Members
- Penny Dash, Chair
- Louise Ansari, Non-Executive Director
- Mark Bailie, Non-Executive Director
- David Bennett, Non-Executive Director
- Duncan Burton, Chief Nursing Officer
- Paul Corrigan, Non-Executive Director
- Paul Dinkin, Director General, Strategy and Healthcare Policy
- Sam Everington, Non-Executive Director
- 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
- Fiona Bride, Interim Director General, Commercial and Growth
- Glen Burley, Financial Reset and Accountability Director
- Rob Checketts, Executive Director of Corporate Affairs and Communications
- Mark Cubbon, National Priority Programme Director for Planned Care
- Amanda Doyle, Director for Primary Care and Community Services
- Jules Hunt, Interim Director General, Technology, Digital and Data
- Danny Mortimer, Director General, People
- Katie Neumann, Assistant Director of Secretariat
1. Welcome and apologies
1.1. The Chair welcomed members and attendees to the public meeting of the NHS England Board.
1.2. The Chair noted that this was the final Board meeting for David Probert, Interim Director General (DG) for Performance and Delivery / Deputy Chief Executive Officer (CEO) and thanked him for his contribution and support to the organisation over the preceding year.
1.3. The Chair reflected on feedback received from members of the public attending Board meetings, particularly the need to reduce the use of acronyms and to communicate in clear and accessible language. Members were encouraged to remain mindful of this throughout the meeting.
1.4. The Chair recognised the challenging operating environment across the NHS and acknowledged the sustained efforts of staff in delivering care under pressure. The Chair emphasised the importance of constructive scrutiny, identifying opportunities for improvement, and ensuring that the Board was clear on how progress and improvement would be measured.
Apologies
1.5. No apologies for absence were received.
Declarations of interest (BM/26/07(Pu))
1.6. No declarations of interest were made over and 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/26/08(Pu))
1.7. The minutes from the public Board meeting held on 5 February 2026 were approved as a correct record.
2. Board Committee updates (BM/26/09Pu))
2.1. The Chair invited updates from Board committee chairs and executive leads, noting that more detailed reporting had been requested to enhance transparency of committee discussions.
People Committee updates – 11 February
2.2. Louise Ansari, Non‑Executive Director and Chair of the People Committee, reported that the Committee had continued to oversee NHS England’s voluntary redundancy programme, receiving regular updates to ensure that staff were supported appropriately throughout the process. The Committee noted that a significant number of staff were leaving NHS England in the coming weeks and months and recorded thanks for their service. The focus was on ensuring that risks to organisational capacity were identified and mitigated, with a continued focus on the retention of critical skills and capabilities and appropriate escalation where required.
2.3. An update had been reported on the Improving NHS England Together Programme. Linking to this Programme and staff changes, consideration was given to leadership, talent management, and succession, including the need to sustain engagement and capability at senior and sub‑executive levels during a period of organisational change.
2.4. The Committee had also reviewed evidence on statutory and mandatory training and noted that further work was underway to ensure training requirements were proportionate and demonstrably effective.
Strategy Committee – 12 February
2.5. David Bennett, NED and Chair of the Strategy Committee, reported that the Committee’s work continued to focus on 4 core areas:
- Overseeing a defined portfolio of strategy and policy projects to ensure appropriate governance and scrutiny in advance of Board consideration.
- Progressing work on a standardised model for strategy and policy development, aimed at improving consistency, coordination, prioritisation, and use of resources across NHS England.
- Developing an overarching analytical framework to support delivery of the 10 Year Health Plan (10YHP), including clearer articulation of intended outcomes and their financial, workforce, and operational implications.
- Ongoing detailed review of selected priority projects within its oversight remit.
Research, Innovation and Growth Board – 3 March
2.6. Penny Dash, NHS England Chair, reported on the establishment of the Research, Innovation and Growth Board as a new Board sub‑committee, which she would Chair. The Board had been created to strengthen alignment with the life sciences sector delivery plan and to provide oversight of NHS England’s contribution to research, innovation, and commercial growth. It was noted that the Board would receive regular updates from the NHS Genomics Programme going forward.
2.7. The first meeting had focused on agreeing terms of reference, membership, and accountabilities. The Board had discussed barriers to adoption of innovation within the NHS, particularly in relation to medical technologies, and the role of modern service frameworks in supporting consistent and value‑based adoption.
Data, Digital and Technology Committee – 12 March
2.8. Mark Bailie, NED and Chair of the Data, Digital and Technology Committee reported that recent discussions had focused on cyber resilience and delivery of digital transformation. Continued progress on the national resilience programme and on preparedness for cyber incidents was noted, including work to test national response arrangements. Concerns were raised regarding the impact of voluntary redundancy on specialist capacity within technology, digital and data teams, and work was underway to review resourcing and prioritisation.
