This guidance sets out the finance business rules for integrated care boards (ICBs) and NHS trusts and foundation trusts (‘NHS trusts’) that will apply from 1 April 2026. The finance business rules include relevant statutory financial duties and other financial policy requirements set by NHS England and the Department of Health and Social Care (DHSC) that apply to ICBs and NHS trusts, as well as setting out how the impact of surpluses and deficits are managed in future years.