What The NHS Medium Term Planning Framework Means for Pharma, Medtech and Device Companies

The Medium Term Planning Framework – Delivering Change Together, 2026/27 to 2028/29 marks another pivotal moment in the transformation of the NHS.

It sits firmly within the trajectory established by the NHS 10-Year Health Plan and the New Operating Model for Health and Care. Taken together, these documents form the architecture for an NHS moving away from crisis management toward sustainable, locally led reform, powered by digital innovation, prevention, productivity and partnership.

For the life sciences sector, pharma, medtech and device companies, this is not just another plan. It’s a roadmap to embed innovation into NHS pathways at scale, provided suppliers align with the system’s core ambitions of better outcomes, reduced variation and financial sustainability.

A Shift from Short Termism to Strategic Stability

For years, the NHS has operated under annual cycles of planning and firefighting. This framework breaks that pattern.

With a three year revenue and four year capital settlement, the NHS now has a degree of financial certainty not seen in more than a decade. Revenue will rise to £226 billion by 2028/29, with capital spending growing by 3.2% in real terms annually.

This stability underpins a new financial regime where Integrated Care Boards (ICBs) and providers must deliver balanced budgets, achieving a minimum 2% productivity gain year on year. The national focus is clear; fiscal discipline, transparency and efficiency will drive freedom and autonomy at local level.

There are clear implications for industry as NHS organisations are now expected to make decisions based on longer term planning horizons. That creates opportunities for multi-year partnerships, particularly those that combine innovation, measurable outcomes and efficiency gains.

The key will be demonstrating how your product or service contributes to productivity and supports the NHS to meet its 2% efficiency mandate.

A New Operating Model – Clarity, Autonomy, Accountability

The new NHS operating model redefines the relationship between centre, region, ICBs and providers:

• The centre sets outcomes and removes barriers.
• Regions provide leadership, oversight and support.
• ICBs act as strategic commissioners, moving resources toward prevention and community capacity.
• Providers, through a revitalised Foundation Trust model, are rewarded with freedoms when they deliver on quality, productivity and collaboration.
• Neighbourhood teams deliver integrated, patient centred care locally.

Performance will be tracked through a revised NHS Oversight Framework, with transparent, league table style reporting, visible not just to the system but to the public. Success brings freedom. Failure triggers proportionate intervention.

For industry market access will increasingly depend on engaging with systems via ICBs and Provider Collaboratives, rather than individual organisations. Demonstrating how your offer supports system performance, whether through improved access, prevention, quality or digital efficiency, will be critical.

Publicly available productivity data will also expose where Trusts and systems are struggling, helping industry identify where partnerships can add the greatest value.

Neighbourhood Health Opportunities Identified for Pharma, Medtech and Device Companies

Neighbourhood health is moving from concept to delivery. The Framework sets out a clear ambition for Integrated Neighbourhood Teams (INTs) working across health, social care and voluntary sectors to provide urgent, proactive, preventive support close to home.

Priority actions from April 2026 include:

• Tackling unwarranted variation in GP access.
• Reducing unnecessary admissions among frail and housebound patients.
• Building 12-hour community urgent care offers with senior clinical oversight.
• Establishing contract based integrated teams with local authorities.

High functioning systems will extend these models into children’s services, mental health and long term conditions like cardiovascular disease and diabetes.

For industry, neighbourhood health creates fertile ground for innovations that reduce hospital demand, from connected diagnostics and home monitoring to community based therapeutics, AI triage and virtual wards.

Suppliers that can prove their solutions prevent admissions or speed recovery will find an increasingly receptive audience. Collaborations that embed technology into integrated neighbourhood pathways, especially for COPD, diabetes, frailty and mental health, will align directly with national priorities.

No More Talk About Prevention – It’s Time To Get On With It

The Framework embeds prevention as a system priority. It commits ICBs to demonstrable progress on:

• Tackling obesity (including access to NICE-approved weight loss drugs for an initial cohort of 220,000 adults by 2028).
• Reducing CVD mortality by 25% over 10 years.
• Implementing opt-out tobacco dependence models.
• Addressing polypharmacy and antibiotic stewardship.
• Reducing health inequalities across all functions.

This marks a clear expectation that every system’s five year plan must operationalise prevention, not simply talk about it.

For industry, the prevention agenda opens the door for pharma and medtech companies to reposition themselves as population health partners.

