“The culture of routine overspending without consequences is over”, Wes Streeting has warned, as he unveiled a new, trimmed-down mandate for the NHS.
The health secretary said that he will bring the health service “back to basics”, adding that the “NHS must learn to live within its means”.
NHS England chief executive Amanda Pritchard warned “difficult decisions will be needed” to deliver the new mandate as the NHS works to find £325m in savings and shrink the organisation by 15 per cent. A move that will mean ditching staff and some programmes to focus on frontline healthcare over the next 12 months.
Mr Streeting’s new targets include cutting waiting times, improving access to GPs and dentists, and boosting urgent and emergency care.
In a foreword to the 2025 mandate, Mr Streeting said the approach will put “the NHS on the road to recovery”.
“The last Labour government delivered the shortest waiting times and the highest patient satisfaction on record. It won’t be easy, but together we’ll do it again”, he said.
“We recognise that this will mean tough decisions need to be made and local systems should feel empowered to make them”, Mr Streeting warned. “The culture of routine overspending without consequences is over.”
Ms Pritchard said: “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.“
The document, which outlines key priorities for the health service, is light on detail of how these priorities will be achieved in practice.
But the government has said it will publish further information on its plan to transform urgent and emergency care in the next few months.
To cut waiting times, an expanded NHS App will boost communication with patients and carers.
The mission to boost access to GP appointments will involve investment in data and digital, alongside an improvement in the coordination of health and social care services to start building what the government said would be a “new neighbourhood health service”.
Meanwhile, the plan to improve urgent and emergency care includes providing new infrastructure for mental health crisis support to avoid unnecessary A&E attendance, as well as relying on neighbourhood health services to cut hospital admissions.
Mr Streeting has also set a target of referring 100,000 additional people for urgent cancer checks within a four-week time frame.
The government has said it will introduce financial rewards for the best-performing NHS organisations.
While the health secretary has insisted the plan will “deliver on patients’ priorities”, health bodies have expressed concerns that the new mandate will sideline important programmes, risking the health and wellbeing of paitents and staff.
Mr Streeting’s mandate comes after chancellor Rachel Reeves announced a £26bn injection over two years into the health service in her autumn statement.
The NHS England chief executive said in operational planning guidance for 2025-26, also published on Thursday, that the NHS would have to reduce spending for the current financial year by at least 1 per cent.
Ms Pritchard warned hard decisions would have to be taken as integrated care boards and NHS trusts must also shed non-frontline staff to meet new targets.
“To balance operational priorities with the funding available, while continuing to lay foundations for future reforms, the NHS will need to reduce or stop spending on some services and functions and achieve unprecedented productivity growth in others,” she said in the guidance.
The Royal College of Surgeons (RCS) noted there were still no national targets or deadlines for the NHS to implement sexual misconduct policy, but argued it should remain a top priority.
Professor Vivien Lees, vice president of RCS England and Council and lead for tacking sexual misconduct in surgery, said: "While we support the secretary of state's push for focused NHS priorities, including waiting times, we argue that addressing significant cultural and workforce issues, particularly sexual misconduct, is crucial for improving NHS working conditions.
“Failure to prioritise this framework will let down those who experience unwanted sexual attention and behaviour when they are at their most vulnerable. This is a time for the NHS to get its house in order and to demonstrate to staff and the public that there really is zero tolerance for sexual misconduct.”
