Segmentation results
These are the first set of segmentation results published under NHS England’s revised 2026/27 NHS Oversight Framework. The 2026/27 framework uses updated metrics and methodology. Any comparison with segmentation results from 2025/26 must be considered in this context.
The average metric score for Q1 of 2026/27 was 2.35 points. This was higher than the average metric score in Q4 2025/26 of 2.30 but broadly similar to the score in Q1 of 2025/26, which was 2.34 points.
While the average score was similar to the same quarter last year, the range of results was narrower. Scores this quarter ranged from a best score of 1.53 points to a worst score of 3.13 points, a spread of 1.6 points. This compares with a spread of 1.96 points in Q1 of 2025/26, indicating there were fewer extreme outliers than last year.
Segment breakdown
2025/26 was the first year in which we applied a calculation to determine segmentation under the NHS Oversight Framework. Initial segmentation was arrived at by taking each trust’s average NOF metric score and using these to create four evenly sized groups (Highest scoring 25%, second highest scoring 25%, second lowest scoring 25% and lowest scoring 25%). Now as we have a full year of actual data from 2026/27, we have moved to a “threshold” based system in which segments are defined by comparing the trust’s average metric score to fixed reference points e.g. anyone with an average metric score below 1.94 will be in segment one. Full details of the threshold values for each segment and how these were arrived at can be found in our methodology manual.
This change has several major advantages:
- Organisations have a clear threshold to aim for to reach each segment.
- Material improvement can more easily be tracked and understood.
- Segments no longer have a pre-defined size limiting the number of organisations that can qualify for them.
Because the segmentation model has changed, comparisons with segmentation spread in 2025/26 must not be made without first recalculating results using the new threshold values. The table below shows the breakdown of segmentation for the current and historic quarters, using the 2026/27 threshold values to calculate segments.
| Q1 2025/26 | Q2 2025/26 | Q3 2025/26 | Q4 2025/26 | Q1 2026/27 | |
|---|---|---|---|---|---|
| Segment 1 | 16.59% | 19.02% | 16.10% | 20.00% | 13.86% |
| Segment 2 | 34.15% | 30.24% | 33.66% | 32.20% | 21.29% |
| Segment 3 | 32.68% | 34.15% | 30.24% | 34.63% | 53.96% |
| Segment 4 | 16.59% | 16.59% | 20.00% | 13.17% | 10.89% |
The Q1 2026/27 results are not precisely comparable with previous quarters because they are based on a revised set of metrics, but the trends should be noted. We are not seeing an increase in the size of segment 4, as might be expected between the end and the beginning of a performance year. This could indicate that organisations are maintaining higher baseline performance, in line with the ambitions of the NHS Oversight Framework.
Financial override
As in 2025/26, the revised NHS Oversight Framework continues to apply a financial override that stipulates that no organisation in financial deficit can be segmented higher than segment 3. The number of trusts classed as being in financial deficit continues to fall: from 119 to 108 trusts in Q4 2025/26 and from 108 to 99 trusts in Q1 2026/27. The financial override was applied for 21 of those 99 trusts, meaning those trusts would have been in a higher segment if they had not been in financial deficit. The override was applied to 38 trusts in Q4 2025/26.
Improvement and deterioration
Because of the changes to the metrics and methodology, it is not possible to identify improvement and deterioration from Q4 2025/26 accurately. From Q2 2026/27, we will provide a quarterly summary of significant performance changes compared with previous quarter.
All providers in the Intensive Recovery Programme are currently within segment 4 and all providers participating in the Advanced Foundation Trust programme are in segment 1 or segment 2.