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.

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.