NHS system oversight framework segmentation

NHS England and NHS Improvement recently consulted on the new NHS system oversight framework (SOF) 2021/22, which introduced a new approach to provide focused assistance to organisations and systems. Following feedback from local leaders and others, the new SOF is now being implemented.

To provide an overview of the level and nature of support required across systems and target support capacity as effectively as possible, NHS England and NHS Improvement have allocated trusts and systems to one of four segments. A segmentation decision indicates the scale and general nature of support needs, from no specific support needs (segment 1) to a requirement for mandated intensive support (segment 4).

For systems and trusts in segments 1 and 2, overall support needs will be formally reviewed on a quarterly basis by the relevant regional team (in the case of individual organisations this will happen in partnership with the integrated care system).

For trusts and systems in segment 3, NHS England and NHS Improvement regional teams will work collaboratively with them to undertake a diagnostic stocktake to identify the key drivers of the concerns that need to be resolved. Through this, we aim to better understand their support needs and agree improvement actions.

Those in segment 4 enter the new Recovery Support Programme (RSP). The RSP replaces the previous financial and quality special measures programmes and will provide a collaborative, system-focused approach for supporting those trusts and systems with the toughest challenges. Systems and trusts will get intensive support to use all their levers to address the often complex, historical problems they face, and embed lasting solutions.