2.9. The Committee also reviewed progress on translating 10YHP ambitions into deliverable digital programmes, noting the need for clear prioritisation, stronger alignment with operational services, and resolution of leadership arrangements.
Audit and Risk Assurance Committee – 19 March (Verbal)
2.10. Jeremy Townsend, Non-Executive Director (NED) and Chair of the Audit and Risk Assurance Committee (ARAC) reported on reported on a joint meeting with the Department of Health and Social Care’s (DHSC’s) Audit and Risk Committee, which had focused on transition risks and the potential impact of legislative timing. The Committee discussed the need for contingency planning should transition dates change, which was not currently considered likely, as well as risks associated with Day 1 readiness if transition proceeded as planned. Work was underway to identify and mitigate these risks.
2.11. The Committee reviewed cyber resilience and the potential for a more challenging control environment during organisational transition, particularly in the context of workforce change. The Committee also discussed ongoing work to review the cost and proportionality of audit arrangements across the NHS.
Finance and Performance Committee – 20 March (Verbal)
2.12. Andrew Morris, Deputy Chair and Chair of the Finance and Performance Committee reported that the Committee had reviewed the month ten financial position and the planning round.
2.13. The Committee noted that the financial reset remained on track, with a significant proportion of systems and providers forecasting delivery against plan. Progress on efficiency delivery was recognised, including reductions in agency and bank staffing.
2.14. Performance challenges were considered, including declining life expectancy trends, variation in maternity outcomes, and workforce metrics.
2.15. The Board emphasised the need for clearer metrics and stronger alignment between performance, strategy, and financial planning. The Board agreed that upcoming agendas will start with performance topics, then shift to strategy. This approach sets the current context before evaluating whether planning and strategic development will help resolve ongoing challenges.
ACTION: Secretariat
NHS England Quality Committee and National Quality Board (NQB) – 25 March (Verbal)
2.16. Professor Sir Robert Lechler, NED and Chair of the Quality Committee updated on the recent meeting. This marked the final standalone meeting of the Quality Committee, ahead of closer integration with the National Quality Board to reduce duplication while maintaining Board assurance.
2.17. It was reported that NQB had reviewed the near final draft of the quality strategy, which was to proceed to ministerial consideration. Members discussed modern service frameworks, including early work on sepsis, and noted the emphasis on safety, effectiveness, and patient experience.
2.18. The NQB and the NHS England Quality Committee also discussed quality risks and accountability arrangements, and considered the regulation of neighbourhood health services, noting that further work would be required.
3. Chief Executive Officer update (verbal)
3.1. The CEO provided an update on key areas of activity since the previous meeting, noting the pace and volume of work underway as the organisation approached the year end while also preparing for the next financial year and the medium-term planning horizon.
3.2. The Board was advised that discussions on industrial action with resident doctors had been extensive and conducted in good faith, but had not resulted in agreement. The CEO described the outcome as extremely disappointing and noted that planning was now required on the basis of a prolonged period of dispute, emphasising the need to establish a sustainable operating rhythm alongside business as usual.
3.3. The Board noted that these challenges coincided with the need to close the year strongly while setting plans for the year ahead. Notwithstanding this, it was reported that the NHS remained within reach of a number of key delivery metrics, with recent elective data showing continued progress.
3.4. The Board was also updated on work underway to transition to a revised approach for supporting challenged providers, as announced by the Secretary of State for Health and Social Care. This was being actively worked through, recognising the need to ensure appropriate oversight, support, and clarity as the operating and governance context continued to evolve.
3.5. The CEO highlighted the latest British Social Attitudes Survey results, noting an improvement in public perceptions of the NHS, while emphasising the need for continued improvement in access, quality, and experience to sustain public confidence.
3.6. The Board noted the ongoing impact of organisational change across NHS England and integrated care boards, including the number of colleagues leaving the organisation. The CEO thanked staff for their professionalism and commitment during a prolonged period of change, with particular recognition given to those affected by the voluntary redundancy process.
3.7. The CEO reflected on the recent meningitis B incident, acknowledging its tragic impact and advising that the system response had been swift and effective despite the complexity involved. Thanks were extended to emergency preparedness, resilience and response colleagues, NHS staff, and partner organisations.
3.8. The Board noted the update and recorded its thanks to colleagues across the NHS for maintaining delivery, resilience, and patient care during a period of sustained challenge and transition.