Whether through obesity management, cardiovascular screening, smoking cessation or chronic disease control, suppliers that offer pathway based prevention solutions (not just products) will be invaluable.

Expect to see growing appetite for collaborative models that use population analytics, digital engagement and remote interventions to reduce future demand.

The NHS Must Be Digital First in Four Years

Perhaps the most transformative element of the framework is the commitment to make the NHS digital by default by 2029.

Three core pillars underpin this:

1. My NHS GP – AI-assisted triage and pathway navigation.
2. Transforming Planned Care – one digital space for managing all appointments, referrals and interactions.
3. Managing My Health – personalised access to prevention services through the NHS App.

By 2028/29:

• 95% of appointments across all settings must be available through the NHS App.
• All providers must be onboarded to the Federated Data Platform (FDP).
• Direct to patient communications will move to NHS Notify and App push notifications.
• AI triage and voice technology will underpin unified access models.

There’s also a commitment to develop NHS Online, an “online hospital” connecting patients to expert clinicians anywhere in England by 2027.

For industry, digital integration is no longer optional. Pharma, medtech and device companies must ensure their technologies are interoperable, data driven and NHS App compatible.

The move to the FDP means new opportunities for those offering analytics, virtual care platforms, remote monitoring or AI decision support tools, particularly those that integrate seamlessly with existing national systems.

The coming Digital Product Adoption Dashboard will also set out which technologies every provider must implement, helping suppliers position themselves early.

Modern Service Frameworks Will Make Market Access Easier

The NHS will roll out Modern Service Frameworks (MSFs) for high impact conditions, starting with cardiovascular disease, serious mental illness, and sepsis, followed by dementia and frailty. These frameworks will define what “good” looks like for quality, digital by default care in each pathway.

Alongside this, a Single National Formulary will be introduced within two years, ensuring consistency, efficiency and faster uptake of best value medicines.

Read my blog – New National Formulary signals long overdue shift in NHS medicines policy – how pharma can navigate the change – here.

Quality improvement will be supported by the new National Quality Board Strategy, National Care Delivery Standards and digital monitoring tools such as the Paediatric Early Warning System and Maternity Outcomes Signal System (MOSS).

For pharma, the Single National Formulary simplifies market access but raises the bar on demonstrating value for money and real world impact. NICE-approved innovations that deliver measurable clinical and financial benefit will be prioritised.

For medtech and device companies, Modern Service Frameworks represent the new blueprint for pathway integration. If your technology helps a provider meet MSF-defined outcomes, e.g., faster diagnosis, reduced harm or better recovery, it will have a clear and defensible route to adoption.

Demand For Tools Which Help Leaders Connect With Their Workforce

Workforce reform underpins everything. NHS leaders are expected to address staff dissatisfaction, discrimination and poor culture head-on.

A new Management and Leadership Framework and a forthcoming College of Executive and Clinical Leadership will establish professional standards for NHS managers, echoing those already in place for clinicians.

Companies working in education, digital training or workforce analytics should track this agenda closely. Tools that improve retention, automate administration or support leadership development will find new demand as Trusts professionalise management and modernise systems.

The NHS Wants Industry’s Help In Driving Forward Research And Innovation

For life sciences, the framework contains an unambiguous signal that research and innovation are to be mainstreamed into everyday care. From April 2026:

• All ICBs must proactively support clinical trials, meeting the government’s 150 day set-up target.
• Providers must deliver genomic testing and population health services aligned to the NHS Genomic Medicine Service.
• Boards must report on research income, study performance and capacity building every six months.

This is the clearest invitation yet for pharma and medtech companies to engage in collaborative research, real world evidence generation, and genomics enabled medicine.

The NHS is explicitly positioning itself as a life sciences partner, not just a customer, and expects industry to help drive discovery, accelerate commercialisation and embed trials within routine care.

The Next Three Years Will See Countless Opportunities Laid At Industry’s Door

Between now and 2028/29, the NHS is committing to:

• 92% of patients receiving treatment within 18 weeks.
• 85% meeting the 62-day cancer standard.
• 1% or fewer waiting over six weeks for diagnostics.
• 85% of A&E attendances within four hours.
• 18-minute average response for Category 2 ambulances.
• 90% of clinically urgent patients seen the same day in primary care.

Meeting these targets depends on re-engineering outpatient care, with digital follow-up as default, improving Advice & Guidance and e-Referral Service use and better managing waiting lists via the Federated Data Platform.

