Consultation on proposed changes to the NHS transactions guidance

Closed 21 Dec 2021

Opened 9 Nov 2021


This consultation document proposes changes to the NHS transactions guidance for trusts undertaking transactions, including mergers and acquisitions, last updated in 2017. The guidance governs the way NHS England and NHS Improvement assures proposed transactions involving NHS trusts and/or foundation trusts.

Our proposed changes are intended to help ensure that transactions are a success: that they are executed safely and deliver significant benefits.

We have developed the proposals in this consultation from speaking to trusts and system leaders, as well as experts in specialist areas, about how best to update our assurance approach. We have taken learning from past transactions in the NHS and from other parts of the public and private sectors.

What happens next

We will analyse your responses to our proposals and publish a response summary after this consultation closes. We aim to publish revised guidance as soon as possible after this.


  • Foundation trusts
  • NHS trusts


  • Financial system controls