Asked by: Martin Wrigley (Liberal Democrat - Newton Abbot)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how NHS organisations will remain financially sustainable where activity is shifted out of acute settings.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Lord Darzi’s independent investigation into the National Health Service in England identified that the NHS’s current financial trajectory is not sustainable, and that spending has risen sharply and productivity has fallen. We are clear that without reform, rising demand, an ageing population, and inefficiencies will cause the NHS to crowd out other public services, undermining long‑term sustainability of the NHS.
The reforms we have set out in the 10-Year Health Plan will ensure that the NHS has long-term sustainability, by shifting from hospital to community care to deliver care that is cheaper and more effective, by shifting from analogue to digital to raise productivity and reduce unit costs, and by shifting from sickness to prevention. Our plan is to bend the cost curve in acute services, so that costs grow more slowly via a combination of shift activity to community settings and increasing productivity. As per existing funding arrangements, acute providers will be fully funded for all activity they undertake.
To ensure that NHS organisations remain financially sustainable during these reforms, we have published the Medium-Term Planning Framework 2026/27 to 2028/29, published in October 2025, which required integrated care boards and NHS providers to complete an integrated planning process with their three‑year numerical plans and five‑year narratives for the commissioning and delivery of NHS services, including the shift from hospital to community over this three year period. These plans will ensure that reform is delivered in a managed way that protects the financial sustainability of NHS organisations.
Asked by: Martin Wrigley (Liberal Democrat - Newton Abbot)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what the evidential basis is that shifting care into community settings will reduce waiting times and improve patient outcomes.
Answered by Karin Smyth - Minister of State (Department of Health and Social Care)
Shifting care into community settings is at the heart of the Government’s efforts to modernise and improve productivity in the National Health Service. Our vision is for a new model of planned care that is local where possible. This shift will provide rapid access to patient-centred services.
The Elective Reform Plan sets out our plan to deliver care in the right place, so patients are able to access the right care more quickly. This includes, for example, expanding the use of Advice and Guidance (A&G), which helps general practitioners and hospital specialists to work together to make the best treatment plans for patients, and decide whether a hospital referral is truly needed.
Where the outcome of A&G is for care management in the community, we expect patients to be seen more quickly, closer to home, benefiting from earlier specialist input. Ensuring patients receive the right care the first time can reduce the waiting list, so that people who need hospital care can receive it in a timely manner.
The plan is working. The waiting list has decreased to 7.22 million in February 2026, a drop of over 405,000 since July 2024. 18-week performance has improved by over 3% from the start of July 2024. The number of waits over 18 weeks has decreased to 2.7 million in February 2026, the lowest it’s been since July 2022.