For industry, every one of these metrics creates opportunity. Diagnostic and device companies can support faster access and reduced waiting times. Pharma can link treatments to pathway redesigns that free up capacity. Digital providers can accelerate elective recovery through workflow automation, remote triage and predictive analytics.

Why This Matters For Pharma, MedTech And Device Companies

This framework is not another layer of bureaucracy. It’s the NHS’s operationalisation of reform, the three year bridge between stabilisation and systemic transformation.

To succeed, companies must pivot from selling products to co-creating pathways. The language of access, prevention, digital integration and productivity must become central to commercial strategy.

In practice, that means:

1. Aligning offers to ICB goals. Every engagement must show how it delivers measurable improvements in access, outcomes or efficiency.
2. Supporting the left shift. Community based, digital enabled and preventive models will dominate commissioning priorities.
3. Demonstrating value through data. Link your product to system-level metrics, e.g., reduced non-elective admissions, improved CVD control, fewer DNAs or faster diagnosis.
4. Partnering on implementation. Providers lack capacity for change; suppliers that bring delivery support, training and real-world evidence will stand out.
5. Engaging at multiple levels. From national frameworks and Model ICB blueprints to local Neighbourhood Health pilots.

A Missing Piece – The Silence on General Practice

For all its clarity and ambition, the Medium Term Planning Framework says surprisingly little about General Practice. This is striking, given so much of the delivery plan – from neighbourhood health to prevention, digital triage and same day access – relies almost entirely on GP led teams.

The framework introduces new access and performance expectations that will profoundly change how practices are run:

• 90% of clinically urgent patients seen the same day.
• Universal use of digital triage and online booking.
• Extended hours integration within neighbourhood teams.

Yet, there is no new investment, no contractual reform and no workforce plan to make these expectations sustainable.

This risks deepening the gap between policy ambition and delivery reality. GPs are already under extraordinary pressure, with rising demand, static funding and shrinking headcount. Expecting the profession to deliver a digital, preventive, population health model without fresh resources may be a stretch too far.

For pharma and medtech companies, this matters. General Practice remains the gateway to population health management, early diagnosis, and prescribing.

A struggling GP sector limits the NHS’s ability to adopt new technologies or implement pathway change. Companies need to recognise this fragility and build support models that reduce workload, improve access and free up capacity, not add to the burden.

A Pivotal Moment For Industry To Align With What The NHS Needs

The Medium Term Planning Framework marks the NHS’s transition from aspiration to execution. It provides the structure, financial stability and accountability needed to deliver the ambitions of the 10-Year Health Plan – shifting care left, embedding prevention, integrating neighbourhood health and digitalising everything.

For pharma, medtech and device companies, this represents a pivotal moment. The NHS no longer wants suppliers who deliver transactions, it wants partners who deliver outcomes.

The organisations that thrive will be those who move beyond product sales and align directly with system priorities. As I explore in my book Embedded, success in this new NHS depends on three critical shifts:

1. From products to pathways. Stop selling what your innovation is and start demonstrating what it does to improve outcomes, efficiency and patient experience. Map your offer to the specific pathways, metrics and productivity challenges the NHS is under pressure to deliver.

2. From access to adoption. Market Access is only the starting point. Real value comes from working with systems to implement and sustain change. The NHS needs partners who stay involved after the sale, helping to operationalise transformation and deliver results over time.

3. From selling to solving. The most effective companies position themselves as collaborators helping ICBs and providers meet national priorities. Whether through workforce support, service redesign, or data-driven evaluation, the emphasis is on solving NHS problems, not selling products.

The next three years will determine which organisations are truly embedded in NHS pathways. Those that align with the NHS’s new operating model, demonstrate measurable system value and stay the course through implementation will shape not only their own success but the future of NHS-industry partnership itself.

At www.scottmckenzieconsultancy.com, we work directly inside the NHS, supporting provider organisations, commissioners and system leaders to implement real change. We then help pharma, medtech and device companies interpret what’s happening, so they can engage the right stakeholders, align with NHS priorities and get their innovations embedded into care pathways.

With more than 20 years working within the NHS and pharma, medtech and devices companies, Scott brings a unique dual perspective, now captured in his book, Embedded: How Pharma, MedTech, and Device Companies Can Get Their Products into NHS Pathways and Stay There, which distils everything he’s learned into a practical playbook. Whether you’re launching a new product or trying to unlock stalled adoption, Embedded shows you how to reframe your offer, align with NHS priorities and make change stick.