This revision to the NHS Operating Framework for 2010/11 sets out which changes need to happen in-year and those areas where change can be expected in the NHS Operating Framework for 2011/12. It centres on five areas:

• revisions to Vital Signs and Existing Commitments;

• new rules on reconfiguration;

• future direction and next steps on transforming community services;

• finance and efficiencies; and

• accelerating development of the payment system.

This revision document makes clear that the NHS is expected to deliver against the 2010/11 NHS Operating Framework in all areas not explicitly mentioned. Standards and quality are also expected to be maintained where existing targets are removed or adjusted pending the development of more outcome-focused measures. Patients would not expect a return to long waiting times for operations.

The NHS must also maintain a relentless focus on achieving the £15-20 billion efficiency savings over the next four years by improving quality and productivity so that this can be re-invested back into the service.

In essence, this revision to the NHS Operating Framework 2010/11 sets a clear way forward on a small number of areas and highlights further issues where change can be expected. It aims to give certainty to the NHS about the new Government's objectives and plans so that we are prepared to respond and adapt as we have shown we can.

Sir David Nicholson, KCB CBE

NHS Chief Executive

• Download the full document here