4. Chief Executive Officer update (verbal)
Integrated Performance report
4.1. The Board received the Integrated Performance Report, reflecting performance for February and emerging end‑of‑year considerations. In introducing the report, the Interim Director General for Performance and Delivery acknowledged the sustained effort of colleagues across the NHS as year end approached, alongside the pressures of organisational transition
4.2. The Board noted some areas of continued improvement, such as in outcomes for adults with autism or a learning disability in inpatient settings, reducing out‑of‑area placements for mental health patients, increasing face‑to‑face crisis care contacts, small but consistent improvements in screening performance.
4.3. A discussion took place on ongoing challenges across performance and delivery, for example sub-optimal and variable performance in the quality of care for people with long term conditions, variation in maternity care, delivery of the MMR vaccination programme for children (which remains off track) and declining life expectancy.
4.4. It was agreed that a dedicated deep dive into declining life expectancy, supported by external partners, should be undertaken to strengthen understanding of the drivers and potential interventions. Members emphasised the need to align this work with the quality strategy, which already addressed several related themes. The discussion acknowledged the critical role of primary prevention (responsibility for which largely sits outside of the NHS) and secondary prevention – very much a responsibility for the NHS and a key driver of future improvement. The Board highlighted the need to improve how the system manages and supports people living with ill health and long term conditions.
ACTION: PDi, MP/CF
4.5. Members noted the continued opportunity presented by blood pressure checks and stressed the importance of maintaining momentum, including alignment with the development of neighbourhood health centres.
4.6. The Board discussed whether performance reporting should better capture outcomes and quality‑of‑life impacts, and whether existing metrics sufficiently reflected what mattered most to patients and the most impactful use of resources. The Board requested expansion of the data presented to include clearer links between life expectancy, deprivation, and inequality, including comparative analysis between the most and least deprived populations. While recognising that not all factors were within the NHS’s control, members agreed it was important to understand what could be influenced, including learning from national and international comparators.
ACTION: GB/MP, PDo
4.7. In response to questions on mortality indicators, the Board was assured that Summary Hospital‑level Mortality Indicator data had been reviewed with Regional Medical Directors and that trusts with elevated indicators had appropriate governance, reporting, and targeted quality improvement arrangements in place.
4.8. The Board noted rising urgent and emergency care (UEC) attendances alongside improvement against the 4‑hour standard. Variation in twelve‑hour waits was discussed, particularly the stability of the lowest‑performing providers and the adequacy of support arrangements, and was identified as an area requiring active monitoring. On planned care, waiting lists were reported to be falling compared with the previous month and the same period last year, with progress on long waits and some improvement in cancer performance.
4.9. The Board agreed that clearer presentation of variation, and a more explicit narrative on how it was being addressed, was required across UEC, planned care, and quality metrics to support targeted action.
ACTION: GB/MP, PDo
4.10. On staff engagement and experience, the Board noted limited but concerning indicators, with deterioration reported across several measures, including staff engagement and raising concerns. Members reflected on these findings alongside patient experience and public attitude survey results, and requested a review of how experience was reported, with greater emphasis on communication and ease of navigating the NHS.
ACTION: GB/MP, PDo
4.11. Finally, members noted that Andy Haldane had been invited to attend the next Board meeting. It was agreed that productivity metrics should be incorporated more explicitly into the Integrated Performance Report to strengthen the link between performance, delivery, and financial sustainability, including clearer provider level read across with the finance report.
ACTION: EOM, GB/MP, PDo
Month 9 Financial Position 2025/26
4.12. The DG, Finance reported that at month 10 the NHS was on track to achieve financial balance, although fifteen systems were forecasting positions off plan. The Board noted that formal board assurance statements had been received for each of these systems, with recovery actions agreed at system board level and supported by analysis of the underlying drivers.
4.13. The Board emphasised the importance of maintaining the current financial run rate through year end and into 2026/27, noting that continued discipline and grip would be critical amid wider operational and organisational pressures.
4.14. Members discussed that deficit support funding was being redistributed to providers that had delivered against agreed expectations. Members considered whether this approach was driving the right incentives and behaviours, and the Executive confirmed that this remained under active review as part of year end and forward planning.
4.15. In discussion on future reporting, the Board agreed that further work was required to strengthen understanding of how financial delivery associated with the “left shift” into primary and community services would be monitored. This included clearer alignment between financial reporting, outcome measures, and emerging oversight and regulatory arrangements for neighbourhood healthcare providers.
ACTION: EOM
4.16. Members highlighted the significant reduction in variation in financial delivery during the year, supported by NHS England intervention and oversight. Members agreed that learning from high‑performing systems should be actively used as exemplars, particularly as delivery expectations increased in the coming year.
