Consultation: Advanced Foundation Trust Programme: guide for applicants

Overview

NHS England is inviting feedback on the Advanced Foundation Trust Programme: guide for applicants.

As set out in our 10 Year Health Plan, the Advanced Foundation Trust Programme will be a vehicle through which to reward and incentivise good performance. Our intention is that by 2035 all providers will have become advanced foundation trusts, with freedoms including strategic and operational autonomy, a capability-based regulatory approach and greater financial flexibilities.

Advanced foundation trusts will use freedoms and flexibilities to improve population health, support integration, shift resources from hospital to community and tackle inequalities.

In addition, organisations that are seeking designation to hold an integrated health organisation (IHO) contract will undergo an additional assessment of their capability and readiness to manage a population-based budget. Further details are provided in Annex 2 of the guide for applicants. Those organisations designated in 2026 will work with us as we define the IHO model during 2026/27, with the first contracts set to be awarded in 2027. We therefore expect to revise the IHO assessment criteria in 2026/27, and to publish subsequent versions as a separate IHO guide.

Input from a range of stakeholders has informed the policy and the development of the consultation. NHS England encourages respondents to share this feedback opportunity with their networks to support NHS England gaining a broad range of feedback and thoughts.

Those interested in responding should complete this online questionnaire.

This consultation is open from the 12 November 2025 to the 11 January 2026.

Following consultation, the updated policy and guide for applicants will be published and implemented in 2026.