NHSE's management of elective care transformation programmes

NHSE plans to reset its central oversight arrangements for elective recovery. As it establishes its new national level oversight board for the transformation programmes it should: ? ensure that performance information reported to the board is prioritised, clear and consistent so that the board has a clear view of trends over time and issues arising. Performance indicators should relate to the outcomes that the programmes are aiming to achieve; ? include programme costs in board reporting to enable the assessment of the relative cost and value of elements of the recovery plan, and to support decision making on the allocation of resources; ? ensure that the risk information reported to the board is up to date and timely and reflects current performance and progress on each programme against planned trajectories; and ? when a programme is not delivering, as the outpatients transformation programme was not, highlight this in reports to the board. The board should document decisions about what it has done to address this.

Ref Page 13, 21a · Implemented Q1 2025/26

The national level oversight board should assess whether it has the right balance of investment across the transformation programmes and other initiatives, including capital and resource spending, to achieve the required reduction in elective care waiting times. It should assess: ? the level of both capital and resource expenditure on the programmes; ? the contribution the transformation programmes have made to date to reduce waiting times and modelling to understand how they are expected to achieve outcomes in future, including the relationship between meeting performance targets and reducing waiting times; and ? the dependencies between the transformation programmes and other initiatives for reducing waiting times, including how they will work together to bring elective recovery back on track.

Ref Page 14, 21b · Implemented Q1 2026/27

The national level oversight board should play an active role in ensuring that lessons are learned on and between the transformation programmes. Practical steps may include reviews, workshops or problem-solving sessions to allow everyone involved to share their perspectives and experiences, and giving people the opportunity to work alongside other teams.

Ref Page 14, 21c · Implemented Q2 2025/26

NHSE should do more to secure buy-in from clinicians across its programmes. It should achieve this by: ? continuing to build support and endorsement nationally by strengthening its work with Royal Colleges and through national clinical directors embedded in the elective recovery programme; ? aligning national and local clinical ambitions and expectations; ? using data and modelling to demonstrate the case for change; and ? building support locally through peer-to-peer engagement.

Ref Page 14, 21d · Implemented Q3 2025/26

Having brought oversight of the outpatients transformation into the wider elective recovery programme, NHSE should: ? make a full assessment of the lessons learned to date. NHSE should set out how these lessons will be incorporated in its plans for taking the transformation forward; ? strengthen risk and programme management; and ? set out how it expects achievement of targets to translate into reduced waiting times and assess their deliverability. This deliverability assessment should set out the key actions that are needed to ensure that targets are delivered and an implementation plan including the resources required and the milestones NHSE will need to meet. NHSE should be clear on how this plan differs from its previous activity which has not delivered a reduction in outpatient appointments.

Ref Page 14, 21e · Implemented Q1 2026/27