NHS Operational Planning Guidance 25/26: What will it mean for race equity?

Responding to the publication of the 2025-2026 NHS planning guidance, Sam Rodger, Assistant Director, Policy and Strategy of the NHS Race and Health Observatory said:

“The NHS last week published its operational planning guidance for 2025/26. Though it doesn’t sound glamorous, this is where the new government can get into the nuts and bolts of their agenda for the health service. It’s also the first real sense we have of how the past few months’ pledges will translate into tangible action. With their headline ambition – reducing elective waiting times – this means putting firm and quantifiable targets in place. For race equity, and equity more generally, the target can be more difficult to grasp.

“Ahead of publication, much was made of the plan to halve the overall number of targets to 18, thereby creating greater focus on a smaller number of priorities. It’s pleasing, therefore, to see that health inequalities – in the form of the Core20PLUS5 programme – remains in that list. Additionally, ambitions around increasing GP access and accelerating flow through mental health services should support Black, Asian, and ethnic minority communities who so often bear the burden of these inefficient systems. That said, it’s vital there is also attention paid to the structural underpinnings of these disparities; correcting for the impacts of racism and inequity is not the same as addressing their causes.

“We’re also highly supportive of the move toward community care, but it’s clear that the success of a neighbourhood health service will depend on the extent to which power and influence is genuinely given over to communities to determine local priorities. Co-production cannot be a buzz-word, it must be business as usual and ethnic minority community participation must be core to the design and delivery of services at a local level.  The guidance also notably lifts several ringfences around funding. Though this move rightfully lends greater power to local decision makers, it also risks drawing even more money away from the health inequalities agenda, which research shows was often overlooked even when those ringfences were in place. Committed funding is essential for an agenda that so many still see as a ‘nice to have’, especially where systems are being asked to make a challenging 4% efficiency saving.

“The next stage will be crucial. The government and NHS have focused their attention here on steadying the ship – they’re asking providers to balance the books and rationalise the services they’re delivering. There’s less in this guidance, however, that speaks to the grand ambitions of the 10 Year Health Plan  With ICBs due to submit their own plans to meet this mandate in the coming weeks, the NHS Race and Health Observatory will be keeping a close eye on how these plans look ensuring that the drive for the NHS to become leaner and more efficient doesn’t leave racialised communities behind.”