NHS England operating framework

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This operating framework sets out how we will operate in the new structure created by the 2022 Health and Care Act.

The framework describes the roles that NHS England, integrated care boards (ICBs) and NHS providers will now play, working alongside our partners in the wider health and care system. It shows how accountabilities and responsibilities will be allocated to improve local health and care outcomes in a way that maximises taxpayer value for money.

The framework has been co-created with 300 system leaders, organisations and stakeholders, including Health Education England and NHS Digital.

The links below provide:

  • The NHS England Operating Framework
  • Letter to the health and care system from Mark Cubbon, NHS England Chief Delivery Officer

These publications can be made available in a number of alternative formats on request. Contact: enquiries@england.nhs.uk.




Accessible version.