NHS England has released its new Medium Term Planning Framework (2026-27 to 2028-29), calling on providers to prioritise digital transformation, including full adoption of the NHS App and the Federated Data Platform, to modernise infrastructure and improve patient access
In a significant and urgent shift, NHS England is calling on healthcare providers to expedite their digital transformation over the next three years. The recently published Medium Term Planning Framework (2026-27 to 2028-29) outlines new mandates that necessitate the widespread use of the NHS App, integration with the Federated Data Platform, and a modernised digital infrastructure. Providers and commissioners must swiftly embed these requirements into their strategic planning to align with the service’s broader goals of reducing waiting times, enhancing access to care and moving from analogue to digital systems.
Key priorities for the next three years
The Medium Term Planning Framework outlines the key, but challenging, priorities to be achieved over the next three years. This includes:
Elective, cancer, and diagnostics
- Reform of elective activity to deliver 92% 18-week referral to treatment by the end of 2028/29.
- Improve performance against key cancer standards, such as maintaining performance against the 28-day Faster Diagnosis Standard (FDS) at 80% and improving the 31-day and 62-day standards to 96% and 85%, respectively.
- Improve performance to reduce diagnostic waiting times, aiming for a rate of 1% of patients waiting over six weeks.
Urgent and emergency care
- Improve A&E waiting times to ensure that 85% of patients wait no more than four hours and reduce the number who stay over 12 hours.
- Improve Ambulance Category 2 performance to an average of 18 minutes.
Primary care and community services
- Improve access to primary care, ensuring 90% of clinically urgent patients are seen the same day.
- Maintain the additional 700,000 urgent dental appointments per year.
- Minimum 80% of community health service activity occurring within 18 weeks.
- Maximise pharmacy first and roll out new services.
Mental health, learning disabilities and autism
- Provide 915,000 courses of NHS Talking Therapies treatment.
- Reach 94% coverage of mental health support teams in schools and colleges, reaching 100% by 2029.
- Reduce the number of inappropriate out-of-area placements.
- Reduce reliance on mental health inpatient care for people with a learning disability and autistic people, delivering a minimum 10% reduction year-on-year.
Digital transformation: Accelerating care through technology
NHS England is prioritising a major digital shift over the next three years, aiming to make care more connected, efficient, and patient-centred. Providers are expected to embed the NHS App, adopt shared data platforms, and move from analogue to digital-first processes, ensuring that staff and patients can fully benefit from modern, interoperable technology.
The NHS App will be home to three new functions that could transform the future of digital healthcare.
My NHS GP will be a new function that uses AI-assisted triage models and data-driven pathways to guide people to the service they need quickly and provide those with an appointment with the ability to book one. Additionally, the app will empower patients to take control of their treatment pathways by providing a central platform to manage appointments, referrals, and interactions, to reduce referral-to-treatment times. Lastly, the NHS app will empower people to manage their own health and the health of their dependents by providing them with targeted access to prevention services, thereby reducing future demand before sickness develops or worsens.
These features will work together to deliver transformational NHS services and unlock a range of benefits, including directing patients to the right services at the initial appointment, streamlining the patient journey, and improving the experience of NHS services.
In addition to updates to the NHS App, work will continue to establish NHS Online, which is a new virtual hospital that digitally connects patients to expert clinicians anywhere in England from 2027. This new tool will give patients autonomy over their care, enhancing patient control and choice.
Providers that are embracing digital tools are already seeing significant gains in performance and productivity. Acute trusts using the NHS Federated Data Platform, for example, have achieved an average of 114 additional elective surgeries per month and a 35% reduction in delayed discharge days.
To continue these improvements, NHS England expects providers to prioritise modern digital infrastructure. Key requirements include:
- Full adoption of the NHS App by 2028/29, covering appointments, medication management, waiting times, and pre‑ and post-appointment questionnaires.
- Onboarding all providers to the NHS Federated Data Platform for elective recovery, cancer care, urgent care, and population health management.
- Migrating all direct-to-patient communications to NHS Notify and using App-based notifications as the primary method of contact.
- Implementing a unified access model with AI-assisted triage, guiding patients to self-care or the appropriate service.
- Achieving full compliance with the Digital Capabilities Framework, including 100% coverage of electronic patient records.
- Rolling out core national products, such as the Electronic Prescription Service and Electronic Referral Service, by the end of 2027/28.
- Deploying advanced digital tools such as ambient voice technology and digital therapeutics where clinically appropriate.
Maintaining and strengthening the NHS workforce
The NHS has faced numerous challenges, particularly with the NHS workforce, with strikes being a recurring theme over the past few years. The forthcoming 10 Year Workforce Plan will set out a shift in how the NHS deploys, retains, and trains its workforce. This plan is a crucial step towards addressing these challenges and ensuring a strong and resilient NHS workforce for the future.
The Medium Term Planning Framework outlines that NHS providers must:
- Fully implement the 10 Point Plan to improve resident doctors’ working lives, which was published earlier this year, with complete transparency on progress.
- Reducing sickness absence rates, which are higher in the NHS than in other industries, and driving the use of temporary staff measures, such as bank staff. NHS providers must outline how they intend to address this.
- Reducing agency staff usage, in support of eliminating all use of agency staff by August 2029.
- Implement the reformed statutory/mandatory training framework due for publication in March 2026.
- Implement reforms to consultant job planning to improve productivity and staff satisfaction.
What happens next for NHS providers
From April 2026, NHS providers and commissioners are expected to begin embedding the framework prioritisation into their local plans, moving from short-term quick fixes to three-year strategies to achieve a more well-rounded NHS. The intended outcome of the framework is a more connected and patient-centred NHS, reducing delays and building a stronger digital presence.
In summary, all NHS providers must adopt digital solutions, including the full rollout of the NHS app, onboarding to the Federated Data Platform, implementing AI-assisted triage, and transitioning all direct-to-patient communications to NHS Notify.
Moreover, local ICBs and trusts must align plans with national priorities, including reducing waiting times and bringing care back into the community, whilst delivering medium-term budgeting to ensure financial sustainability.
