NHS Oversight Framework

The NHS oversight framework replaces the NHS system oversight framework for 2021/22, which described NHS England’s approach to oversight of integrated care boards (ICBs) and trusts.

This framework outlines NHS England’s approach to NHS oversight and is aligned with the ambitions set out in the NHS Long Term Plan and the NHS operational planning and contracting guidance. It also reflects the significant changes enabled by the Health and Care Act 2022 including the formal establishment of integrated care boards and the merging of NHS Improvement (comprising of Monitor and the NHS Trust Development Authority) into NHS England.

The framework describes how the oversight of NHS trusts, foundation trusts and integrated care boards will operate. This supports our ambition for system-led delivery of integrated care in line with the direction of travel set out in the NHS Long Term Plan, Integrating care: next steps to building strong and effective integrated care systems across England and the government’s white paper on integration – Joining up care for people, places and populations.

Oversight metrics

A set of oversight metrics has been published, applicable to integrated care boards, NHS trusts and foundation trusts, to support implementation of the framework. These will be used to indicate potential issues and prompt further investigation of support needs and align with the five national themes of the NHS oversight Framework: quality of care, access and outcomes; preventing ill health and reducing inequalities; people; finance and use of resources; and leadership and capability.

Annual assessment of integrated care boards (ICBs): supporting guidance

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.

This guidance has been developed together with ICBs and it sets out the areas that annual assessments will cover as well as information on timing and process. It should be read in conjunction with other key planning and oversight documents including the NHS Long Term Plan, the NHS Oversight Framework and the priorities and operational planning guidance.