NHS England has published the board papers from its 27 March 2025 meeting: the first since the announcement that the organisation will be brought under the Department of Health and Social Care (DHSC). The papers highlight recent progress, ongoing operational pressures, and the financial realities facing the health service in 2025.

Headline takeaways:

• NHS productivity has improved year-on-year despite industrial action, with a 2.7% growth reported in acute care productivity.
• Elective care pressures remain high, with over 198,000 52-week waiters and 1.62 million patients on the diagnostic waiting list.
• Financial performance has stabilised, with the system forecast improving to a £604m overspend, down from £1.4bn last year.

Structural changes:

The papers include a forward from Amanda Pritchard setting out NHS England’s delivery record across cancer survival, diagnostics, genomics, and digital. However, it also outlines the impact of under investment, referencing:

• A £37 billion capital investment shortfall
• Fewer scanners, nurses, and doctors per capita than peer countries

Pritchard describes this as an“opportune moment” for NHS leadership and government to define the next phaseof transformation, building on lessons from the pandemic.

Innovation and access:

The papers also highlight the NHS’s role in driving innovation:

“The NHS has been at the forefront of therapeutic innovation… creating financial headroom to commission cost-effective advanced therapies, including personalised gene therapies.”

Operational and financial performance:

• A&E performance: 73.4% of patients admitted/discharged within four hours
• Electives: 58.9% seen within 18 weeks
• Cancer (Jan 2025):
   
  • 28-day faster diagnosis: 73.4%
   
  • 62-day treatment standard: 67.3%
 
• Diagnostics: 364,000 patients waited over     6 weeks
• Provider deficit forecast (2024/25): £787m (down from £1.3bn in 2023/24)
• Efficiency target: £9.3bn planned for 2024/25, with £8.7bn forecasted delivery

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Productivity and procurement:

• NHS acute productivity up 2.7% (YTD vs     YTD)
• Inputs grew 3.0%, while output rose 5.8%
• NHS England targets £1bn in medicines savings by 2029
• NHS Supply Chain projected to deliver up to £1bn in savings by 2030

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New performance framework

NHSE will replace the current Oversight Framework with a new Performance Assessment Framework for 2025/26,designed to:

• Increase clarity on success metrics
• Apply consistent ratings from Segment 1 (high-performing) to Segment 5 (intensive support)
• Offer greater autonomy to top performers and more structured intervention for struggling systems

The framework will undergo consultation in Q1 and is scheduled for formal implementation in July.

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Cancer Programme

• Early diagnosis up 2.8% since 2019 to 58.7% : the first increase in a decade
• 995,000 invited to lung cancer screening in 2024/25
• NHS is on track to meet March 2025 goals:
   
  • 77% for 28-day diagnosis
   
  • 70% for 62-day treatment
 
• Tiered support is improving outcomes in the most challenged providers (e.g. gynaecology, breast, urology)

Full board papers available here: https://www.england.nhs.uk/long-read/meeting-of-the-board-of-nhs-england-27-march-2025-agenda/

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