The NHS has set out a new Operating Model designed to give Integrated Care Boards (ICBs) and Trusts greater autonomy while ensuring a more streamlined and supportive role from NHS England. This shift aligns with the broader move towards devolution outlined in the 2025/26 Planning Guidance, emphasising strategic commissioning, data-driven decision-making, and targeted interventions to improve efficiency and patient care.
Key Areas of the New Operating Model:
- Devolution and strategic commissioning – ICBs will take greater control over resource allocation and service design, with NHSE stepping back to focus on assurance, planning, and support.
- Data and digital transformation – The NHS Federated Data Platform will drive more consistent decision-making, while enhanced digital infrastructure and cyber security will underpin operational improvements.
- Performance and accountability – A new NHS Improvement & Assessment Framework will determine system support needs and grant more autonomy to high performers.
- Waste reduction and efficiency – A national campaign will encourage frontline staff to share ideas for optimising resources and reducing inefficiencies.
- Leadership and workforce development – A Management & Leadership Framework will introduce professional standards and training to equip NHS leaders with the skills to drive transformation.
A full breakdown of the guidance is summarised in the snapshot below:
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Source: NHS New Operating Model 2025/26
The new Operating Model signals a fundamental shift in how NHS England interacts with ICBs and Trusts. With a focus on empowering local systems, providing targeted support where necessary, and simplifying the planning and oversight process, the goal is to enable more responsive, data-driven, and efficient healthcare services.
See the full operating model guidance here.
