Hundreds of thousands of patients to get faster access to NHS care as targets halved under new guidance

The NHS will focus on delivering faster treatment for hundreds of thousands of patients – including for planned surgeries and emergency care – as the number of national targets is almost halved under new guidance to reform services.

Published today, NHS England's planning guidance for the next financial year sees a significant streamlining of priorities and success measures – from 32 in 2024/25 down to 18 in 2025/26 – to focus on what matters most to patients and reduce waiting times.

The NHS has set out a new national ambition for 65% of patients to receive elective treatment within 18 weeks by March 2026, with every trust asked to deliver at least a 5% improvement on their performance this year. Based on current levels of demand, the guidance sets out how NHS services will aim to see nearly 450,000 more patients treated within 18 weeks next year.

With staff diagnosing and treating more people with cancer than ever before, NHS England has also confirmed new national ambitions to speed up diagnosis for patients.

Under the guidance, around 100,000 more people referred for urgent cancer checks will get a diagnosis or the all-clear within four weeks next year.

The plans also signal that improving access to mental health care for patients will be a key priority for the NHS next year, with all local systems expected to meet the Mental Health Investment Standard in 2025/26, so the share of NHS resources going to mental health increases in every part of the country.

The reduction in targets will empower local health leaders to improve care for their patients, helping deliver on the government's commitment to rebuild the health service through its Plan for Change.

NHS England will give local systems greater spending flexibility to use funding to meet the needs of their patients, and the plans for reform will see local areas required to make tough decisions to meet the needs of their populations, including where this means reducing or stopping lower value activity. 

While in the first seven months of this year the acute sector improved productivity by over 2% – double the improvement rate pre-pandemic and the NHS is on track this year to surpass the £7 billion of efficiencies delivered in 2023/24 – all systems have been asked to make further progress, delivering a 4% overall improvement in productivity and reducing their cost base by at least 1%.

Setting out the plan, NHS chief executive Amanda Pritchard said the health service must have a “relentless focus” on driving efficiencies for the taxpayer, including reducing agency spend – with all local systems expected to deliver at least a 30% reduction in agency spending (based on current spending) next year, equivalent to around £650 million to invest in the frontline.

The work of NHS England, which leads the health service, will also reflect the streamlined priorities, and over the coming months programme resources will be reprioritised, and action will be taken to achieve £325 million in savings. This will include reducing the organisational structure by 15% to redirect resources to support the frontline over the coming year.

The additional reduction follows the recent merger with Health Education England and NHS Digital, making the organisation almost 35% smaller than its predecessors and generated nearly £500million of savings, which have been reinvested in patient care.

Amanda Pritchard, NHS chief executive, said: “Thanks to the incredible work of our staff, the NHS is providing more appointments, tests and treatment than ever before, helping to cut long waits – but we know there is much more to do.

“The NHS must go further and faster to improve and reform care, and today's guidance aims to deliver more timely treatment for hundreds of thousands of patients. In what will undoubtedly be another tough financial year, the NHS will continue its relentless focus on boosting productivity and driving efficiencies for the benefit of patients and taxpayers.

“Our main focus will always be on supporting frontline teams to deliver what matters most to patients – so it is also right that we prioritise and streamline the work of NHS England to ensure we maximise frontline resources. Together with Government, we have also honed down national priorities, allowing local leaders maximum flexibility to plan better and more efficient services for their population.”

The guidance follows the publication of the Government's new Mandate for reform of the NHS, which sets out five core objectives for the health service to deliver, including cutting waiting times, improving access to primary care and improving urgent and emergency care.

In a written statement to Parliament published this morning, Health and Social Care Secretary Wes Streeting says he is giving local health leaders the tools to get on with the business of reforming the NHS, while emphasising the importance of the NHS living within its means.

Following a record Budget settlement for the NHS, the Secretary of State has set out that every penny of investment must come with reform and deliver better outcomes for patients.

Wes Streeting, Health and Social Care Secretary, said: “If everything is a priority, then nothing is. I want to empower NHS leaders to deliver the innovation and reform required to fix the NHS, rather than overload them with targets which have failed to deliver better outcomes for patients.

“This new approach will see the NHS focus on what matters most to patients – cutting waiting lists, getting seen promptly at A&E, and being able to get a GP appointment.

“We've provided significant extra investment and given clear directions to trusts on what we expect, so there is no excuse for failure. We will reward high performance and drive up standards as we deliver on our Plan for Change and build a health service fit for the future.”

The plans come amid record demand on NHS services this year – with worrying levels of flu and high bed occupancy in hospitals this winter – and significant challenges facing the health service in meeting the growing needs of an ageing population, as set out by the independent Darzi investigation.

Hard-working staff have delivered the new Faster Diagnosis Standard for cancer in November for the eighth month out of the last ten, and NHS England today confirmed that the performance standard would be increased so that 80% of patients receive a diagnosis or have cancer ruled out within four weeks by March 2026. This change will see around 100,000 patients more patients who are referred for cancer checks receive a diagnosis or the all-clear within four weeks next year.

As part of NHS and government plans to shift healthcare from analogue to digital, the health service has asked local areas and providers to make full use of digital tools to revolutionise access to care for patients, ensuring at least 70% of elective appointments are available to manage at the touch of a button on the NHS App this year – helping give patients more choice and control over their care.

The planning guidance and Mandate today set out the immediate priorities for the health service next year, while the NHS and government develop a new 10 Year Health Plan to build an NHS fit for the future, due to be published in the Summer.

As NHS staff continue to contend with record demand for care, NHS England has asked all local systems and providers to develop Neighbourhood Health Service models next year with an immediate focus on preventing long admissions to hospital and improving access to urgent and emergency care.

This drive will include scaling up local initiatives in the best performing areas to improve A&E and ambulance services, including increasing the proportion of patients seen, treated and discharged in one day or less, and implementing joint working arrangements to ensure no ambulance handover is longer than 45 minutes.

The guidance also sets out three national targets on mental health, including to reduce the average length of stay in adult acute mental health beds, increase the number of children and young people accessing services, and reduce the number of people with a learning disability or autistic people needing mental health inpatient care.

NHS England has also asked all local areas to have action plans in place by June 2025 to improve GP contract oversight, commissioning and transformation for general practice, while reducing variation – as well as to commission additional urgent dental appointments to ensure all local systems deliver their share of the government's commitment to 700k more appointments.