Imagine your house is falling apart. The roof is leaking, the walls are cracking, and the electrics are one bad fuse away from disaster. Now imagine your builder comes along and says, “Great news! We’ve simplified our focus—no more fixing roofs or walls, just painting and new curtains!”
That, in a nutshell, is what the NHS’s new 2025/26 priorities and operational planning guidance feels like. Fewer national targets? Sounds good in theory. But removing workforce planning, community care, and mental health priorities while expecting better elective, emergency, and GP performance? That’s not reform—that’s wishful thinking.
Wes Streeting and NHS England say this is about freeing local leaders from micromanagement so they can focus on what really matters.
A good idea in principle. But here’s the problem: who decides what matters?
Right now, it looks like the NHS has been told to “prioritise what’s important”, while quietly dropping the long-term strategies that actually make those priorities achievable.
It’s like sprinting on broken legs and being told to run faster. Let’s face it, the NHS is not David Goggins.
With 110,000 vacancies across the NHS and temporary staffing costs hitting £3 billion last year, we can’t keep pretending workforce planning is optional.
If you want a more productive NHS, start with workforce planning. It’s not glamorous, but it’s the only way to balance capacity with demand. Right now, trusts are playing a constant game of crisis Tetris—rearranging staff to cover gaps, plugging holes with agency workers, and hoping for the best.
Yet:
❌ We still don’t have accurate, real-time workforce data.
❌ Job planning is still disconnected from operational demand.
❌ Retention strategies are still an afterthought.
NHS England says workforce retention and productivity remain a focus—but without clear national targets, where’s the accountability?
This isn’t about more bureaucracy—it’s about ensuring the NHS has the staff it needs to function. Removing workforce planning from national priorities is like taking the engine out of a car to make it lighter—sure, it’s less burdened, but good luck getting anywhere.
It’s easy to say “we’re still committed to mental health and community services” while quietly dropping the targets that hold the system accountable.
Let’s be honest: if something isn’t measured, it isn’t prioritised.
By removing specific objectives for community service waiting times, early cancer diagnosis, and access to mental health support, this plan sends a clear message: “These are nice to have, but not essential.”
🔹 The NHS says mental health funding is ring-fenced—but without clear success measures, how do we ensure this money is spent in the right places?
The problem? Every system is interconnected.
If you don’t plan for demand at every level, you’re just shifting the crisis elsewhere.
They’ve rebranded “targets” as “success measures”, which is a nice touch—because if you call something a “measure,” it sounds less like pressure and more like progress.
But look closer, and you’ll notice a pattern: some of the hardest-to-hit targets have been softened or removed entirely.
For example:
✅ A&E performance target lowered.
✅ Long-wait elective targets adjusted.
✅ Cancer waiting time goals made less ambitious.
Meanwhile, they’re introducing new measures around “productivity” and efficiency. That’s all well and good—but if you aren’t measuring the full patient journey, you’re just creating a system that’s efficient at missing people.
Some will argue that focusing on fewer, more achievable targets is exactly what the NHS needs right now.
“We’re drowning in complexity,” they’ll say. “Simplifying targets gives teams clear direction and builds momentum through visible progress.”
Fair point. Quick wins can boost morale and create positive headlines.
But here’s the problem: quick wins without foundation-building aren’t wins at all—they’re loans against our future that we’ll have to pay back with interest.
Just ask any trust that’s hit their elective targets by pulling staff from community services, only to watch emergency admissions spike six months later.
We don’t need fewer targets or simpler targets. We need smarter ones.
Cutting targets isn’t inherently bad. Intentions matter more than goals. The NHS doesn’t need rigid box-ticking exercises—it needs flexibility to innovate, test, and refine solutions.
But here’s the catch: freedom without strategy is chaos.
If we’re serious about making the NHS work better, we need to:
✅ Invest in workforce planning—because you can’t fix waiting lists without enough staff.
✅ Reform job planning & real-time workforce management—not just track headcount, but align staff to actual demand.
✅ Focus on long-term patient outcomes, not just immediate numbers—fix the root causes, not just the symptoms.
✅ Use data & predictive analytics properly—many workforce tools are unreliable, but there are proven ways to forecast demand and deploy resources intelligently.
If NHS leaders are really being “freed” from micromanagement, let’s free them to build long-term solutions—not just play a numbers game with waiting lists.
This plan will produce short-term wins and long-term problems. A year from now, we’ll probably see reports showing “record improvements in elective performance,” while community services, mental health, and workforce gaps quietly worsen in the background.
So here’s the real test: will we finally move beyond crisis management and start fixing the NHS from the ground up?
Because cutting targets might make for a cleaner spreadsheet. But if we don’t fix the foundations, we’ll just be back here again next year—wondering why things haven’t really changed.
💬 What do you think? Are fewer targets the answer, or do we need to completely rethink how we measure NHS success?
Managing Director
07894 128377
philip@sardjv.co.uk
Managing Director
07894 128377
philip@sardjv.co.uk
Registered address
SARD JV Limited
Unit 76, Innovation Centre
University Road, Canterbury
CT2 7FG
A joint venture with Oxleas NHS Foundation Trust.
Registered in England and Wales with company number 07916735. VAT No. 131901840
Designed and built By Tweak Marketing
Privacy Policy