Executive summary and action required
This paper is for the Board’s information only to provide an overview of the NHS Vaccination and Screening Directions 2026 (Directions) issued to NHS England in March 2026 by the Secretary of State for Health and Social Care (SoS) and the accompanying Requirements Specification relating to Cancer Screening Services. These Directions have been issued under section 254 of the Health and Social Care Act 2012 (2012 Act) and section 13ZC and 272(7) and (8) of the National Health Service Act 2006 (the 2006 Act).
The purpose of the Directions, which operate as framework directions, is to enable NHS England to collect and analyse data as set out in separate Requirements Specifications, to develop, commission and evaluate vaccination and screening programmes in England. This forms part of its obligations in exercising the Secretary of State’s public health functions under section 7A of the 2006 Act.
The Board is asked to note the new Directions, the accompanying Requirements Specification relating to the analysis of data relating to Cancer Screening Services and the information provided in this Paper regarding the purpose, effect, and requirements of the Directions.
Background
1. Under section 254 of the 2012 Act, the SoS may direct NHS England to establish and operate a system for the collection or analysis of information. These are functions exercisable in relation to the development or operation of information systems in connection with the provision of health services or of adult social care in England. Under section 13ZC of the 2006 Act, the SoS may give NHS England directions as to the exercise of any of its functions. The Directions are issued by the SoS to NHS England under these provisions.
Purpose of the Directions
2. The purpose of the Directions (Purpose) is to enable NHS England to develop, commission and evaluate vaccination and screening programmes in England. This forms part of its obligations in exercising the Secretary of State’s public health functions, as set out in the NHS public health functions agreement established between the Department of Health and Social Care and NHS England, by virtue of section 7A of the 2006 Act (the section 7A Services).
3. The section 7A Services protect and drive improvements in population health and complement the work of wider public sector-commissioned health services. Vaccinations and screening data is required to inform the effective planning, delivery and ensuring efficiency of section 7A Services.
4. The Directions operate as framework directions. This means that they establish a broad Purpose for which data is to be collected and/or analysed and provide for separate requirements specifications to be put in place under the Directions over time to reflect specific systems of collection and/or analysis of data that NHS England may be directed to operate under the broad Purpose set out in the Directions. Each separate requirements specification will also be published alongside the Directions.
5. The first information system to be established under the new Directions is that for breast, bowel and cervical cancer screening services under the Cancer Screening Services Requirements Specification. Under the Directions and this Requirements Specification, NHS England is required by the SoS to undertake analysis of screening data it already processes for direct care purposes, for the following secondary use purposes:
- National statistics – producing KPI reports and annual bulletins for screening programmes.
- Health inequalities analysis – linking data with demographics (e.g. age, deprivation, ethnicity) to identify disparities in the provision of screening services.
- Capacity planning – analysing uptake and referral data to inform workforce and resource planning relating to screening programmes.
- Programme evaluation and policy development – assessing performance to inform improvements and future policy.
- Health research – supporting approved research activity.
Effect and requirements of the direction
6. From the date of signature of the Directions, NHS England will have a legal duty to comply with the Directions, which will require it:
- to establish and operate a system for the collection and analysis of information described in related Requirements Specifications. This will initially involve the establishment of a system to analyse data relating to breast, bowel and cervical cancer as set out in the Cancer Screening Services Requirements Specification;
- to analyse the information obtained as may be required by the SoS or as NHS England considers necessary to achieve the Purpose of the Directions. Analysis includes:
- analysis by reference or linkage to any other information described in a Requirements Specification;
- analysis for data quality purposes, including undertaking comparison and consistency analysis of the same or similar information obtained by complying with other directions;
- any other analysis as NHS England considers appropriate to maintain data quality, accuracy and consistency in relation to the information.
7. These functions are to be exercised in accordance with the Requirements Specifications issued under the Directions, including the Cancer Screening Services Requirements Specification published with the Directions in March 2026. Also, in accordance with the service levels, support and monitoring requirements, and the reporting and governance requirements notified by the SoS in writing to NHS England.
8. The exercise by NHS England of the functions set out in the Directions is also subject to the statutory guidance issued by the SoS to NHS England under section 274A of the 2012 Act: NHS England’s protection of patient data, 23 May 2023 which is guidance that NHS England has a duty to have regard to when discharging its functions under these Directions.
Approval of acceptance of Directions and publication
9. The National Medical Director as Caldicott Guardian and the Director of Privacy and Information Governance approved acceptance of the Directions on behalf of the Accounting Officer as set out in the NHS England Scheme of Delegation.
10. The Directions and the Cancer Screening Services Requirements Specification have been published on the NHS England website, the link to which is in the Annex to this Paper.