The NHS is launching its most significant overhaul in a generation to speed up care for millions of patients.
Key commitments
– Reduce the number of people waiting more than 18 weeks for planned care by 2.5 million by March 2029.
– Raise the share of people with a cancer diagnosis receiving first treatment within two months (62 days) to 85% (up from about 70%), with NHS projections showing just over 300,000 patients starting treatment in 2028/29 (compared with 226,939 in 2024/25).
– Deliver faster access to diagnostics and GP appointments.
Medium Term Planning Framework (2026/27–2028/29)
The new Medium Term Planning Framework, Delivering Change Together, replaces short-term annual planning with a three-year roadmap. It simplifies rules, removes bureaucratic layers and gives local leaders more freedom to prioritise patient care, with the aim of restoring constitutional standards for elective treatment.
How the targets will be achieved
– Move more care out of acute hospitals into local neighbourhood teams and community diagnostic centres to free hospital capacity and shorten waits.
– Reconfigure financial incentives so hospitals are rewarded for delivering appropriate care outside hospital settings.
– Take immediate steps to improve GP access, including consultation on a priority to offer same-day appointments (face-to-face, online or by phone) for all clinically urgent patients.
– Aim for 80% of community health service activity to be completed within 18 weeks, targeting long waits in community services where some patients have waited more than two years.
– Reallocate resources toward community services for people with the highest needs to reduce avoidable hospital admissions and support care at home.
Digital and productivity measures
– Target 95% of appointments after triage to be bookable via the NHS App and require all providers to use the Federated Data Platform fully by the end of 2028/29.
– Cut unnecessary follow-up appointments so clinicians can focus on patients who most need review; areas that do not progress will face performance management.
– Expand Advice and Guidance so GPs can get rapid specialist input digitally, reducing unnecessary hospital referrals.
– Roll out i-Refer clinical software to ensure imaging follows current guidance and only patients who need scans are imaged.
Leadership views
Sir Jim Mackey, NHS England CEO, said the service had been stuck in a “doom-loop” of short-term planning and excessive bureaucracy that limited local innovation. He described the Framework as a reset that aligns incentives, restores local leadership and creates a clear route map to improve access and reduce waiting times. He said every provider will be required to measure patient experience carefully and act on what matters to patients.
Health and Social Care Secretary Wes Streeting called the plan the bold change promised by the government, aiming for the fastest turnaround in NHS history. He said it will treat millions more patients on time, improve cancer outcomes, speed up GP access and prioritise community care. He noted the plan is already delivering over 5 million extra appointments, 2,500 additional GPs and a reduction of about 200,000 on waiting lists since the government took office.
Professor Peter Johnson, National Clinical Director for Cancer at NHS England, said meeting constitutional standards will deliver faster cancer care for tens of thousands more patients by investing in community diagnostic centres, boosting productivity in cancer teams, and strengthening community cancer services to support patients during and after treatment.
