The NHS National Oversight Framework

NHS England has introduced a new system to monitor organisational performance: NHS National Oversight Framework 2025/26. Its aim is to support improvement, ensure accountability, and promote effective use of resources.

What is the NHS National Oversight Framework?

This is a national system designed to assess how NHS organisations are performing in areas like finance, operations, and leadership. NHS England uses this information to determine the level of support or autonomy each organisation receives. An important element of the framework is the financial reset, which requires organisations to stay within their budgets and prevent overspending.

What does “segmentation” mean?

NHS organisations are placed from Segment 1 (best performance) to Segment 5 (needs most support).

What are the 22 indicators?

NHS England uses various measures to evaluate performance. These include Emergency Department four-hour wait times, staff sickness absence rates, treatment waiting times, annual inpatient survey results, and financial performance. By using these indicators, NHS England can compare Trusts and determine what support or oversight may be needed.

Where does WWL currently stand in the Q2 Publication?

WWL is currently in Segment 4 and ranked 119th out of 134 specialist and acute providers (Quarter 2 Publication – December 2025).

We know exactly the key areas that require attention and there are significant transformation programmes already underway to improve our performance, focusing on what matters most to patients, staff, and Wigan Borough residents. Our system-wide Better Lives Programme is a major initiative driving these improvements.

This programme is a tripartite agreement between the Trust, the Council, and the Integrated Care Board, designed to enable residents, particularly older and frail individuals, to remain in their homes rather than be admitted to hospital beds. This system approach not only supports necessary improvements in urgent and emergency care but also enhances residents’ ability to live independently, thereby contributing to a higher quality of life.

Within the hospital setting, our Better Lives Programme is specifically targeting a reduction in waiting times in the Emergency Department, avoiding unnecessary hospital admission, helping patients leave the hospital on time, and making ambulance handovers more efficient. Essential services are also being delivered outside of the hospital setting, ensuring that care is accessible within the community and facilitating support for recovery at home.

It's important to recognise that lasting change doesn't happen overnight and right now, the Emergency Department at the Royal Albert Edward Infirmary is seeing far more patients than it was originally designed to handle. As a result, wait times have increased, especially for those who require admission to hospital. Our teams will continue to clinically prioritise care for individuals with the most critical needs and because of this prioritisation, some patients may experience extended wait times than we would want for any patient.

How often will rankings be updated?

Every quarter, our performance - particularly financial, which continues to show sustainable improvement year on year - can influence our segmentation.

How can the public continue to support WWL on our journey of improvement to outstanding?

Patient safety is always our highest priority, as shown by our positive hospital mortality indicators. We are committed to putting patients at the centre of our improvement plans, ensuring everyone in our community receives high-quality, compassionate healthcare now and in the future. The public can help WWL in several ways:

• If someone you care about is ready to leave the hospital and go home, your support with their discharge helps us provide care to those who urgently need hospital services.
• We recommend using our Emergency Departments only for serious conditions affecting life, limb, or sight. For less urgent health issues, please use NHS 111 online or by phone, or seek advice from your local pharmacy or GP practice.
• If you have a scheduled appointment at one of WWL’s hospitals, please attend as planned. If you need to change your appointment, contact the relevant department as soon as possible so we can offer the slot to someone else.