Last week, NHS finance leaders came together at the Healthcare Financial Management Association (HFMA) Spring Leadership Forum to reflect on recent progress over the past year and discuss what comes next for the service.
The HFMA Spring Leadership Forum offered a clear view of where NHS finance leadership is focusing ahead of the new financial cycle. The message from national, system and provider leaders was consistent: financial discipline has improved, but the next phase requires a shift from control to transformation.
Phill Wells, Deputy CFO at NHS England, highlighted a milestone many did not expect a year ago. In 2025/26, around 90% of trusts and 67% of ICBs balanced their books, alongside a reported 2.8% productivity improvement. This demonstrates real progress. However, leaders were equally clear that this level of performance will be difficult to sustain without structural change.
There is little expectation of additional funding. The focus is moving towards how existing resources are allocated, managed and translated into outcomes. A key development is the transition in payment mechanisms, designed to support more care outside acute settings and reinforce the shift towards the NHS’s three strategic shifts: hospital to community, analogue to digital, and treatment to prevention.
The focus is shifting towards productivity beyond acute care. Community, mental health and ambulance services are under increasing scrutiny, yet data maturity in these areas continues to lag behind acute providers. For finance teams, this means that expectations are rising, while visibility and consistency of data are not keeping pace.
Several examples at the forum illustrated what progress looks like in practice. ‘Home First’ discharge models are already delivering measurable impact, including the closure of 14 beds in one system as patient pathways improve. At a national level, the fact that just 3% of patients account for 40% of hospital bed days highlights how targeted interventions could unlock significant capacity.
Looking ahead, multi‑year planning is firmly back on the agenda, alongside a push for greater system accountability and collaboration between finance, clinical and operational teams. At the same time, the proposed Advanced Foundation Trust model signals a future where high‑performing organisations are given greater autonomy, but also greater responsibility for system outcomes.
Reliable, well‑governed data will be critical to demonstrate productivity, understand variation, and support decisions across increasingly complex care pathways.
Without that foundation, it becomes significantly harder to evidence value, prioritise investment, or deliver on the ambitions of the 10‑year plan.
This is where the opportunity lies: translating financial performance into actionable insight that supports both operational improvement and long‑term transformation.