list from April 2026; raising the referral age to 18; ending self‑referral with advice and guidance for those struggling to obtain a referral; extending the National Research Oversight Board to include the adult pathway; and setting productivity goals for every service. A joint National Oversight Board with DHSC would oversee implementation.
8.12 On the use of plain language, it was reported that commissioning policies and service specifications follow legislation and use clinically accurate terminology. Where terminology is contested or unclear, clear definitions are provided. All specifications are supported by an Equality and Health Inequalities Impact Assessment, and any significant changes would be subject to full public consultation.
8.13 Question 4: Before any further scaling-up of Advice and Guidance (A&G), how does NHS England determine which groups are engaged in the design phase, and what mechanisms ensure this involvement constitutes genuine co-production rather than passive consultation?
8.14 Response: The National Priority Programme Director for Planned Care responded that A&G is an established clinical model designed to give patients earlier access to specialist advice and reduce unnecessary hospital appointments. NHS England had engaged a wide range of stakeholders, including clinical representatives and system leaders, in developing the approach. Local systems were also expected to work with relevant organisations and patient representatives to ensure that service changes reflected meaningful engagement rather than passive consultation.
8.15 Question 5: Whether NHS England plans to mandate the use of Advice and Guidance as a requirement for GP referrals before April 2027, with a request for details on the intended scope, timeline, and guiding principles of any such mandate.
8.16 Response: The National Priority Programme Director for Planned Care reported that, in line with the Medium Term Planning Framework for 2026/27, systems had been asked to prioritise A&G in the ten specialties where its impact would be greatest. General Practice would continue to be able to refer patients into secondary care, but referrals would increasingly be clinically triaged to ensure patients were directed promptly to the most appropriate pathway. No national mandate had been set for A&G to be a prerequisite for referral before April 2027; instead, adoption would be phased and supported by digital tools, with impact assessed before further decisions were taken.
9. Any other business
9.1 There was no other business.