4.17. The Board noted that these messages had been reinforced at the recent Chief Financial Officer event, with a strong emphasis on integrated delivery across finance, performance, and operational leadership.
5. Annual Emergency Preparedness, Resilience and Response (EPRR) Assurance Report (BM/26/11(Pu))
5.1. The National Priority Programme Director for UEC provided an overview of the annual EPRR assurance report. The Board noted that the principal risk from an EPRR perspective continued to be a pandemic, with Exercise Pegasus providing important learning and assurance. Cyber risk was highlighted as the next most significant risk, particularly in relation to the duration of outages and the system’s ability to sustain services over prolonged incidents. It was noted that strengthening resilience to extended incidents had been a key focus during the year, in direct response to Board feedback.
5.2. Members discussed whether preparedness extended sufficiently beyond the health and care system into wider societal resilience. It was noted that work was ongoing with the DHSC, wider government, and partners, and that NHS England’s role in preparedness and response would vary depending on the nature of the risk.
5.3. The Board requested that a specific future agenda item be scheduled on Covid Inquiry Module 3, explicitly linking this with the learning from Exercise Pegasus. Members agreed that this should focus on how learning from both processes informed current and future EPRR arrangements and system resilience.
ACTION: SJM
6. Directions and/or Mandatory requests issued to NHS England (BM/26/12(Pu))
6.1. The Board noted the following Directions which had been issued to NHS England:
- Delegation of NHS England Direct Commissioning Functions – Evaluation and Monitoring of Services Directions 2026
and - GPES Data for Consented Research Directions 2026.
7. Public Q&A
7.1. The Board received questions from members of the public in advance of the meeting with responses provided by Executive leads.
7.2. Question 1: How does NHS England assure itself that its oversight arrangements can distinguish isolated clinical error from potential executive level concealment where trust leadership has acknowledged systemic complaints failures but denied Duty of Candour breaches in cases of admitted negligence, and what routes exist for patients to escalate concerns involving alleged misconduct by senior trust leaders beyond internal processes?
7.3. Response: The National Medical Director – Secondary Care responded that concerns about the conduct of chief executives should be raised with the Chair in the first instance. If patients are not happy with a trust response to a complaint, they can escalate the complaint to the Health Service Ombudsman. Concerns about alleged criminal behaviour should be reported to the Police whilst concerns about potential provider breaches of Regulation 20 (Duty of Candour) should be raised with the CQC, the regulator of health and care providers.
7.4. It is not NHS England’s role to investigate individual patient complaints. Nor is it our role to generally investigate concerns about individual trust board members, but where such concerns are raised with NHS England, we will consider whether they indicate broader governance concerns about how the trust is run by its board.
7.5. NHS England can and does use proportionate assurance reviews, provider‑licence oversight, Fit and Proper Persons scrutiny, and, where appropriate, independent external reviews to understand whether concerns indicate isolated error or potential leadership‑level concealment.
7.6. The Board asked that detail on how complaints and concerns should be raised is made clear on NHS England’s website, including clarification of whistleblowing and speaking up arrangements.
ACTION: RC, Tom Grimes
7.7. Question 2: We received several questions about prescribing liothyronine, mainly focused on these 2 points:
- How will NHS England resolve the misalignment between its liothyronine policies and ensure that guidance is both clinically coherent and consistently implemented by all ICBs?
- What steps will NHS England take to address persistent ICB non compliance and ensure patients receive equitable access to liothyronine where it is clinically indicated?
7.8. Response: The National Medical Director – Primary Care advised that liothyronine was a medication used in a limited number of thyroid conditions. NHS England had established policy guidance and prescribing advice on liothyronine, which reflected National Institute for Health and Care Excellence recommendations and the available clinical evidence.
7.9. It was noted that the guidance did not recommend routine prescribing of liothyronine on the basis that it was neither clinically nor cost effective. However, the policy set out specific exceptions where prescribing could be an appropriate clinical consideration. The policy position was kept under regular review with clinical leads, who continued to advise that the evidence base remained unchanged and that the current policy should continue.
7.10. NHS England expected commissioners and prescribers to act with due regard to the national guidance. As part of the new operating model, regions would have oversight of commissioner and provider performance, including ensuring access to high quality care and addressing health inequalities.
7.11. Question 3: Doctors have a professional duty under General Medical Council (GMC) guidance to refer patients to specialist care where this is in the patient’s best interests. The forthcoming General Practice contract introduces additional requirements prior to referral. Can the Board confirm whether NHS England has formally engaged with the GMC on how these contractual requirements interact with that professional duty, and whether any joint risk assessment or patient safety review has been undertaken to ensure GPs are not placed in conflict between their contractual and professional obligations?
