The updated framework for 2026/27 describes a consistent and transparent approach to assessing integrated care boards (ICBs), NHS trusts and foundation trusts (providers) This ensures public accountability for performance and provides a foundation for how NHS England works with systems and providers to support improvement.

This framework sets out how NHS England will assess and oversee providers and ICBs, against a range of agreed metrics, promoting improvement while helping us identify quickly where organisations need support, as well as those that are performing well.

The framework is supported by a focused set of national priorities, including those set out in the Medium Term Planning Framework, 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 those that may benefit from greater freedoms and those that need further support to improve. We will do this by considering an organisation’s segment as set out in this framework, and their leadership capability.

The framework will be reviewed for 2027/28 with a view to incorporating changes to the roles of NHS England, the Department of Health and Social Care and ICBs.

Accompanying documents

• NHS Oversight Framework 2026/27 – methodology manual
• NHS Oversight Framework – technical metric specification document