Roy Lilley's NHSManagers.net e-Letter Podcasts Future
Oct 28, 2025
Roy Lilley critiques NHS planning, questioning if ambitious recovery targets by 2028–29 are realistic amidst financial squeezes. He discusses the tension between central control and local autonomy in multi-year plans. The ambition for a primary NHS app raises concerns over digital exclusion, while traditional hospital-centric focus overshadows community care. Mental health funding risks are highlighted, along with challenges in fostering genuine collaboration. Lastly, he emphasizes the reliance on robust data and workforce plans to ensure success.
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Ambitious Targets Risk Perverse Responses
- The medium-term planning framework sets steep recovery targets across most major access measures by 2028-29.
- Such steep trajectories risk gaming, creative accounting, demoralisation, or unsustainable short-term fixes.
Financial Targets May Harm Frontline Care
- ICBs and trusts must hit break-even or surplus while delivering 2% annual productivity gains with no deficit support.
- In a high-inflation environment this is near impossible and may cut into quality or frontline services.
Plan Realistically For Inflation And Deficits
- Avoid relying on deficit support while forced to deliver large productivity gains.
- Plan realistically for inflation and protect quality when setting efficiency targets.