The new framework describes a consistent and transparent approach to assessing integrated care boards (ICBs) and NHS trusts and foundation trusts, ensuring public accountability for performance and providing a foundation for how NHS England works with systems and providers to support improvement.

This 1-year framework sets out how NHS England will assess providers and ICBs, alongside a range of agreed metrics, promoting improvement while helping us identify quickly where organisations need support.

The framework is supported by a focused set of national priorities, including those set out in the Planning guidance for 2025/26, aiming to strengthen local autonomy. These are presented alongside wider contextual metrics that reflect medium-term goals in areas such as inequalities and outcomes.

Our assessment will be the starting point for how we work with organisations throughout the year and will help us determine how we can support them to improve. We will do this by considering an organisation’s segment score, as set out in this framework, and leadership capability.

The framework will be reviewed in 2026/27 to incorporate work to implement the ICB operating model and to take account of the ambitions and priorities in the 10 Year Health Plan.

• NHS Oversight Framework 2025/26

Methodology, latest segmentation and scoring results

The NHS Oversight Framework sets out how NHS trusts and foundation trusts are automatically allocated to a segment (1 to 4) based on performance, with full details set out in the methodology manual. A dashboard and downloadable file with segmentation results, supporting data, and league table comparisons will be published shortly.

The framework sets out how the Recovery Support Programme will be replaced by the Provider Improvement Programme with the most challenged organisations placed into a new segment 5.

Performance improvement

We will use segmentation and our assessment of capability to determine how we will support providers to improve. We plan to finalise our approach to the assessment of provider capability and issue guidance during Q2.

NHS England will align our targeted improvement support offer to organisational delivery scores. Regional teams will coordinate the response to segmentation working with NHS England national teams and wider system partners.

Where performance falls below an acceptable standard and/or has governance concerns that may lead NHS England to step in and use our regulatory powers to secure improvement.

Annual assessment of integrated care boards (ICBs)

Under the terms of the NHS Act 2006 (as amended by the Health and Care Act 2022), NHS England is required to undertake an annual assessment of each ICB in respect of each financial year and publish a summary of these assessments.

Further information can be found here: NHS England » Annual assessment of integrated care boards (ICBs)