How we support our most challenged NHS trusts and foundation trusts (‘providers’) to improve is changing to align with the NHS’s new operating model.

Introduction

The National Provider Improvement Programme (NPIP) is NHS England’s new mandated intensive improvement offer for the most challenged NHS providers.

A combination of being allocated to NHS Oversight Framework (NOF) segment 4 and receiving a ‘red’ provider capability score will identify a provider as being among the most challenged. These organisations will receive the NPIP support offer.

Further interventions, including withholding of very senior manager annual pay awards and use of NHS England’s enforcement powers, will form part of a suite of measures available to NHS England to drive rapid improvement.

Purpose

The NPIP will determine whether these providers have the conditions in place to deliver sustainable improvement, supported by a deliverable integrated improvement plan.

Scope

Based on evidence and experience of supporting challenged organisations, these conditions are:

• an effective board and organisational leadership
• effective and insightful governance arrangements
• engaged staff
• a shared approach to, and capability for, improvement

As well as this, the NPIP will identify any systemic, strategic and structural barriers that could be impacting a provider’s ability to improve – recognising that, for some organisations, the delivery of key standards or regulatory requirements may continue to be challenged, without further, bespoke intervention.

Providers with single issue operational challenges (for example, in urgent and emergency or elective care) may also be in receipt of targeted support via the Getting It Right First Time (GIRFT) programme.

Process

Over 6-9 months, providers will progress through 5 structured phases: mobilise, assess, plan, support, transition.

The NPIP will enable the most challenged providers to deliver sustainable improvement in 3 key ways:

• Collating and synthesising what is already known about a provider’s performance and capability – to ensure improvement activity always builds on and harnesses insights from existing diagnoses.
• Assessing the underlying conditions for high quality, safe, sustainable and efficient care, rather than the symptoms of poor performance – as set out in existing best practice guidance and policy.
• Ensuring the provider has an integrated improvement plan that is fit for purpose, underpinned by a delivery plan, supporting the provider to secure the right expert support from the right partner, where required.

Recovery Support Programme

Please note: the Recovery Support Programme (RSP) has now been retired.

The following providers who were previously in the RSP will continue to receive support to deliver their RSP exit criteria until March 2026.

At this point, regional and national review of progress will determine whether the ongoing needs of these providers should be supported through transition to the NPIP.