NHS England to pay hospitals to divert patients into community settings
NHS England is launching a financial incentive scheme to move patient care from hospitals into community services to help tackle waiting lists. The initiative includes new targets for cancer care and GP access as part of a service reset.
From 1 July 2026 hospitals in England will receive financial incentives for steering patients away from acute wards and into community‑based services. The change is part of a new NHS England guidance that also introduces the first waiting‑time target for community care and a promise of same‑day GP appointments for urgent cases. Officials say the move is designed to stop the waiting‑list snowball that has grown for three straight months and to keep up with winter demand.
The plan aims to cut the number of people waiting more than 18 weeks for treatment by 2.5 million by 2029. It also sets a cancer‑care benchmark of 85 % of patients beginning treatment within two months of referral, with a stretch goal of 96 % treated within a month.
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How the “pay‑to‑divert” scheme works
Hospital trusts will be rewarded when they refer patients to community diagnostic centres, physiotherapy, or direct‑to‑GP blood‑test and scan pathways instead of adding them to elective queues. The mechanism mirrors the existing “advice and guidance” (A&G) service, which lets GPs consult specialists before deciding on a referral.
- GPs can claim £20 per A&G request, a figure introduced in January 2024.
- Between July and December 2023, 660,000 treatments were diverted, an increase of 60,000 on the previous year.
- The expansion aims to divert up to two million patients by the end of the 2025/26 financial year.
Key dates and milestones
| Milestone | Date |
|---|---|
| Publication of the “reset” guidance | July 2026 |
| Target for 85 % of cancer patients to start treatment within two months | 2029 |
| Goal of 2.5 million fewer patients on >18‑week waits | 2029 |
| Community‑service 18‑week target (80 % of patients) | 2029 |
| March target for 75 % of urgent cancer referrals to be treated within 62 days | 2024 March |
Official voices
“For too long the NHS has been stuck in a doom‑loop of not being able to properly plan beyond each financial year and responding to overly bureaucratic processes that have stifled local leadership and innovation.”
Sir Jim Mackey, chief executive of NHS England, via The Standard
“It offers a path to recovery, but there are several key risks facing the NHS that stand in the way, not least from the absence of national funding for redundancy costs, further strike action and expected increases in drug pricing.”
Matthew Taylor, chief executive of the NHS Confederation, via Yahoo! News
Professor Peter Johnson, national clinical director for cancer at NHS England, added that the new cancer‑treatment target would “mean faster cancer care is on the horizon for tens of thousands more patients.”
Health Minister Karin Smyth framed the scheme as a way to “save time and stop masses of people having to head to hospital for unnecessary appointments,” stressing that the government is “rewiring the NHS so that we are doing things differently, more efficiently and delivering better outcomes for patients.” Her remarks appear in both the Chronicle Live and LBC reports.
What critics warn about
The scheme’s ambition to push GP practices to deliver same‑day urgent appointments has drawn scepticism. Matthew Taylor notes the target “could significantly impact on the ability to deliver proactive and personalised care to patients, which will risk worsening health outcomes.” The Royal College of GPs chairwoman Kamila Hawthorne echoed this concern, insisting that “GP services have the capacity to accommodate the shift from hospitals to community care so this funding is a good step in the right direction.” She added that “funding must follow the patient” and warned against “shifting care into general practice without appropriate resource.”
The Patients Association’s chief executive Rachel Power welcomed the move but warned that success “will depend on genuine partnership between patients, GPs and specialists.” She called for “transparency around how GP capacity challenges will be addressed” and for “proper investment in resources, training and support for shared decision‑making.”
Numbers that illustrate the scale
At the end of August, NHS England reported an estimated 7.41 million treatments waiting to be carried out, affecting 6.26 million patients – a slight rise on the previous month’s 7.40 million treatments for 6.25 million patients. The same data show that 69.1 % of urgent suspected cancer referrals were treated within 62 days, just under the record high of 71.7 % set earlier this decade.
What happens next
Within the next quarter NHS England will publish detailed consultation questions on the same‑day GP appointment priority. Hospitals are expected to submit their first diversion‑payment claims by the end of September 2026. A performance review of community‑service waiting times is scheduled for early 2027, with the first public dashboard of diverted‑patient numbers due in January 2027. The government has pledged an additional £80 million to support the A&G expansion, a sum first reported by Chronicle Live.
Whether the financial incentives will be enough to break the “doom‑loop” remains to be seen, but the coordinated push from NHS England, the Department of Health and Social Care, and professional bodies marks a clear shift toward community‑centric care. Patients, providers and policymakers will be watching the first set of diversion figures closely – the data will decide if the “radical reset” can deliver on its promise of shorter waits and faster treatment for millions across England.
