The NHS has published its Medium Term Planning Framework for 2026/27 to 2028/29 which sets out a 3-year roadmap to get the NHS back to its constitutional standards. This marks a shift away from the annual planning cycle, offering NHS organisations a three-year horizon to align reform, recovery and transformation.
Diagnostics (alongside elective care and cancer) is a core performance domain with specific trajectories and expectations.
The framework provides a clear focus on the delivery of neighbourhood health — a cornerstone of the NHS 10-Year Plan. It demands immediate action on improving the variation of GP access across the UK, reducing bed days and admissions among high priority cohorts and enabling patients with planned care to access specialised support closer to home. A Model Neighbourhood Framework and a National Neighbourhood Health Planning Framework will follow.
The former will expand upon how ICBs and primary care will provide greater access to specialist advice and direct access to diagnostics for specific specialties, when aligned to neighbourhoods, and support GPs to manage more patients without the need for referral.
Neighbourhood health archetypes will also be developed to help inform the improvement of existing estates and better utilisation of services.
Prevention must be central to ICB 5-year plans, including supporting the following goals: a 25% target for the reduction of CVD-related premature mortality over the next 10 years and reducing exposure to antibiotics to meet thresholds set in recent guidance and addressing problematic polypharmacy to reduce avoidable harm.
On genomics, by April 2026, ICBs should ensure clinical trials are proactively supported, including by reducing the time they take to set up, while providers are expected to deliver services in line with the NHS Genomic Medicine Service service specification, including the delivery of genomic testing services and testing strategies as well as clinical functions for cancer, rare disease and population health and the new genomics population health service.
Key diagnostic targets include:
- Elective (including diagnostic) reform and activity to deliver 92% 18-week referral to treatment by the end of 2028/29.
- Improve performance against key cancer standards: Maintaining performance against the 28-day Faster Diagnosis Standard (FDS) at 80% and improving 31 and 62 day standards to 96% and 85% respectively.
- Improve performance for diagnostic waiting times so that the rate of those waiting over 6 weeks is 1% (DM01 measure).
