NHS England have a new way of monitoring how NHS organisations are performing called the NHS National Oversight Framework 2025/26 It is designed to help NHS England support improvement, ensure accountability, and make sure organisations are using their resources wisely.
What is the Oversight Framework?
It’s a national system that looks at how well NHS organisations are doing - financially, operationally, and in terms of leadership. Based on this, NHS England decides how much support each organisation needs and how much freedom they should have to make decisions. A key part of the framework is the financial reset. This means we must stick to our budgets and avoid overspending.
What does “segmentation” mean?
NHS organisations are placed into segments (from 1 to 5) based on how they’re performing. Segment 1 means things are going well; Segment 5 means more support is needed. Right now, NCA is in Segment 4, which means we’re under close review and need to improve our performance and financial position against 22 indicators.
What are the 22 indicators?
These are the measures NHS England uses to assess performance. They include things like Emergency Department four-hour wait times, sickness absence rates, waiting times for treatment, Care Quality Commission ratings and financial performance. These indicators help NHS England compare Trusts and make decisions about support and oversight.
Where does NCA stand?
Based on these indicators, we’re currently ranked 116 out of 134 Trusts that provide similar services. This is not where we want to be, and we’re sorry to be in this position but we have a strong plan in place and need to keep moving forward.
Our key priorities include:
- Improving patient safety.
- Cost improvement activities to provide smarter care.
- Rolling out our Clinical Leadership Model so that we strengthen the clinical voice in decision-making, ensure leadership is closer to where care happens and support better, more consistent outcomes for our patients and service users.
- Preparing to implement an electronic patient record so that across the NCA, health professionals have all the information they need, in one place, about the people they’re caring for.
- Improving waiting times for patients in both planned and emergency care.
How often will rankings be updated?
Every three months. That means how we perform - especially financially - can quickly change our position. Now more than ever, we need to stay focused on delivering great care and managing our budget responsibly.