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NHS Oversight Framework 2026/27

The Oversight Framework, in real time

Where you stand right now on your own numbers, which of the framework’s 86 metrics you can evidence, and the published sums behind the segment you were given. We don’t compute a segment, and the page tells you why.

Live vs demonstrated: Live — real, API-backed platform logic (wired end-to-end today) Demonstrated — representative control surface with seeded data / illustrative UI mock-up
© 2026 Commvita Digital Health Solutions Ltd. All rights reserved.

1 What the framework does to you

Every quarter NHS England puts each trust and each ICB into one of four segments. Segment 1 means you’re doing well nearly everywhere. Segment 4 means you’re a long way behind across several areas and can expect a co-ordinated response, possibly intervention. Once a year you also get a capability rating — green, amber-green, amber-red or red — decided by the regional team after your own self-assessment across six board domains.

Quarterly

Segmentation

Worked out from last quarter’s verified official data. By the time your board sees a segment, the position underneath it’s three months old and you’ve usually moved.

Annually

Capability rating

You self-assess in May and June, the region reviews in July and August, ratings are moderated and finalised in October. They can be changed during the year.

Nothing to submit

There’s no NOF return

Your segment is built from national collections you already file. Nothing goes to NHS England for the framework itself, so there’s no return to prepare and no deadline to miss.

Between those two dates you want to know something else: where do we stand right now, on our own numbers, and what can’t we evidence at all. That’s what this is for.

2 The thing that shapes everything else

Three of the four scoring models are relative. Target-and-spread, floor-and-spread and even-spread all rank you by percentile against every other organisation of your type. To work that out you need the national distribution, and only NHS England has it — your system holds your data. Only banded scores are absolute, and even those need thresholds we haven’t got.

So we don’t show you a segment. The page says so before it says anything else.

The NHS Oversight Framework tab opening with a banner reading commvita does not compute a segment, and cannot, above the framework counts for an acute trust
The first thing the page says, above anything it offersCaptured from the running system, build B-592 · pinned framework
Why we’re strict about this. We could work out a segment locally. It would look right. It would sit in a board pack next to a real one and nobody — not the board, not the regulator reading the same pack — could tell which was which. That’s the problem. A number nobody can check is worse than no number at all.

3 A pinned copy of the real document

The framework and its methodology manual are published documents, so we serve a pinned copy of each with a checksum on it instead of typing the contents into code. Eighty-six metrics, eight domains, four segments, four scoring models, the published thresholds. If the copy stops matching its own stated metric count it refuses to load, so you can never end up with a blank framework quietly reading as a framework with no metrics.

The People domain metric list, with one row marked scoring and varies by type
Domain 7, and the row that shows why status can’t sit on the metric aloneCaptured from the running system, build B-592 · pinned framework

Each metric says whether it’s scoring or contextual. One row shows why that can’t sit on the metric on its own: the staff survey engagement theme score is scoring for trusts and contextual for ICBs. Get it wrong and you’d score an ICB on a metric the framework calls contextual for ICBs, and it would look perfectly fine on the screen.

4 Which metrics apply to you

The framework publishes how many metrics apply to each type of organisation: 43 for an ICB, 35 for an acute trust, 24 for mental health, 19 for community, 18 for ambulance. We derive the set from the published list and show you both numbers side by side.

Organisation type switched to mental health trust, showing 86 metrics in the framework, 24 applicable published and 50 applicable derived, with a note about the technical annex
Switch to a mental health trust and the two counts pull apartCaptured from the running system, build B-592 · pinned framework

For an ICB we get 43, which matches exactly. For any trust we get 50, because the published list tells you which metrics reach trusts but not which ones your type is let off — those sit in the technical annex. So the page says the derived figure is a superset and why. We don’t pick 24 of the 50 and hand them to you as the mental health set.

We haven’t read the technical annex. We tried. Every link to it in the 2026/27 documents points at the 2025/26 edition, and that one can’t cover the new metrics for mental health, community and ambulance trusts, because the 2026/27 change list is what brings them in. So we ship no thresholds, no scoring-model assignments and no exemptions. We’d be making them up, and a made-up threshold looks exactly like a sourced one by the time it’s setting your segment.

5 Checking the segment you were given

Steps 2 to 4 of the methodology are written out in full, and the manual says people should be able to recreate the results from the raw data. So we do that, using the scores NHS England published for you. Your board can see how the segment it was handed was arrived at instead of taking it on faith.

The segment check panel with four published scores entered, showing an average of 1.69, provisional segment 1 arrowed to 3, and a note that the financial deficit override only ever downrates
Four published scores, and the deficit override doing its one jobCaptured from the running system, build B-592 · scores entered by hand
2

Average the scores

A metric you didn’t submit for scores zero, and the zeros are thrown out before the average. That sounds like tidying. It isn’t. 1.00 is the best score, so a zero left in would be better than perfect, and an organisation that submitted nothing at all would average 0.00 and land in segment 1.

3

Band the average

Under 1.94 is segment 1, up to 2.33 is segment 2, up to 2.77 is segment 3, anything above that’s segment 4. NHS England set those from last year’s mean of 2.34, one standard deviation either side, and published them.

