The NHS oversight framework
Our survey reflects the experiences of trust in 2023/24, when NHSE was using the NHS oversight framework for 2022/23 (NHSE, 2022a).
Taken as a whole, the results show a decline in confidence among trust leaders in the oversight framework:
- Under half (47%) of respondents agreed that NHSE’s oversight metrics were the right ones to be measured against, which is down from 56% agreeing or strongly agreeing last year.
- Those agreeing that segmentation descriptions and associated support were clearly defined dropped from 59% agreeing or strongly agreeing last year to 45% agreeing in 2024.
- Those agreeing or strongly agreeing that decision making for segmentation was clear dropped from 45% in 2023 to 34% agreeing in 2024.
- There was also a decline in the percentage of respondents who agreed or strongly agreed the framework is a support tool (from 31% last year to 23% this year).
- In line with last year’s responses, over three quarters of respondents (77%) perceived the framework as a performance management tool.
NHSE’s operating framework
NHSE’s operating framework was published in 2022, aiming to bring clarity to oversight and to embed the principles of collaboration and system working. As in last year’s survey, we have tested the perceptions of our members as to whether these aims have been achieved.
We have seen some positive shift in these perceptions compared with last year:
- This year 44% of respondents agreed that NHSE’s operating framework has clarified the respective roles of ICBs, and NHSE regional and national teams. This is up from 32% agreeing or strongly agreeing last year.
- One quarter (25%) of respondents agreed with the statement that the operating framework has ensured proportionate and streamlined oversight and performance management by ICBs and NHSE. This is up from 20% last year.
However:
- Much smaller percentages of respondents agreed that the operating framework has had a positive impact on NHSE’s (16%) and on ICBs’ (17%) culture and behaviours.
- Just over three in ten respondents (31%) agreed that NHSE’s oversight and regulation had enabled trusts to collaborate in a system context, down from 36% last year.