7.12. Response: The National Director for Primary Care and Community Services advised that a general practitioner’s clinical decision to refer a patient was unchanged under the new General Practice contract, which came into effect on 1 April 2026. Nothing in the contract altered a GP’s professional duty to act in the best interests of their patient, and there were no new contractual barriers to referral.
7.13. It was confirmed that GPs could refer patients in the same way as previously, and that suggestions of additional hurdles to referral were incorrect. The contractual changes related to how referrals were managed within secondary care, including expanded advice and guidance arrangements, rather than to GP obligations. These arrangements were intended to support faster consultant‑led decision‑making and clearer next steps for patients.
7.14. No formal engagement had taken place with the GMC on the contract, as the GMC was not involved in contractual matters and acted as a professional regulator. It was confirmed that there was no conflict between the contractual requirements and GPs’ professional duties.
7.15. Question 4: We received a couple of questions relating to Trusts operating without compliant single sex staff facilities and maintaining policies that are suggested to be inconsistent with the Equality Act 2010, citing tribunal findings, requests for policy review in 2025, and evidence of patient and staff safety risks. Can the Board explain what action NHS England has taken to ensure legal compliance across Trusts, why previous requests to review relevant policies were declined, and how it is assuring itself that staff and patient safety is not being compromised?
7.16. Response: The Chief Nursing Officer responded that the 2 questions received cover the linked but separate issues of single sex facilities for staff and same sex accommodation for patients.
7.17. In relation to staff facilities, which was the issue under consideration in the recent employment tribunal involving County Durham and Darlington NHS Foundation Trust, NHS England does not issue guidance for the system on this. It is for local organisations to design their own policies based on the relevant legislation.
7.18. In terms of patient accommodation, NHS England does provide national guidance to support delivery of this NHS Constitution pledge. As outlined at the last Board meeting, NHS England has been reviewing this, and all relevant policies and procedures, to ensure that they are aligned with the Supreme Court ruling.
7.19. However, it is important that the Equality and Human Rights Commission’s (EHRC) updated Code of Practice for services, public functions and associations, which sets out the legal framework for how services are delivered in line with the Equality Act, is available before final decisions about national policies are taken.
7.20. The updated Code of Practice will be published shortly, subject to Parliamentary approval and updated guidance for the NHS will be available following this. We are in ongoing discussions with Ministers in DHSC to ensure that NHS organisations have a clear national steer on these issues as soon as possible.
7.21. Question 5: Phase 1 of the NHS Core List, launched in February 2026, introduced nationally agreed pricing frameworks to drive uptake and savings through NHS Supply Chain. Can the Board set out how learning from Phase 1 will inform the prioritisation and design of future Core List categories, including the role that ease of implementation will play, how suppliers can propose existing framework products with significant recurrent savings for inclusion, and how NHS England assures that cost driven product choices, including those used for pre operative skin preparation, continue to meet appropriate regulatory, licensing, and patient safety standards?
7.22. Response: The Interim DG, Commercial and Growth outlined how learning from Phase 1 of the NHS Core List, launched in February 2026, was being used to inform future development. Feedback had been gathered from internal and external stakeholders, and the programme was being refreshed to ensure it was underpinned by robust processes and clear timescales. This was intended to support safe scaling and expansion of the Core List while managing risk and delivering value.
7.23. It was explained that future prioritisation would focus on product categories offering opportunities to rationalise product range, reduce unwarranted variation, and deliver value where there were low barriers to implementation. The approach would be developed with clinical colleagues, NHS partners, and suppliers, and NHS England would continue to improve market engagement, including work towards a clearer single entry point for suppliers.
7.24. In response to questions on patient safety and regulatory compliance, it was confirmed that products used for pre‑operative skin preparation containing active antiseptic ingredients were classified as medical products and were required to hold appropriate Medicines and Healthcare products Regulatory Agency (MHRA) authorisation. NHS England worked in line with joint statements issued with the Royal College of Surgeons and the MHRA on the licensed use of such products.
7.25. System‑level assurance was provided through the NHS Standard Contract, national infection prevention standards, clinical guidance, and procurement frameworks, all of which required NHS trusts to use products that were safe, clinically appropriate, and compliant with regulatory requirements.
7.26. The Board requested an update on procurement and supply chains at a future meeting, and to agree how we feed this into future performance reports.
ACTION: FB, GB/MP, PDo, EOM
8. Any other business
8.1. There was no other business.
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