4

Apply the deficit override

If you’re in financial deficit a provisional 1 or 2 becomes a 3. It’s the only override in the whole methodology and it only ever moves you down. Something that could move you up would be a different instrument altogether.

Feed it your own internal figures and it stops you: “only PUBLISHED metric scores may be used. Three of the four scoring models are relative and need the national distribution, which a single deployment does not hold, so an internally computed value is not a score and cannot be segmented.”

6 Where you stand right now

Between quarters your own current number is more use than a segment built on data from three months ago, and the framework accepts that a provider’s live figure may be ahead of the official one. So we work out what we can from your record and label it honestly.

A table of operational figures commvita already holds, with an amber warning that these are not Oversight Framework metrics, and two rows reading no denominator, not reported
Two of the five have no denominator, and say so instead of reporting noughtCaptured from the running system, build B-592 · demonstration data

These are our counts on our definitions. We haven’t read the annex, so we don’t know how NHS England defines a DNA rate or an 18-week compliant pathway, and we don’t claim ours match theirs. Where there’s no denominator you get “not reported” and the denominator, never 0.0 — a nought per cent DNA rate reads like a service nobody missed.

You can then record a figure against a framework metric. Every value you record says which of three things it is: published by NHS England, worked out internally, or not held at all. Try to hang a 0–1 score off an internal figure and you get: “a score may only be recorded against a PUBLISHED value. An internally computed figure is a value, not a score.”

7 What you can’t evidence

Your segment is worked out over the metrics you were scored on. The set that applies to you is bigger, because anything you didn’t submit scores zero and drops out of the average. So a segment can rest on part of the picture, and most organisations can’t tell you which part. NHS England raises the exception at its end. Nothing at yours has been keeping track.

Coverage answers it from your own systems. Ask for an acute set and you get 35 applicable as published, 50 derived, and every metric sorted into three buckets: evidenced here, held somewhere else, or not scored. Record one internal figure — a 4.8% sickness absence rate for 2026-Q2, out of the rostering record — and that metric moves out of not scored. The count went from 50 to 49.

Two different things reported as one. “Not scored” covers a metric you aren’t submitting anything for and a metric your type is let off scoring on. Those are opposite findings. One’s a gap to close, the other is the framework doing its job, and you can’t separate them without the exemption list from the annex. So we give you one honestly labelled bucket instead of a guess.

8 It’s NHS England’s framework

The framework belongs to NHS England. Putting it in front of an organisation in Jersey, Gibraltar, Kenya or Montserrat as something they’re subject to would be wrong, so outside England it stays off until somebody adopts it.

Adopting it’s a decision someone signs for. It needs a named person, a reason and a date, and it won’t save without them: “an adoption decision requires adopted_by, basis. A decision with no named person and no stated basis is not a decision.” Superseded decisions are kept, so you can see who adopted what, when, and on what grounds.

Two more refusals sit alongside it. Ask for coverage without saying what type of organisation you’re and nothing gets guessed: “commvita does not default to acute, which would score a community trust against metrics it does not report.” Ask for a type the framework doesn’t define and it lists the five it does.

9 What we won’t do

The limits aren’t buried in a document you have to ask for. They’re on the page and in the API, next to the thing they limit.

Two columns headed Does and Does not, listing four capabilities against five refusals
What it does and what it won’t do, side by side on the pageCaptured from the running system, build B-592 · pinned framework

One gap worth being straight about: coverage and the adoption record are API-only at the moment. The tab gives you the framework, the arithmetic, your own figures and the ceiling. Coverage is there today for anyone building a board pack or an integration, and it belongs on the page next.

Where it lives in commvita

CapabilityRouteAPIStatus
Pinned framework (86 metrics, 8 domains, 4 segments)/benchmarking/nof/framework● Live
Applicable set per organisation type/benchmarkingThe same call, with an organisation type● Live
Segment arithmetic reproduced (steps 2 to 4)/benchmarking/nof/segmentation/compute● Live
Operational figures from your record/benchmarking/nhs-oversight/derived-kpis● Live
Metric values, with where each came from/nof/metric-values● Live, API only
Coverage (evidenced · held elsewhere · not scored)/nof/coverage● Live, API only
Adoption outside England (named person, stated reason)/nof/adoption · /nof/status● Live, API only
The ceiling (what it won’t do)/benchmarking/nof/methodology● Live
It won’t predict your segment. It’s not a segment predictor and it won’t forecast one. There’s no league table and no peer ranking. It ships no thresholds, no scoring-model assignments and no exemptions, because we haven’t read the document that carries them. It doesn’t work out or predict a capability rating — that’s the regional team’s call, on evidence we don’t hold. And it submits nothing: the framework takes what it needs from the national collections you already file.
© 2026 Commvita Digital Health Solutions Ltd. All rights reserved. NHS Oversight Framework 2026/27 (PRN02437)Segmentation methodology manual 2026/27 NHS Digital Model Health SystemInsightful provider board domains Non-SaMD