Terms of reference
1. The Committee approved the Terms of Reference, subject to minor corrections to the membership and noting the Committee’s main purpose to review and oversee system performance across access, workforce and finance domains to identify where improvements need to be focused.
Chief executive and chief financial officer update
2. Updates were provided on the issue of Planning Instructions on 20 October and financial approach for the year ahead.
3. Members discussed the importance of strengthening financial accountability and aligning resources with strategic priorities, including improving productivity and supporting care closer to home.
2026/27 planning process – spending review and allocations
4. The Committee reviewed the approach to ICB allocations and deficit support funding, noting the challenging settlement and associated risks.
5. Members supported using the process to identify structural issues and ensure equity, while maintaining formula-based allocations for deprivation and inequality.
6. The Committee discussed intergenerational equity, the ‘left shift’ towards prevention and community care, and alignment with strategic ambitions.
7. Support was confirmed for the proposed allocation approach, with emphasis on transparency and engagement with the Board and HM Treasury.
Proposals for the 2026/27 Payment Scheme
8. The Committee approved proposed changes to the Payment Scheme designed to incentivise timely patient management and support system efficiency.
9. Members noted work underway to ensure payment models reflect activity and encourage best practice. The Committee approved proposed changes to the Payment Scheme.
Deconstructing block payments
1The Committee reviewed proposals to move away from block payment arrangements as part of a broader programme to improve financial discipline and service alignment.
11. Members emphasised the need for clarity on service delivery impacts and visibility of contract changes at local and aggregate levels.
Capital planning and allocations approach
12. The Committee discussed the approach to capital allocations, noting alignment with long-term planning objectives and the importance of managing estates risks.
13. It was agreed that the capital position would inform the forthcoming NHS Estates update to the Board.
Performance and delivery
14. Mid-year reviews were being implemented [now complete] in regions to consider delivery and risk profiles and bolster local action and support.
15. Operational performance was reviewed, including urgent and emergency care performance, elective recovery and winter preparedness.
16. Members emphasised the need for metrics that reflect transformation ambitions and progress towards care in community settings.
Any other business
17. The Committee agreed to strengthen links between performance and risk reporting and encouraged continued engagement with Non-Executive Directors on programme development.