Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what support his Department plans to offer hospital trusts that are in Strand 4 of the NHS acute trust league table.

The NHS Oversight Framework 2025/26 sets out how NHS England will support trusts to improve, based on an assessment of their performance. This is available at the following link:

https://www.england.nhs.uk/long-read/nhs-oversight-framework-2025-26/

NHS England works through regional teams to monitor National Health Service trust performance, identify issues, and deliver improvement in the most challenged areas. Improvement metrics and trajectories are agreed and proactively monitored.

NHS England may also apply interventions and require NHS trusts to take broad actions or address specific concerns related to known issues. This may involve use of NHS England’s enforcement powers, particularly to secure improvement or where improvement is deemed insufficient.

Trusts rated low for both performance and capability will receive support from the National Provider Improvement Programme (NPIP), which will replace the Recovery Support Programme. NPIP will determine whether the most challenged have the necessary conditions in place to deliver sustainable improvement and will ensure support is in place as needed. This will be in addition to any targeted improvement support for specific issues such as urgent and emergency care, outpatients, mental health, finance, or maternity.

Additionally, newly appointed very senior managers (VSMs) to NHS trusts in segment 5 will be eligible for ‘challenged organisation recruitment premiums’, to attract talented VSMs to join challenged organisations and help turn them around.