2025/26 cost improvements: Why NHS CFOs must lead with system and community Focus”

As the new financial year gets underway, NHS Chief Financial Officers (CFOs) face big challenges — and bigger opportunities. In our latest blog as part of our Future of Healthcare Delivery blog series, I share my reflections on what should be front of mind as we move from Month one into full delivery mode. It’s not just about savings — it’s about working with communities, embracing system leadership, and making smart, sustainable choices.

With Month one closing and the new financial year underway, NHS CFOs are already under pressure to demonstrate early progress against their Cost Improvement Plans (CIPs). Delivering financial targets in 2025/26 will require sharper focus, stronger system working, and the willingness to make difficult decisions from the outset.

First, clarity and shared ownership are essential. Financial targets must be jointly agreed and embedded within operational and clinical teams, making CIPs a collective responsibility, not just a finance task.

Second, CFOs should focus on evidence-led opportunities. Patient-level costing, service line reporting, and robust benchmarking are essential to identifying areas for sustainable savings without compromising care quality.

Tackling patients with no criteria to reside must remain a key priority. Delayed discharges not only block flow but drive significant avoidable costs and reduce the ability to generate additional income. CFOs need to work closely with community hospitals, local authorities, and importantly, neighbourhood health teams to create more effective, community-led pathways that support faster, safer discharges and keep people well at home.

CFOs must also be willing to decommission unprofitable or unsustainable services. Where services no longer meet population needs or deliver value for money, system collaboration and reconfiguration will be necessary to redirect resources to where they are most needed.

The focus should be on transformational change — redesigning care pathways, optimising estate utilisation, embracing digital solutions, and investing in workforce productivity, not just relying on temporary quick wins. Finally, setting the right culture of transparency and engagement early is crucial. Building a shared understanding that financial recovery enables better patient care will help secure the commitment needed to deliver through 2025/26.

Month one sets the tone: strong grip, system leadership, and community collaboration will be key to success. If you’d like to learn more about how we have worked with both health and care system partners to deliver sustainable financial improvement – and more importantly better patient outcomes, feel free to get in touch — we’d love to share more about the work we do in this space.