The National Health Service (NHS) has unveiled its most comprehensive reform in decades, aimed at dramatically reducing waiting times and improving access to care across England. The new Medium Term Planning Framework – Delivering Change Together (2026/27 to 2028/29) sets out a three-year roadmap to overhaul service delivery, eliminate bureaucratic inefficiencies, and empower local leadership.
Under the plan, the NHS aims to cut the number of patients waiting more than 18 weeks for planned care by 2.5 million, ensure 190,000 more cancer patients begin treatment within two months of referral, and expand access to diagnostic tests and GP appointments.
Key performance targets by 2028/29 include:
- 85% of cancer patients to start treatment within 62 days of referral
- 96% of patients to begin treatment within one month of diagnosis
- 80% of community health services delivered within 18 weeks
To meet these goals, the NHS will shift more care into community settings, incentivise hospitals to collaborate with neighbourhood teams and diagnostic centres, and improve GP access, including same-day appointments for urgent cases.
Speaking on the framework’s release, NHS England CEO Sir Jim Mackey said the plan marks a decisive break from short-term crisis management:
“We have to get out of the trap of short-term thinking and break the cycle of ‘just about managing’. This reset aligns incentives to deliver more care and creates a clear route map to get waiting times back to where patients need them to be.”
The framework also introduces digital reforms, including the goal that 95% of appointments post-triage be accessible via the NHS App by 2028/29. The Federated Data Platform will be fully integrated across providers to streamline services and enhance productivity.
Additional measures include reducing unnecessary follow-up appointments and radiology scans, allowing clinicians to focus on patients with the greatest need. Tools such as i-Refer and Advice and Guidance will help GPs access specialist input without requiring hospital referrals.
The framework supports the broader 10 Year Health Plan and is designed to restore public confidence in the NHS by delivering timely, high-quality care through a modern, responsive system.
NHS England Picture by Lad 2011
Sources: NHS England NHS England, NHS Confederation NHS Confederation.
