NHS ordered to make improvements to patient care while cutting costs

The NHS has been ordered to drive improvements in hospital waiting times and cancer care while at the same time cutting costs.

New planning guidance for the health service in England, which sets out national priorities for the year ahead, calls on NHS providers to reduce costs by 1%.

The NHS has also been challenged to raise productivity by 4%.

NHS England said that it plans to make £325 million in savings to reinvest in frontline services, this includes “reducing the organisational structure by 15%” – it is thought this will lead to around 2,000 job cuts.

The news comes as resident doctors in England – formerly known as junior doctors – voted to go into dispute in a row over working conditions.

The medics, from the British Medical Association, said there has been a lack of progress over reforms to overtime and safe working systems.

The announcement was made after NHS England set out its 2025/26 planning guidance, which includes specific aims to improve care, including:

– To make sure that 65% of patients on the waiting list for routine hospital care to be seen within 18 weeks, which will help towards the Prime Minister’s aim for 92% of patients to be seen within this time frame by July 2029.

– To cut the number of people waiting more than a year for routine hospital treatment to “less than 1% of the total waiting list by March 2026”.

– For a rise in the proportion of people who have suspected cancer to be diagnosed or given the all-clear within 28 days.

– The Mental Health Investment Standard – which ensures that funding for mental health keeps pace with overall NHS spending – will be retained. The NHS has also been given specific targets on reducing the length of stay in mental health settings and giving more access to children and young people who are trying to access services.

– The document calls for improvements in A&E waiting times and ambulance response times.

– Hospitals have been told that at least 78% of A&E patients should be admitted, transferred or discharged within four hours by March 2026.

– The guidance also calls for better access to GP surgeries, an increase to the number of urgent dental appointments and improvements in safety in maternity and neonatal services.

– There are a number of demands about productivity improvements, including a call to “reduce agency expenditure as far as possible, with a minimum 30% reduction on current spending across all systems”.

Some 32 goals were set in the planning guidance last year, but the number has been cut to 18 this year in a move designed to give local NHS bodies more freedom to deliver care to patients, officials said.

Some organisations and charities have expressed dismay over reports that specific priorities set out in 2024/25 guidance will not be repeated in 2025/26.

A row erupted after it emerged that a pledge made in 2024/25 on women’s health hubs would not be renewed.

Officials claimed that the target, which called for women’s health hubs to be established in every local health area in England by the end of the year, had been met so did not need to appear in the new list of priorities.

But the Conservatives said that Labour was “going to erase women from their health strategy”.

Health and Social Care Secretary Wes Streeting 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.”

Amanda Pritchard, NHS England chief executive, said: “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.”

Responding to the guidance, Matthew Taylor, chief executive of the NHS Confederation, said: “We should be under no illusion – this is going to be one of the most challenging financial settlements of recent years and these ambitions will be unbelievably stretching for the NHS.”

Sarah Woolnough, chief executive of The King’s Fund think tank, said: “If achieved, (this guidance) will bring improvements for many patients, but emphasis in these areas will inevitably mean other services get deprioritised.”

Dr Becks Fisher, from the Nuffield Trust think tank, added: “The coming year will be particularly tough financially, with NHS trusts being asked to hit ambitious remaining targets while cutting their costs by at least 1%.

“This includes reducing the use of staff overtime, which until now has played a significant role in slowing the growth of waiting lists.”

Fiona Carragher, from the Alzheimer’s Society, said: “Alzheimer’s Society is shocked to learn that dementia, including a dementia diagnosis target, has been removed from the NHS Operational Planning Guidance meaning it is not considered one of England’s healthcare priorities.

“This glaring omission is unacceptable and sends the message that dementia doesn’t matter.”